Mind over matter? The role of individual perceptions in understanding the social ecology of housing environments for individuals with psychiatric disabilities

Loneliness and Social Isolation Detection Using Passive Sensing Techniques: Scoping Review

BACKGROUND

Loneliness and social isolation are associated with multiple health problems, including depression, functional impairment, and death. Mobile sensing using smartphones and wearable devices, such as fitness trackers or smartwatches, as well as ambient sensors, can be used to acquire data remotely on individuals and their daily routines and behaviors in real time. This has opened new possibilities for the early detection of health and social problems, including loneliness and social isolation.

OBJECTIVE

This scoping review aimed to identify and synthesize recent scientific studies that used passive sensing techniques, such as the use of in-home ambient sensors, smartphones, and wearable device sensors, to collect data on device users' daily routines and behaviors to detect loneliness or social isolation. This review also aimed to examine various aspects of these studies, especially target populations, privacy, and validation issues.

METHODS

A scoping review was undertaken, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Studies on the topic under investigation were identified through 6 databases (IEEE Xplore, Scopus, ACM, PubMed, Web of Science, and Embase). The identified studies were screened for the type of passive sensing detection methods for loneliness and social isolation, targeted population, reliability of the detection systems, challenges, and limitations of these detection systems.

RESULTS

After conducting the initial search, a total of 40,071 papers were identified. After screening for inclusion and exclusion criteria, 29 (0.07%) studies were included in this scoping review. Most studies (20/29, 69%) used smartphone and wearable technology to detect loneliness or social isolation, and 72% (21/29) of the studies used a validated reference standard to assess the accuracy of passively collected data for detecting loneliness or social isolation.

CONCLUSIONS

Despite the growing use of passive sensing technologies for detecting loneliness and social isolation, some substantial gaps still remain in this domain. A population heterogeneity issue exists among several studies, indicating that different demographic characteristics, such as age and differences in participants' behaviors, can affect loneliness and social isolation. In addition, despite extensive personal data collection, relatively few studies have addressed privacy and ethical issues. This review provides uncertain evidence regarding the use of passive sensing to detect loneliness and social isolation. Future research is needed using robust study designs, measures, and examinations of privacy and ethical concerns.

Subjective housing stability in the transition away from homelessness

Housing stability is a complex concept to measure. One set of factors under consideration are those based on a personal or subjective sense of stability. We explore the variables associated with subjective stability and explore how subjective stability relates to housing stability across time. We use data from longitudinal, mixed methods research with 85 young people exiting homelessness. We find that subjective stability is a meaningful construct that can be validated through qualitative and quantitative data. The construct is primarily linked to indicators of environmental and social wellbeing. Subjective stability is also one of the only variables with a significant relationship to T2 housing stability. Qualitative analysis is used to explore these relationships in more detail. We conclude that subjective stability can provide holistic insight into the complex life circumstances influencing housing stability. However, this strength introduces complexity in that subjective stability appears to be developed in comparison with past experiences, as well as feelings of forward momentum on goals beyond housing.

Associations between perceived neighborhood environment and cognitive function among middle-aged and older women and men: Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

PURPOSE

To examine cross-sectional associations between perceived neighborhood environment and cognitive function among middle-aged and older Hispanic/Latino women and men.

METHODS

Data from the Hispanic Community Health Study/Study of Latinos (2008-2011) and its Sociocultural Ancillary Study (2009-2010) were used. Participants were Hispanic/Latino women (n = 1812) and men (n = 1034) aged 45-74 years. Survey-weighted linear regression models were used to examine associations between self-reported perceived neighborhood environment (i.e., neighborhood social cohesion and problems categorized as quintiles, and neighborhood safety from crime categorized as low, medium, or high) with cognitive function (i.e., global cognition, verbal learning, memory, verbal fluency, and processing speed scores) in women and men. Final model adjusted for age, Hispanic/Latino background, language, field site, household income, education, years lived in neighborhood, and depressive symptoms.

RESULTS

Women in the lowest quintile of perceived neighborhood problems (vs. highest quintile) had higher global cognition (β 0.48, 95% CI 0.03, 0.94, p trend 0.229) and memory scores (0.60, 95% CI 0.11, 1.09, p trend: 0.060). Women in the highest quintile of perceived neighborhood social cohesion (vs. lowest quintile) had lower global cognition (β - 0.56, 95% CI - 1.02, - 0.09, p trend 0.004), verbal learning (B - 1.01, 95% CI - 2.00, - 0.03, p trend 0.015), verbal fluency (B - 2.00, 95% CI - 3.83, - 0.16, p trend 0.006), and processing speed (B - 2.11, 95% CI - 3.87, - 0.36, p trend 0.009). There was no association between perceived neighborhood safety from crime and cognition among women, or between any perceived neighborhood environment measure and cognition among men.

CONCLUSIONS

Middle-aged and older Hispanic/Latina women living in neighborhoods with the lowest perceived problems had higher global cognition and memory. Women living in neighborhoods with the highest perceived social cohesion had lower global cognition, verbal learning, verbal fluency, and processing speed.

Studies regarding supported housing and the built environment for people with mental health problems: A mixed-methods literature review

Places where people live are important for their personal and social lives. This is also the case for people with mental health problems living in supported housing. To summarise the existing knowledge, we conducted a systematic review of 13 studies with different methodologies regarding the built environment in supported housing and examined their findings in a thematic analysis. The built environment of supported housing involves three important and interrelated themes: well-being, social identity and privacy. If overregulated by professionals or located in problematic neighbourhoods or buildings, the settings could be an obstacle to recovery. If understood as meaningful places with scope for control by the tenants or with amenities nearby, the settings could aid recovery.

