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Purpose: Studies have shown positive housing retention and quality of life outcomes in moving on initiatives (MOIs). However, less is known about how movers' health service use changes post-move. This paper aims to explore physical and mental health service use over time for participants in New York City's MOI program. Design/methodology/approach: This paper uses data collected at baseline, 12-months post move and 24-months post move to explore patterns in mental and physical health service use and their association with mental and physical health status for participants (N = 41). Health status was measured with the Medical Outcomes Study Short Form Survey Instrument. Findings: Three mental health service use patterns emerged: service use at all time points, inconsistent service use across time points and no service use at any time point. Significant group differences in mental health were found at baseline and 12 months. Two physical health service use patterns emerged: service use at all three time points and inconsistent service use across time points. Significant group differences were found in mental health at 12 and 24 months. Originality/value: This study showed that physical and mental health service use varied slightly over time for participants, with the majority of service use being for outpatient/non-acute care. The findings also point to possible relationships between service use and mental health status. Positive and negative implications of these findings are framed within the broader context of PSH and MOI goals. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to present insights into the way in which system change can be activated around the provision of services and support for people experiencing multiple disadvantages in an urban setting. Design/methodology/approach: This paper is informed by a thematic analysis of reflections, reports, learning logs, interviews and experiences of those "activating" system change in the Golden Key partnership in Bristol between 2014 and 2021. Findings: Four themes are identified, including "creating the conditions for change", "framing your involvement", "investing in relationships" and "reflective practice and learning". For each of these, an illustrative vignette is provided. Practical implications: Practical recommendations and reflective questions are provided with suggestions of further considerations for applying this approach in different contexts. Originality/value: This paper describes an original approach of activating and supporting people to do system change to improve the lives of people facing multiple disadvantages. [ABSTRACT FROM AUTHOR]

