Is Housing a Predictor of Autonomy and Quality of Life of People with Severe Mental Illness? Implications for Social Work

ABSTRACT

For people with severe mental illness (SMI), housing type based on the level of professional input and support is an important factor in maintaining health. Housing impacts on quality of life (QOL); however, studies have not comprehensively explained the relationship between the types of housing and QOL. This scoping review investigates the relationship between the quality of life of people living with severe mental illness, housing, and objective sense of autonomy. Nine online databases were searched for studies published from 2000 onwards that identified research studies of adults with severe mental illness living in a variety of housing types. Fourteen studies met the eligibility criteria. The findings show that supported housing that offered access to trained staff led to a higher QOL and in turn an increase in autonomy. Allowing residents to choose their preferred type of housing also increased their QOL. Nonsupported group housing allowed for the development of friendships, which in turn had a positive impact on QOL, but there was little evidence to support this model. Despite this, social isolation and victimisation were areas of concern. This review adds to the body of evidence against transinstitutionalisation and emphasises the need for ongoing psychosocial interventions and support for people living with SMI in community settings.

IMPLICATIONS

• Different housing options for residents living with severe mental illness can impact their quality of life.

• Policymakers and practitioners need to consider the impact of the level of support and sense of autonomy on the quality of life of residents living in supported and nonsupported housing.

• Social work can contribute professional expertise in developing a policy or framework to improve quality of life in society.

对于有严重心理疾患的病人，具有专业水平的投入及支持的居住类型是维持健康的重要因素。居住影响生活质量。既有的研究对于居住类型与生活质量之间的关系尚未作出全面的解释。本文采用范围研究，考察了有严重精神疾患人员的生活质量与居住、客观独立感之间的关系。我们在九个线上数据库中搜索了2000年以来所发表的研究文章，确定有哪些研究针对严重精神疾患、居住类型不同的成年人。符合标准的文章计有十四篇。我们发现，得到专业人士帮助的居住类型有利于更高的生活质量，从而提升自主性。允许当事人根据自己的偏好选择居住类型也有助于提高生活质量。未得到支持的群体居住类型有助于发展友谊，因而对生活质量也有积极的影响，但支持这一模式的证据还太少。社会孤立和伤害也是关注的领域。本文反对转机构化，强调在社区环境内对严重精神疾患人员进行不断的心理干预和支持。

KEYWORDS:

• Adult Mental Illness
• Social Work
• Supported Housing
• Quality of Life

Disclosure Statement

No potential conflict of interest was reported by the authors.