Center of Innovation, Health Services Research and Development Service, U.S. Department of Veterans Affairs (VA) Greater Los Angeles, Los Angeles (Gabrielian, Hamilton, Gelberg, Koosis, Young); Department of Psychiatry (Gabrielian, Hamilton, Young) and Department of Family Medicine (Gelberg), University of California, Los Angeles, David Geffen School of Medicine, Los Angeles; Department of Psychiatry, University of Pennsylvania, Philadelphia (Johnson).
Psychiatr Serv. 2019 May 1;70(5):374-380. doi: 10.1176/appi.ps.201800508. Epub 2019 Feb 20.
By combining supportive services with independent housing, permanent supportive housing (PSH) programs effectively address homelessness. Yet, many persons with serious mental illness struggle to attain and retain housing in these programs. Social skills-which facilitate social interactions and instrumental tasks-predict premature exit from PSH. This project aimed to build consensus on a set of social skills that supports independent housing attainment and retention among homeless persons with serious mental illness, with a clinical focus on PSH programs.
Guided by the RAND/University of California, Los Angeles, appropriateness method, the set of social skills was developed by using literature review; key informant interviews (N=12), a national consensus panel of experts in psychosocial rehabilitation and homelessness (N=11), and two focus groups with homeless persons with serious mental illness (N=17).
These methods identified 24 social skills in seven domains: finding and renting an apartment, using one's time well, getting closer to people, managing finances, avoiding problems with drugs and alcohol, solving interpersonal problems, and managing one's health. Expert panelists and focus group participants agreed that these social skills were feasible for inclusion in social skills training and could strongly affect housing outcomes in PSH settings.
Consensus was reached about a set of social skills relevant to housing attainment and retention for persons with serious mental illness engaged in PSH. Next steps include modifying social skills training interventions to this skill set, making contextual modifications relevant to the setting and context of PSH, and studying the effectiveness and implementation of the adapted intervention in PSH.
通过将支持性服务与独立住房相结合，永久性支持性住房（PSH）计划有效地解决了无家可归问题。然而，许多患有严重精神疾病的人在这些计划中难以获得和保留住房。社交技能——促进社交互动和工具性任务——预测提前退出 PSH。本项目旨在就一套支持患有严重精神疾病的无家可归者获得和保留独立住房的社交技能达成共识，重点关注 PSH 计划。
在兰德/加州大学洛杉矶分校适宜性方法的指导下，通过文献回顾；关键知情人访谈（N=12）、社会心理康复和无家可归问题专家全国共识小组（N=11）以及两组患有严重精神疾病的无家可归者焦点小组（N=17），制定了一套社交技能。
这些方法确定了七个领域的 24 项社交技能：寻找和租用公寓、合理利用时间、亲近他人、管理财务、避免药物和酒精问题、解决人际关系问题以及管理健康。专家小组成员和焦点小组参与者一致认为，这些社交技能适合纳入社交技能培训，可以强烈影响 PSH 环境中的住房结果。
就一套与参与 PSH 的严重精神疾病患者的住房获得和保留相关的社交技能达成了共识。下一步包括将社交技能培训干预措施修改为这一套技能，对 PSH 的环境和背景进行适当的修改，并研究适应后的干预措施在 PSH 中的有效性和实施情况。
