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Soc Psychiatry Psychiatr Epidemiol (2013) 48:875894 DOI 10.1007/s00127-012-0590-x
ORIGINAL PAPER
A domains-based taxonomy of supported accommodation for people with severe and persistent mental illness
Dan Siskind Meredith Harris Jane Pirkis
Harvey Whiteford
Received: 1 December 2011 / Accepted: 8 September 2012 / Published online: 2 October 2012 Springer-Verlag 2012
AbstractPurpose A lack of denitional clarity in supported accommodation and the absence of a widely accepted system for classifying supported accommodation models creates barriers to service planning and evaluation. Methods We undertook a systematic review of existing supported accommodation classication systems. Using a structured system for qualitative data analysis, we reviewed the stratication features in these classication systems, identied the key elements of supported accommodation and arranged them into domains and dimensions to create a new taxonomy. The existing classication systems were mapped onto the new taxonomy to verify the domains and dimensions.
Results Existing classication systems used either a service-level characteristic or programmatic approach. We proposed a taxonomy based around four domains: duration of tenure; patient characteristics; housing characteristics; and service characteristics. All of the domains in the taxonomy were drawn from the existing classication
structures; however, none of the existing classication structures covered all of the domains in the taxonomy. Conclusions Existing classication systems are regionally based, limited in scope and lack exibility. A domains-based taxonomy can allow more accurate description of supported accommodation services, aid in identifying the service elements likely to improve outcomes for specic patient populations, and assist in service planning.
Keywords Supported accommodation Mental illness
Health services Community mental health
Literature review
Introduction
People with severe and persistent mental illness (SPMI) have a high level of housing instability [1] and are more likely than the general population to be homeless. The combination of housing instability and SPMI is linked with increased rates of functional disability [3], victimisation [4], physical illness [5], mortality [6] and emergency department presentations, and decreased engagement with community mental health services [2].
Patients with SPMI and housing instability need, at a minimum, a tripod of basic services: clinical services; stable housing; and personalised support [7]. Clinical services refer to outpatient clinics, and acute and extended inpatient care [8]. Stable housing refers to housing stock provided by government or non-government providers as ongoing accommodation at an affordable...