Purpose Comment on the contribution that housing can make to delivering better health and wellbeing outcomes. More specifically, the purpose of this paper is threefold: summarise recent evidence that makes the case for housing in helping to address health and social care issues; comment on the challenges and opportunities of partnership working; and describe examples of interesting and innovative local joint provision.Design/methodology/approach Draws on the author's briefing papers on housing, health and social care for housing quality network, which is a national housing consultancy organisation as well as the author's role as Chairperson of East Midlands Housing Care and Support, which is a regional housing association.Findings Collaboration between housing, health and social care is making slow progress at the national level in England. This is despite an ever-increasing evidence base highlighting that good housing can help to address issues, such as delayed discharges. Nevertheless, there are an increasing number of interesting examples of successful local initiatives on housing, health and adult social care. The way forward is to facilitate joint working at a local level.Originality/value Focusses on the success of examples of local joint working between housing, health and social care to achieve better outcomes for vulnerable people. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to present a case study about the Team Around Me (TAM) model of case coordination which was developed by Fulfilling Lives Islington and Camden (FLIC) as an action experiment. The model is a standardised tool for running case conferences for clients experiencing multiple disadvantage (MD). Design/methodology/approach: Deploying a case study approach, this study explores why a TAM-coordinated approach is beneficial for people experiencing MD. Findings: The authors explore why the need for effective case coordination is integral for clients experiencing MD, and how current structures fail to facilitate effective case management. The authors put forward an argument for the four core principles underpinning the TAM model: strengths-based, action-focussed, systems thinking and client involvement. The barriers to embedding and upscaling this approach are discussed, alongside the obstacles presented by the wider system that prevent wider implementation. Originality/value: The TAM model is a new approach to case conferences, designed and upscaled by FLIC, and has since been adopted across two London boroughs, and training has reached services across the UK. This paper highlights the need for innovative approaches to case coordination that centre client involvement, promote a strengths-based approach and recognise system blockages as a key barrier to client progress. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to explore the barriers to accessing mental health support for people experiencing multiple disadvantage along with some potential solutions for attempting to overcome these. It draws on evidence and learning from 12 voluntary sector-led partnerships in England funded by the National Lottery Community Fund's Fulfilling Lives programme. Design/methodology/approach: Qualitative research was undertaken with frontline staff, senior leaders, volunteers, beneficiaries and stakeholders from Fulfilling Lives partnerships. This comprised focus groups (21 participants) and individual face-to-face interviews (41 participants), both of which explored barriers and local solutions to accessing statutory mental health services. Following a thematic analysis of transcripts, research participants and stakeholders were invited to a face-to-face workshop to review and validate emerging findings (34 participants). Findings: People experiencing multiple disadvantage face significant barriers in accessing support for their mental health. These include a complex system that is difficult to navigate, long waiting lists, high eligibility thresholds and models of support that lack flexibility. Fulfilling Lives partnerships have had the funding and the flexibility to trial different approaches. Promising solutions to barriers include the use of navigators, person-centred support and multi-agency networks and training. However, overcoming systemic barriers remains the most difficult challenge. Originality/value: Fulfilling Lives was a rare example of substantial and long-term (eight years) funding to work with people experiencing multiple disadvantage. This provided a unique opportunity to try different approaches and gather learning. The programme evaluation provides insights into the experiences of people facing multiple disadvantage and those who support them and offers evidence-based suggestions for policy and practice. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to report the findings of a scoping review on the health challenges of families experiencing homelessness. There is a bi-directional relationship between health and homelessness in that poor health can increase the risk of housing loss, and experiencing homelessness is bad for one's health. The experience of homelessness differs between populations and this review focuses on families as one of the fastest growing segments of the homeless population. While research has been integrated on the causes of homelessness for families, this same integration has not been conducted looking at health challenges of families experiencing homelessness. Design/methodology/approach: A scoping review methodology is utilized in the paper. As the goal of this work is to ultimately develop interventions for a Canadian context, primacy is given to Canadian sources, but other relevant literature is also included. Findings: A clear distinction is seen in the literature between health challenges of children of homeless families and health challenges of parents. These themes are explored separately, and preliminary recommendations are made for potential points of intervention as personal, program and policy levels. Originality/value: This review of current evidence is an important first step in building a foundation for interventions to improve health outcomes for those experiencing housing loss. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to explore keyworkers’ experience and perceptions working with people experiencing homelessness and the use of psychologically informed approaches in an Irish context.Design/methodology/approach In this paper a qualitative descriptive methodology was employed and face-to-face in-depth semi-structured interviews were conducted. Data collected were analysed using a thematic framework and transcribed by the researcher.Findings It was the view of the keyworkers psychological approaches allowed them greater understanding of psychological trauma and its effects promotes safe physical and emotional environments builds rapport between staff and clients and enables keyworkers to work more effectively with people with complex needs. There was also convincing evidence staff are quite receptive to training.Originality/value Given there is no research exploring the use of psychologically informed approaches in homelessness service settings, this study researched an area that has not yet been explored in Ireland. This qualitative descriptive research provides a platform from which further research can be conducted. It is hoped that highlighting the psychological issues of homeless people, the data obtained will help improve Irish homeless services, and the findings extracted beneficial in terms of future service developments, professional training and education. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to present results from an evaluation of the experience of a move to independent living for people with mental health needs or a learning disability. The discussion focuses on the shift in organisational culture from providing care within a hostel setting to supporting people in their own tenancies. Design/methodology/approach - The evaluation was underpinned by a participatory action research design. A total of ten co-researchers with experience of using services or as caters were recruited. Qualitative data was obtained from "before" and "after" interviews with residents, staff and relatives. Findings - Widespread satisfaction was expressed with people's new homes. Many residents were found to be increasingly independent. There was some evidence of concerns regarding the pace and process of change and the introduction of new practices to promote independence. Research limitations/implications - The timing of the evaluation limited the opportunity for comprehensive "before" and "after' data collection. The involvement of co-researchers required considerable time and support although the experience of those involved was positive. Practical implications - Learning from this evaluation emphasises the importance of support and preparation for staff as well as residents, in moving from hostel to independent living. Social implications - This study highlights the advantages of a participatory design in evaluating a major change in service deliveoz Originality/value - This paper raises important issues about organisational change. It contributes to wider debates regarding the implementation of personalisation and recovery-focused agendas. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to explain the history of the Fairweather Lodge Program, its utility, the development of one program in a small Midwestern city, the role of psychology, and the importance of disseminating information about the program to combat homelessness. Design/methodology/approach – This paper takes a short case study approach to describing the evolution of a peer support-based housing program for individuals with serious mental illness and a history of homelessness. Findings – The Fairweather Lodge facilitates peer support, community engagement, stable housing, and work engagement in those struggling with mental illness and homelessness. Originality/value – The Fairweather Lodge Program is a program intended to support the mental health and employment needs of individuals with severe mental illness who are at increased risk of homelessness. Housing alone often does not address the complex needs of chronically homeless individuals. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to present an overview of the current state of evidence on the effect of housing circumstances, and housing-related interventions, on adult mental health and well-being. It covers the entire range of health from chronic illness to positive thriving, and both individual and community-level/public health. Design/methodology/approach – The paper is based upon a purposive review, commissioned originally for the UK Department of Health; and therefore is selective in giving priority to research relevant to public policy considerations, and to the UK context. Research with a variety of methodological foundations is considered, where robust enough by its own standards. Findings – The available evidence gives conditional support to policies accentuating empowerment at individual and community levels; early intervention; locality or place-based interventions; and integrated working practice. The complexity of methodological issues emerges as a key challenge for research in this field, and for the prospect of evidence-based national policy. Meanwhile local knowledge and interpretation of data in context may be more reliable than context-blind studies. Research limitations/implications – Where "hard evidence" is unavailable, reports of the lived experience of individuals and in communities remain a legitimate basis for policy and commissioning. Originality/value – This appears to be the first attempt in print to cover such a wide canvas in one overview. [ABSTRACT FROM AUTHOR]

