Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles.
Psychiatr Rehabil J. 2021 Jun;44(2):176-185. doi: 10.1037/prj0000457. Epub 2020 Oct 12.
Many persons with serious mental illness (SMI) who have experienced homelessness struggle to sustain stable and independent housing. We know little about determinants of this population's housing status. This study aimed to identify person-level determinants of housing status among homeless-experienced veterans with SMI, focused primarily on cognition. We administered cross-sectional surveys and detailed cognitive assessments on a convenience sample of homeless-experienced veterans with SMI ( = 90); we also reviewed these participants' medical records. We captured person-level potential predictors of housing status (demographics, cognition, diagnoses, symptoms, and service utilization) and 2 years of retrospective housing history. Participants' housing status was conceptualized as the setting (stable housing, other sheltered settings, and streets) they lived in for >50% of the past 2 years. We used the chi-square test and analysis of variance to determine how potential predictors differed by housing status. We used recursive partitioning to identify the combination of potential predictors and corresponding scores that best-differentiated participants by housing status. No between-groups differences (p < .05) in cognition, symptoms, or other person-level factors were found among participants grouped by housing status. Recursive partitioning did not yield a stable model to predict housing status from the potential predictor variables. Conclusions and Implications for These data suggest that clinical interventions addressing studied person-level factors (e.g., cognitive rehabilitation) may not affect housing status for homeless-experienced veterans. As housing is highly influenced by social determinants of health, policies, and practices that affect contextual factors (e.g., affordable housing supply) may be more likely to improve housing status. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
许多有严重精神疾病 (SMI) 且经历过无家可归的人难以维持稳定和独立的住房。我们对决定这一人群住房状况的因素知之甚少。本研究旨在确定有过无家可归经历的 SMI 退伍军人的个人层面决定因素，主要侧重于认知。我们对一个有过无家可归经历的 SMI 退伍军人的便利样本进行了横断面调查和详细的认知评估（n = 90）；我们还查阅了这些参与者的医疗记录。我们捕获了个人层面的住房状况（人口统计学、认知、诊断、症状和服务利用）和过去 2 年的回顾性住房史的潜在预测因素。参与者的住房状况被概念化为他们在过去 2 年中居住时间超过 50%的住所（稳定住房、其他有遮蔽的住所和街头）。我们使用卡方检验和方差分析来确定潜在预测因素如何根据住房状况而有所不同。我们使用递归分区来确定潜在预测因素及其相应分数的组合，这些因素可以最好地区分参与者的住房状况。根据住房状况对参与者进行分组后，在认知、症状或其他个人层面的因素方面没有发现组间差异（p <.05）。递归分区没有产生一个稳定的模型，无法根据潜在预测变量来预测住房状况。结论和对这些数据的影响表明，针对所研究的个人层面因素（例如认知康复）的临床干预可能不会影响有过无家可归经历的退伍军人的住房状况。由于住房受到健康的社会决定因素、政策和实践的高度影响，可能会采取影响背景因素（例如经济适用房供应）的政策和实践来改善住房状况。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