Housing and Support Narratives of People Experiencing Mental Health Issues: Making My Place, My Home

Background: Choice, control, privacy, and security are widely reported housing preferences of mental health consumers, are associated with improved well-being and greater housing satisfaction, and are important for recovery. This paper describes housing and neighborhood experiences from a larger qualitative study that sought to learn with people experiencing mental health issues about their everyday lives in an Australian urban community. Methods: A participatory approach to health research informed this study. A participatory reference group, including four people with consumer perspective knowledge and experience of mental health issues and four mental health practitioners with service provider and researcher perspectives, worked together to design and implement this study over a 4-year period. Thirty-nine participants were recruited, including 18 women and 21 men living in metropolitan Melbourne and receiving community mental health care for ongoing mental health issues related mainly to either psychotic or affective disorders. Participants each took part in one to three interviews or a focus group. The data were transcribed and analyzed using narrative and thematic analytic strategies, underpinned by reflective discussions with the participatory reference group. Findings: Participants' experiences of their housing and neighborhoods emphasized qualities that either contributed to or challenged their sense of being "at home." Identifying with a place as home was transformative, especially when supported by friendly neighborhood interactions, safety, and accessibility of local amenities. Unsatisfactory housing situations and limited income worked against participants' efforts to regain a sense of well-being and improve their situations. When being home was challenging, strategies used to counteract this included getting a pet and getting out as a means of resisting isolation at home. Differing views and ways of using the available support workers were described, suggesting tensions between seeking to be self-sufficient and valuing support. Conclusions: Social housing locations and housing-related support should explicitly attend to safety and security concerns. Collaborative care planning and outreach support should attend to supports for navigating issues with neighbors, housing, harnessing natural supports, and opportunities for being in others' company, as well as recognizing the importance of pets in people's lives. Understanding the strategies that mental health consumers find helpful in creating a sense of being at home, and the role of "place" in recovery merit further consideration in research and practice.

Impact of Design on Emotional, Psychological, or Social Well-Being for People With Cognitive Impairment

AIM

The objective of this article is to identify and analyze what is known about characteristics in and around the home that support well-being for those with cognitive impairment. This could provide direction for designers of homes in general, but specifically for designers trying to meet the needs of people with cognitive impairment.

BACKGROUND

It has been established that there is a relationship between psychological well-being and a person's environment. Research also shows that particular design aspects can reduce the impact of cognitive impairment. However, there is limited design expertise in the Australian housing market to create supportive spaces which will help to reduce the impact of the disability for those with cognitive impairment.

METHOD

A literature review was carried out to determine the extent and details of what is known about the relationship of home design and its impact on emotional, psychological, or social well-being for people with cognitive impairment.

CONCLUSIONS

The study indicates that researchers in various disciplines understand that pragmatic design inputs such as thermal comfort and adequate lighting are important for people with cognitive impairment. In addition, some researchers have shown or surmise that there are other "intangible" designer-controlled elements that have beneficial impacts on people with cognitive impairment. Details of these intangible elements are sparse, and how much they might improve the quality of life for a person with cognitive impairment is not well understood. Further research is required to meet a growing need.

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses.

Social isolation in mental health: a conceptual and methodological review

PURPOSE

Social isolation and related concepts have been discussed increasingly in the field of mental health. Despite this, there is a lack of conceptual clarity and consistency in the definition and operationalisation of these terms. This review aimed to provide a clear framework for social isolation and related concepts, and to identify well-established measures in the field of mental health for each conceptual domain discussed.

METHODS

We used an iterative strategy of expert consultation and literature searching. A multi-disciplinary group of senior academics was consulted both before and after the literature searching to identify relevant terms, conceptual papers, or recommended measures. Our conceptual framework was also validated through expert consultation. We searched the Web of Science database using terms suggested by experts and subsequently identified further relevant studies through review articles and by reading full texts and reference lists of included studies. A narrative synthesis was conducted.

RESULTS

We developed a model with five domains incorporating all the concepts relevant to social isolation in regular use in the mental health research literature. These five domains are: social network-quantity; social network-structure; social network-quality; appraisal of relationships-emotional; and appraisal of relationships-resources. We also identified well-developed measures suitable for assessing each of the five conceptual domains or covering multi-domains.

CONCLUSIONS

Our review proposes a conceptual model to encompass and differentiate all terms relating to social isolation. Potential uses are in allowing researchers and intervention developers to identify precisely the intended outcomes of interventions, and to choose the most appropriate measures to use in mental health settings.

Meta-analysis of the effects of peer-administered psychosocial interventions on symptoms of depression

Many community mental health centers have implemented peer treatment models that employ recovered former clients as cost-efficient adjunct providers. The effectiveness of these and other peer-administered interventions (PAIs) for treating depression symptoms has not been well-established. The current study is a meta-analysis of PAIs' effects on depression symptoms. Twenty-three eligible studies were identified. Study characteristics were coded by multiple raters, random-effects models were used to compare mean effect sizes, and mixed-effects models were used to test for moderation. PAIs produced significant pre-post reductions in depression symptoms (d = .5043 [95 % CI .3675-.6412]). In direct comparisons, PAIs performed as well as non-peer-administered interventions (.0848 [-.1455-.3151]), and significantly better than no-treatment conditions (.2011 [.0104-.3918]). PAIs that involved a professional in a secondary treatment role were significantly less effective than those that were purely peer-administered, and educational/skills-based PAIs produced better outcomes than those that were mainly supportive. Follow-up data, when available, indicated that PAIs' benefits were maintained. PAIs reduce depression symptoms and warrant further study. The clinical significance of PAIs' benefits, and whether they are better suited as stand-alone or adjunct treatments, remain to be established. Implications for the roles of mental health professionals are discussed.