Purpose – Homeless populations are a politically contentious problem and researchers struggle to achieve a balanced approach. They place emphasis on sharply contrasting factors, such as; institutional structures, ideologies or individual dispositions and differences. Central questions remain unanswered, i.e., is homelessness an outcome of society’s failings related to housing shortages, or a personal choice, as in the status of “intentional homelessness?” The purpose of this paper is to set aside assumptions, to explore experiences of homelessness and psychosis. Design/methodology/approach – An existentially informed hermeneutic phenomenological analysis; exploring transcribed narratives from semi-structured interviews with three men. Findings – These participants started to wander as a spontaneous response to distressing life experiences. Without any plan they travelled to new locations living on the street. Being contained and treated against their will in the psychiatric system was another source of distress. They did not choose homelessness through a rational calculation of their best interests. They felt at odds with society, which did not protect them and failed to meet their needs. Research limitations/implications – In qualitative research, findings are not generalisable to other settings. Practical implications – Homeless services should be enhanced by psychological expertise along with more person-centred emphatic approaches; the authors of social policies should consider their philosophical assumptions. Social implications – Systemised mental healthcare does not solve complex problems; fails to meet needs. Originality/value – The analysis informs the design of further research, prompts practitioners to review their understandings and provides grounds for the rewriting of policies. [ABSTRACT FROM AUTHOR]

Purpose – This paper is an extended review and expert commentary on a recently published study by the Centre for Housing Policy (CHP) which discusses the complexities of research in "housing related support" in the UK context, and proposes further work. This review aims to explore the strengths and limitations of the study; and the potential wider relevance outside the UK research context. Design/methodology/approach – The review methodology is traditionally that of expert opinion. The reviewer draws upon previous evaluation studies of mental health and housing, commissioned by the UK Dept of Health, the (Dept of) Communities and Local Government, the National Institute for Mental Health in England, and the Care Services Improvement Partnership, including additional material on the Mental Health Minimum Dataset. Findings – The CHP report reviewed raises important questions over the complexities of evidencing innovative services. Despite some omissions, it should be helpful to health local commissioners in assessing the value of services; and the further research the report proposes is to be welcomed. The report also provides a useful introduction to "housing related support" for an international research audience, less familiar with the UK social policy and funding context. Originality/value – The review introduces and recommends the CHP study – which is itself a valuable contribution to future research on housing-related support – to a wider audience. The review also includes additional material never before published on the potential research value in the context of the Mental Health Minimum Dataset. [ABSTRACT FROM AUTHOR]

Too many health and social care services are failing to meet people's complex needs. In this paper, 'complex needs' is presented as a framework to help understand multiple interlocking needs that span health and social issues. The concept encompasses mental health problems, combined with substance misuse and/or disability, including learning disability, as well as social exclusion. The paper outlines a strategy for promoting the well-being and inclusion of people with complex needs. At the heart of this strategy is a new kind of delivery model: connected care centres, a type of bespoke social care service, a model which has been endorsed by the Social Exclusion Unit (SEU). In addition, the paper describes how new responses from existing services can promote better support for people with complex needs, such as a reformed commissioning process and a new 'navigational' role for the social care worker. [ABSTRACT FROM AUTHOR]

We are now more aware of the mental health needs of children and young people with learning disabilities, but are we really aware of the range of services and support needed for this group? Until very recently, most child and adolescent mental health services (CAMHS) were not meeting these needs, yet by the end of 2006 CAMHS were required to be fully comprehensive and to include care pathways for children and young people with learning disabilities and mental health problems under the Public Service Agreement Targets (PSA). The Foundation for People with Learning Disabilities has undertaken a great deal of work in this area, including a year-long inquiry and a research programme, and now we are working with three regions in England to make CAMHS more accessible for this group of children and young people. In this article we describe how services have traditionally served this group, explore the policy context for change and discuss some of the projects currently under way that aim to address the PSA target for later this year. [ABSTRACT FROM AUTHOR]

Purpose -- The purpose of this qualitative systematic review is to examine how the nature and quality of housing affect adults receiving support for mental health problems, focusing on the less considered structural aspects of housing. Design/methodology/approach -- A systematic search identified relevant research. Data consisting exclusively of service-user testimony was taken from seven studies based in varied types of accommodation in England. A synthesis was carried out using thematic analysis, and a conceptual model developed based on the themes identified from the data. A literature review examines the context, with relevant material drawn from a variety of disciplines and professions. Findings -- There were three main determinants of whether housing was a setting that enabled users to benefit from support and enjoy a good quality of life -- "autonomy", "domain", and "facilitation". Secondary themes influenced these primary themes, or described respondents' condition or feelings in relation to their housing situation. The "Tripod Model" illustrates the relationships between these themes. Research limitations/implications -- Applying systematic review methods to qualitative material proved contentious and challenging. The model produced is a hypothesis based on limited data and requiring further investigation. Practical implications -- The findings suggest that a balance is required to increase the chances of successful and sustainable housing outcomes for service-users. Originality/value -- The model enables a holistic understanding of issues affecting service-users, and the interdependent nature of these. It offers a new typology based on a synthesis of data drawn from a spectrum of accommodation, which gives it a breadth a single piece of research could not encompass. [ABSTRACT FROM AUTHOR]

Four routes or pathways have now been identified by which individuals may come within the scope of PSA 16 National Indicator 149, which is concerned with monitoring efforts to achieve settled accommodation for individuals with significant mental health problems. This article focuses on their needs and the identification of those with mental health needs as seen through these four principal routes. An understanding of these four possible pathways can help to identify areas for priority action, local delivery chains and partnerships, and also highlight some of the challenges and risks in and for delivery. [ABSTRACT FROM AUTHOR]

The new local government performance framework, in combination with the move towards greater personalisation in services, creates a radically new funding environment for housing with care and support. From the Public Service Agreement (PSA) on achieving settled accommodation for individuals at risk of exclusion, through to the impact of local joint strategic needs asessments and individual budgets, the principles and mechanisms of the new joint commissioning culture create more opportunities for providers to articulate the needs of the client group served, and to assert the case for more joined-up and responsive services. This may require different skills and new styles of leadership at local level, and providers who have become adept at being competitors may need to re-discover the skills of partnership. Meanwhile, new social exclusion policy frameworks are emerging for supported accommodation, which can support moves away from institutional care for those with mental health problems. [ABSTRACT FROM AUTHOR]

This article is a 'taster', and summarises the issues identified in the UK Inquiry report on Mental Health in Later Life. It looks at how the Inquiry undertook its work, how older people with mental health problems are often overlooked and what their views and experiences are of accessing services, what actions are proposed for the housing, health and care sectors, and key issues and recommendations. Age Concern is committed to auditing the response to the recommendations and will report progress in 2009. [ABSTRACT FROM AUTHOR]