Conger Lydia R, Jagannathan Aarti, Breuer Erica, Amudhan Senthil, Thirthalli Jagadisha, Ponnuchamy L
Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India.
Psychiatric Rehabilitation Services, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, 560029, India.
Soc Psychiatry Psychiatr Epidemiol. 2024 Dec 11. doi: 10.1007/s00127-024-02797-w.
The bidirectional phenomenon of homelessness and Mental Illness (MI) creates a vicious circle that is hard to escape. In India, Homeless Women with Severe Mental Illness (HWSMI) often rely on institutional care due to the absence of family or community alternatives, which distances them from socio-economic, cultural, political resources and the right to live with dignity. Hence, there is a need to develop a model that will help reintegrate HWSMI into the community.
We aimed to develop and validate (content and face validity) a supported housing programme (SHP) for HWSMI in Bengaluru, India.
We developed the SHP using 1) a needs assessment from HWSMI (n = 14), 2) qualitative interviews with Mental Health Professionals (MHPs) (n = 18), and 3) visits to organizations (n = 3) involved in reintegration and supported housing for HWSMI. We articulated a Theory of Change (ToC) for the program. Three international experts and seven Indian experts reviewed the same.
Five themes- Causes of homelessness/barriers to reintegration, consequences of homelessness, models/processes, facilitators, and needs of HWSMI and eighty sub-themes emerged from the qualitative thematic analysis of the interviews and observational visits. The themes and subthemes were organized as interventions in each phase of the SHP: Interventions in the tertiary care setting, transit home, and community.
We describe the development and validation of a comprehensive need-based SHP. We will implement and test the feasibility of the SHP for HWSMI.
无家可归与精神疾病（MI）的双向现象形成了一个难以摆脱的恶性循环。在印度，患有严重精神疾病的无家可归女性（HWSMI）由于缺乏家庭或社区安置选择，往往依赖机构照料，这使她们与社会经济、文化、政治资源以及有尊严生活的权利相脱节。因此，需要制定一个有助于HWSMI重新融入社区的模式。
我们旨在为印度班加罗尔的HWSMI开发并验证（内容效度和表面效度）一个支持性住房项目（SHP）。
我们通过以下方式开发SHP：1）对HWSMI进行需求评估（n = 14）；2）对心理健康专业人员（MHP）进行定性访谈（n = 18）；3）走访参与HWSMI重新融入和支持性住房工作的组织（n = 3）。我们阐述了该项目的变革理论（ToC）。三位国际专家和七位印度专家对其进行了审查。
通过对访谈和观察走访的定性主题分析，出现了五个主题——无家可归的原因/重新融入的障碍、无家可归的后果、模式/过程、促进因素以及HWSMI的需求，以及八十个子主题。这些主题和子主题被组织为SHP每个阶段的干预措施：三级护理机构、过渡之家和社区的干预措施。
我们描述了一个基于需求的综合SHP的开发和验证过程。我们将实施并测试该SHP对HWSMI的可行性。
