Schutt Russell K, Goldfinger Stephen M
Massachusetts Mental Health Center, Harvard Medical School. Present address: Department of Psychiatry, SUNY/Downstate Medical Center. 450 Clarkson Ave., Brooklyn NY 11203.
Asian J Psychiatr. 2009 Dec 1;2(4):132. doi: 10.1016/j.ajp.2009.10.006.
Previous research on housing loss among severely mentally ill persons who have been placed in housing after being homeless has been largely atheoretical and has yielded inconsistent results. We develop a theory of housing loss based on identifying fundamental causes-problems in motives, means and social situation-and test these influences in a longitudinal, randomized comparison of housing alternatives. As hypothesized, individuals were more likely to lose housing if they had a history of alcohol or drug abuse, desired strongly to live independently contrary to clinician recommendations, or were African Americans placed in independent housing. Deficits in daily functioning did not explain these influences, but contributed to risk of housing loss. Our results demonstrate the importance of substance abuse, the value of distinguishing support preferences from support needs, and the necessity of explaining effects of race within a social context and thus should help to improve comparative research.
以往针对那些在无家可归后获得住房安置的重症精神病患者住房丧失情况的研究，大多缺乏理论依据，结果也不一致。我们基于识别动机、手段和社会状况方面的根本原因——问题，构建了一种住房丧失理论，并在一项关于住房选择的纵向随机比较研究中对这些影响因素进行了检验。正如所假设的那样，如果个体有酗酒或药物滥用史、不顾临床医生建议强烈渴望独立生活，或者是被安置在独立住房中的非裔美国人，那么他们更有可能失去住房。日常功能缺陷并不能解释这些影响因素，但会增加住房丧失的风险。我们的研究结果证明了药物滥用的重要性、区分支持偏好与支持需求的价值，以及在社会背景下解释种族影响的必要性，因此应该有助于改进比较研究。
