Residential placement and well-being among persons recovering from serious mental illness

Thesis advisor: Thomas O'HareTwo primary community-based programs currently in use for people who suffer from severe, persistent mental illnesses are staffed group-homes, or intensive outreach residential programs, where the consumer lives independently and services are provided in vivo. This study utilized a cross-sectional relational design and employed a consumer survey to examine how the well-being of people with severe and persistent mental illness and who receive one of these residential services. Well-being refers to the general quality of a person’s life and living situation, including their own perceptions of the quality of their life. For the purposes of this study, well-being was operationalized as the product of three domains: 1). demographic/diagnostic characteristics, including age, gender, race, length of service, educational level, marital status, diagnosis, and intensity of residential support; 2). objective life satisfaction indicators, such as immediate social network, extended social network, independent living/self care, working/productivity, global functioning, freedom from crisis/hospitalization; and 3). subjective life satisfaction indicators, including satisfaction with living arrangements, money, leisure time, family, social life, and health. An analysis of demographic and diagnostic variables indicated that with the exception of education level, respondents living in group homes are very similar to their counterparts receiving supported housing. Independent functioning ability was significantly higher for respondents receiving supported housing services in eight areas, including cooking, shopping, housekeeping, personal finances, use of medications, active use of services, pursuit of recovery goals, and ability to find and use health care. Group home residents were significantly more likely to have substance abuse problems than respondents receiving supported housing, and were more likely to have problems that could put them or others at risk. Respondents living independently with supported housing services reported higher satisfaction with their living situation and with their relationship to their family. Group home residents were more satisfied about the availability of money for leisure activities. Exploratory analysis of the data using logistic regression suggested that such an analysis might be useful in identifying which qualities of applicants for residential services would provide a better “fit” to a particular model of treatment. Implications for policy, practice, and future research are addressed.Thesis (PhD) — Boston College, 2008.Submitted to: Boston College. Graduate School of Social Work.Discipline: Social Work