Resident and staff perceptions of an activity- and recovery-based intervention in supported housing for people with severe mental illness - a longitudinal pilot study

Mona Eklund, Carina Tjörnstrand, Mona Eklund, Carina Tjörnstrand

Abstract

Background: People with severe mental illness who reside in supported housing (SH) and need a high level of assistance are at risk of an everyday life with little meaning and low community participation. Interventions to counteract that seem warranted, which was the rationale for this study. The aim was to investigate how residents and staff perceived an intervention designed to enhance meaningful everyday activity and personal recovery.

Methods: The intervention, termed Active in My Home (AiMH), was led by an occupational therapist. It consisted of five individual and three group sessions, and AiMH staff acted as supporters. Twenty-nine AiMH participants and 43 staff members were included in this un-controlled study with three measurement points - before (T1), at completion (T2), and 6-9 months after completion of AiMH (T3). The data collection was based on self-report questionnaires addressing perceptions of satisfaction, meaningfulness, and recovery-oriented support.

Results: The residents' satisfaction with the SH per se was rated high (at 75% of the maximum score) and did not change over the study period from T1 to T3 (p = 0.544); nor did the participants' perceived recovery-oriented support from the AiMH supporter (p = 0.235). Satisfaction with AiMH was rated by both participants and staff at T2. Their scores differed regarding general satisfaction (p = 0.008), staff scoring higher, but no differences were found regarding satisfaction with group sessions, individual sessions, or support of activity (p-values 0.062-0.836). The staff rated the SH unit's provision of meaningful activities higher than the AIMH participants at T2 (p = 0.029) but not at T1 (p = 0.226) or T3 (p = 0.499).

Conclusion: This study has offered some glimpses of how AiMH participants and staff perceived the AiMH intervention. It has also generated some ideas for better support for meaningful activity and recovery-oriented support in SH for people with mental illness, such as assisting SH residents in identifying activity opportunities and making activity choices when providing support for meaningful activity in the SH context.

Trial registration: Registered at ClinicalTrials.gov ID: NCT05157854.

Keywords: Activity; Intervention; Occupational therapy; Psychiatric disabilities; Recovery; Supported accommodation.

Conflict of interest statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

© 2022. The Author(s).

