Predictors of moving on from mental health supported accommodation in England: national cohort study

Helen Killaspy, Stefan Priebe, Peter McPherson, Zohra Zenasni, Lauren Greenberg, Paul McCrone, Sarah Dowling, Isobel Harrison, Joanna Krotofil, Christian Dalton-Locke, Rose McGranahan, Maurice Arbuthnott, Sarah Curtis, Gerard Leavey, Geoff Shepherd, Sandra Eldridge, Michael King

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    27 Citations (Scopus)
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    Background Around 60 000 people in England live in mental health supported accommodation. There are three main types: residential care, supported housing and floating outreach. Supported housing and floating outreach aim to support service users in moving on to more independent accommodation within 2 years, but there has been little research investigating their effectiveness. Aims A 30-month prospective cohort study investigating outcomes for users of mental health supported accommodation. Method We used random sampling, accounting for relevant geographical variation factors, to recruit 87 services (22 residential care, 35 supported housing and 30 floating outreach) and 619 service users (residential care 159, supported housing 251, floating outreach 209) across England. We contacted services every 3 months to investigate the proportion of service users who successfully moved on to more independent accommodation. Multilevel modelling was used to estimate how much of the outcome and cost variations were due to service type and quality, after accounting for service-user characteristics. Results Overall 243/586 participants successfully moved on (residential care 15/146, supported housing 96/244, floating outreach 132/196). This was most likely for floating outreach service users (versus residential care: odds ratio 7.96, 95% CI 2.92-21.69, P < 0.001; versus supported housing: odds ratio 2.74, 95% CI 1.01-7.41, P < 0.001) and was associated with reduced costs of care and two aspects of service quality: promotion of human rights and recovery-based practice. Conclusions Most people do not move on from supported accommodation within the expected time frame. Greater focus on human rights and recovery-based practice may increase service effectiveness. Declaration of interest H.K., S.P., M.K., S.E., P. McCrone, M.A., S.C., G.L. and G.S. report a grant from National Institute of Health Research during the conduct of the study. All other authors report having no conflicts to disclose.

    Original languageEnglish
    Pages (from-to)331-337
    Number of pages7
    JournalBritish Journal of Psychiatry
    Issue number6
    Early online date3 May 2019
    Publication statusPublished (in print/issue) - 1 Jun 2020

    Bibliographical note

    Funding Information:
    The study was funded by the National Institute of Health Research (RP-PG-0610-10097). The funders had no role in the collection, analysis or interpretation of data; in the writing of the manuscript; or in the decision to submit for publication. The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute of Health Research or the Department of Health.

    Publisher Copyright:
    © The Authors 2020.

    Copyright 2020 Elsevier B.V., All rights reserved.


    • Cohort
    • Mental health
    • Move on
    • Supported accommodation


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