Lee Sungeun, Wong Yin-Ling Irene, Rothbard Aileen B
Department of Social Welfare, Pusan National University,Geumjung-gu, Busan, Korea.
Psychiatr Serv. 2009 Mar;60(3):367-73. doi: 10.1176/ps.2009.60.3.367.
Supported housing is a viable model that offers independence and opportunity for community integration. However, previous studies have shown that not all residents can sustain long-term tenancy. This study examined the extent to which personal and housing characteristics predicted positive and negative departures from independent housing programs that provided support services to persons with serious mental illness.
The sample consisted of 237 persons participating in a supported independent living program in Philadelphia. Cox proportional hazards models were used to estimate the effects of personal and housing characteristics on the probability of positive departure (to an arrangement with more autonomy) and negative departure (to an arrangement with more supervision or to homelessness).
Most participants (69%) maintained continuous residence in the program for the study period, 14% experienced a positive departure, and 17% a negative departure. A self-reported past substance abuse problem increased the probability of a negative departure, and a more supportive relationship with program staff decreased the probability. A higher income increased the probability of a positive departure, whereas a higher level of social distress in the neighborhood decreased the probability.
The findings suggest that long-term housing tenure was not uncommon among supported independent living residents, but some were not able to maintain independent living and were discharged to shelters, institutions, or residential settings with more supervision. Predictors of positive and negative departure identified in this study may help service providers design services to meet the various needs of persons with serious mental illness for stable independent living.
支持性住房是一种可行的模式，为社区融入提供独立性和机会。然而，先前的研究表明，并非所有居民都能维持长期租赁。本研究调查了个人和住房特征在多大程度上预测了从为重度精神疾病患者提供支持服务的独立住房项目中出现的正向和负向离开情况。
样本包括237名参与费城支持性独立生活项目的人员。使用Cox比例风险模型来估计个人和住房特征对正向离开（转向更自主的安排）和负向离开（转向更受监督的安排或无家可归）概率的影响。
在研究期间，大多数参与者（69%）持续居住在该项目中，14%经历了正向离开，17%经历了负向离开。自我报告的过去药物滥用问题增加了负向离开的概率，而与项目工作人员更支持性的关系则降低了该概率。较高的收入增加了正向离开的概率，而邻里中较高水平的社会困扰则降低了该概率。
研究结果表明，在支持性独立生活居民中，长期住房保有情况并不罕见，但有些人无法维持独立生活，被安置到监管更严格的庇护所、机构或居住场所。本研究中确定的正向和负向离开的预测因素可能有助于服务提供者设计服务，以满足重度精神疾病患者对稳定独立生活的各种需求。