References

    1. Bitter N, Roeg D, van Nieuwenhuizen C, van Weeghel J. Recovery in supported accommodations: a scoping review and synthesis of interventions for people with severe mental illness. Community Ment Health J. 2020;56:1053–1076. doi: 10.1007/s10597-020-00561-3.
    1. Bitter NA, Roeg DP, van Nieuwenhuizen C, van Weeghel J. Identifying profiles of service users in housing services and exploring their quality of life and care needs. BMC Psychiatry. 2016;16:419. doi: 10.1186/s12888-016-1122-0.
    1. Tjörnstrand C, Eklund M, Bejerholm U, Argentzell E, Brunt D. A day in the life of people with severe mental illness living in supported housing. BMC Psychiatry. 2020;20:508. doi: 10.1186/s12888-020-02896-3.
    1. Gunnarsson AB, Brunt D, Tjornstrand C, Argentzell E, Bejerholm U, Eklund M. Navigating in a misty landscape - perceptions of supporting a relative residing in supported housing for people with a psychiatric disability. Issues Ment Health Nurs. 2020;41:1–9. doi: 10.1080/01612840.2020.1756012.
    1. McPherson P, Krotofil J, Killaspy H. What works? Toward a new classification system for mental health supported accommodation services: the simple taxonomy for supported accommodation (STAX-SA). Int J Environ Res Public Health. 2018. 10.3390/ijerph15020190.
    1. Le Boutillier C, Leamy M, Bird VJ, Davidson L, Williams J, Slade M. What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatr Serv. 2011;62:1470–1476. doi: 10.1176/appi.ps.001312011.
    1. Eklund M, Argentzell E, Bejerholm U, Tjörnstrand C, Brunt D. Wellbeing, activity and housing satisfaction - comparing residents with psychiatric disabilities in supported housing and ordinary housing with support. BMC Psychiatry. 2017;17:315. doi: 10.1186/s12888-017-1472-2.
    1. Aubin G, Hachey R, Mercier C. Meaning of daily activities and subjective quality of life in people with severe mental illness. Scand J Occup Ther. 1999;6:53–62. doi: 10.1080/110381299443744.
    1. Aubin G, Hachey R, Mercier C. The significance of daily activities in persons with severe mental disorders. Can J Occup Ther. 2002;69:218–228. doi: 10.1177/000841740206900406.
    1. Eklund M, Hansson L, Bejerholm U. Relationships between satisfaction with occupational factors and health-related variables in schizophrenia outpatients. Soc Psychiatry Psychiatr Epidemiol. 2001;36:79–83. doi: 10.1007/s001270050293.
    1. Argentzell E, Bäckström M, Lund K, Eklund M. Exploring mediators of the recovery process over time among mental health service users, using a mixed model regression analysis based on cluster RCT data. BMC Psychiatry. 2020;20:520. doi: 10.1186/s12888-020-02924-2.
    1. Bejerholm U, Eklund M. Time-use and occupational performance among persons with schizophrenia. Occup Ther Ment Health. 2004;20:27–47. doi: 10.1300/J004v20n01_02.
    1. Tjörnstrand C, Argentzell E, Bejerholm U, Brunt D, Eklund M. Active in My Home (AiMH) – a pilot and feasibility study of a lifestyle intervention in supported housing for people with psychiatric disabilities. Groningen: ENMESH Conference; 2017.
    1. Wilcock AA, Hocking C. An occupational perspective of health 3ed. Thorofare: Slack; 2015.
    1. Anthony W. Recovery from mental illness: the guiding vision of the mental health service system in the 1990s. Psychosoc Rehab J. 1993;16(4):11–23.
    1. WHO . International classification of functioning, disability and health. Geneva: World Health Organization; 2001.
    1. Champagne T. Sensory modulation & environment: essential elements of occupation. 3. San Antonio: Pearson; 2011.
    1. de las Heras CG, Llerena V, Kielhofner G. Remotivation Process: Progressive intervention for individuals with severe volitional challenges (Version 1.0). Swedish version 1.0 (2012) by Wahlström Wärngård G. Chicago: MOHO Clearinghouse; 2003.
    1. Eklund M, Brunt D. Development of 7-item perceived meaning of activity in housing (PMA-H-7) to assess opportunities for meaningful activities in the supported housing context for people with psychiatric disabilities. Eval Health Prof. 2019. 10.1177/0163278719845036.
    1. Williams J, Leamy M, Bird V, Le Boutillier C, Norton S, Pesola F, et al. Development and evaluation of the INSPIRE measure of staff support for personal recovery. Soc Psychiatry Psychiatr Epidemiol. 2015;50:777–786. doi: 10.1007/s00127-014-0983-0.
    1. Schön UK, Svedberg P, Rosenberg D. Evaluating the INSPIRE measure of staff support for personal recovery in a Swedish psychiatric context. Nord J Psychiatry. 2015;69:275–281. doi: 10.3109/08039488.2014.972453.
    1. Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale NJ: Lawrence Erlbaum; 1988.
    1. Altman DG. Practical statistics for medical research. London: Chapman & Hall; 1993.
    1. IBM SPSS Statistics 26 core system user’s guide Armonk [NY]: IBM Corp.; 2019.. Accessed 15 Nov 2021.
    1. Brolin R, Rask M, Syren S, Baigi A, Brunt DA. Satisfaction with housing and housing support for people with psychiatric disabilities. Issues Ment Health Nurs. 2015;36(1):21–28. doi: 10.3109/01612840.2014.930216.
    1. Chiolero A, Paradis G, Rich B, Hanley JA. Assessing the relationship between the baseline value of a continuous variable and subsequent change over time. Front Public Health. 2013;1:29. doi: 10.3389/fpubh.2013.00029.
    1. Priebe S, Kaiser W, Huxley PJ, Roder-Wanner UU, Rudolf H. Do different subjective evaluation criteria reflect distinct constructs? J Nerv Ment Dis. 1998;186:385–392. doi: 10.1097/00005053-199807000-00001.
    1. Eklund M, Argentzell E, Bejerholm U, Brunt D, Tjörnstrand C. Corrigendum. Br J Occup Ther. 2021;84:65. doi: 10.1177/03080226211037864.
    1. Kjellin L, Sjödahl RC, Eklund M. Activity-based assessment (BIA)--inter-rater reliability and staff experiences. Scand J Occup Ther. 2008;15:75–81. doi: 10.1080/11038120701526518.
    1. Eklund M, Örnsberg L, Ekström C, Jansson B, Kjellin L. Outcomes of activity-based assessment (BIA) compared with standard assessment in occupational therapy. Scand J Occup Ther. 2008;15:196–203. doi: 10.1080/11038120802022110.
    1. Eklund M. Therapeutic factors in occupational group therapy identified by patients discharged from a psychiatric day center and their significant others. Occup Ther Int. 1997;4:198–212. doi: 10.1002/oti.56.
    1. Lund K, Argentzell E, Leufstadius C, Tjörnstrand C, Eklund M. Joining, belonging, and re-valuing: a process of meaning-making through group participation in a mental health lifestyle intervention. Scand J Occup Ther. 2019;26:55–68. doi: 10.1080/11038128.2017.1409266.
    1. Piat M, Seida K, Padgett D. Choice and personal recovery for people with serious mental illness living in supported housing. J Ment Health. 2019;29:1–8.
    1. Bitter N, Roeg D, Van Nieuwenhuizen C, Van Weeghel J. Training professionals in a recovery-oriented methodology: a mixed method evaluation. Scand J Caring Sci. 2019;33:457–466. doi: 10.1111/scs.12644.
    1. Bejerholm U, Areberg C, Hofgren C, Sandlund M, Rinaldi M. Individual placement and support in Sweden - a randomized controlled trial. Nord J Psychiatry. 2015;69:57–66. doi: 10.3109/08039488.2014.929739.
    1. Killaspy H, Priebe S, McPherson P, Zenasni Z, McCrone P, Dowling S, et al. Feasibility randomised trial comparing two forms of mental health supported accommodation (supported housing and floating outreach); a component of the QuEST (quality and effectiveness of supported tenancies) study. Front Psychiatry. 2019;10:258. doi: 10.3389/fpsyt.2019.00258.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner