Landlords' experiences of housing tenants suffering from severe mental illness: a Swedish empirical study

Support Needs Among Older Tenants Living in Public Housing in Sweden: Perspectives of Janitors and Maintenance Staff

Neighborhood support can improve aging in place for older adults, but research on the role of public housing staff in supporting older tenants is lacking. Twenty-nine participants (janitors, n = 11; maintenance staff, n = 18) collected data about critical situations among older tenants residing in apartments in Sweden. Modifying the Critical Incident Technique (CIT) and applying a mixed-methods design, quantitative and qualitative data were collected and analyzed with descriptive statistics and thematic analysis, integrated through narrative. We found that older tenants asked staff for help with daily tasks. The staff identified CI management dilemmas in meeting older tenants' support needs while following the housing company's regulations, maintaining professional responsibilities, respecting individual work attitudes and preferences, and experienced a lack of competencies in some situations. Staff members were responsive to offering support in simple, practical, and emotional situations and in addressing matters they perceived as deficits in social and health services.

Unmet needs of persons with a severe and persistent mental illness and their relationship to unmet accommodation needs

This is a cross-sectional study of unmet needs of persons enrolled in Australia's Partners in Recovery (PIR) initiative. It aimed to explore the unmet needs reported by persons with a severe and persistent mental illness (SPMI) and to examine the associations between unmet accommodation needs and other unmet needs. The study was undertaken in the Gippsland region of Victoria from February to May 2015. Data were collected from the administrative database for the PIR initiative in Gippsland, which was held by the Gippsland Primary Health Network. Data on unmet needs, as measured by the Camberwell Assessment of Needs Short Appraisal Schedule, were analysed using proportions and logistic regression. Psychological distress, daytime activities, company/someone to spend time with and employment and volunteering were the most commonly reported unmet needs. Participants with unmet accommodation needs were less likely to receive information on their condition or access other services. They also had unmet needs relating to food, money, transport, childcare, looking after home, physical health, psychological distress and self-care. Supported accommodation may not be enough for persons with SPMI who have poor functioning skills and are incapable of looking after themselves. Services such as Housing First that have shown promising results need to be part of a comprehensive strategy to care for persons with severe and enduring mental illness.

Models of Housing in the Quebec Setting for Individuals With Mental Illness

The World Health Organization (WHO) defines mental health as "a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community". A person's mental health is shaped by various social, economic, physical, and environmental factors, at different stages of life. Risk factors are heavily associated with social inequalities in the domains of employment, housing, and education. Theories of social determinants of health postulate the beneficial effects of factors exterior to medicine (regarding income, housing, education, and employment) on the health of individuals and populations. Recognition of the effect of social determinants on the health of vulnerable populations has been at the core of the intervention models and housing services developed by social service professionals in Québec. This article offers a review of housing services provided to psychiatric patients living in the community, over the last 50 years in Quebec. Different models of housing with social support which contribute to the autonomy, the security, and the empowerment of psychiatric patients are presented.

Social tenants' health: evaluating the effectiveness of landlord interventions

BACKGROUND

The National Health Service (NHS) scores well internationally on access to healthcare. But access has been measured on methods likely to undersample the more disadvantaged. Social landlords have access to more disadvantaged groups and may be able to improve health outcomes for their tenants and reduce their NHS usage by simple interventions.

METHODS

This is a randomised controlled trial of 547 London social housing 'general needs' tenants over 50 years of age. Participants were given a health assessment, then split into a control group or one of two treated groups. Following early assessment 25 participants had to be withdrawn to receive intensive treatment because of currently untreated major health problems. Participants were followed up over 18 months and changes in health outcomes and NHS usage measured.

RESULTS

Compared with the control the most intensively treated group showed non-significant improvements on health outcomes but a significant reduction in NHS resource use, on conventional costings worth some £760 per person. All 25 participants transferred to the most intensively treated group after their early health assessments showed improvement on all health outcomes at final assessment, but these improvements were not statistically significant.

CONCLUSIONS

Drawing a sample from disadvantaged but not the most seriously disadvantaged groups in London revealed 4.5% of the population to have very serious untreated health problems. The reason for lack of treatment was mainly non-registration with a general practitioner or psychiatric issues. Simple interventions to a targeted group were found to produce significant reductions in NHS usage and other, although non-significant, health benefits.

TRIAL REGISTRATION NUMBER

ID ISRCTN96259142.

Canadian Service Providers’ Perceptions of Barriers and Support Gaps in Housing and Mental Health

People experiencing mental illness and homelessness face numerous barriers to becoming housed. Service providers who work with this population also encounter challenges to meeting service users’ needs, yet their perspectives have been only minimally studied. Using survey data from a pan-Canadian study, this article explores the barriers and facilitators to fostering lasting change in housing and mental health according to 96 housing providers and 186 community-based mental health service providers. Findings show that the perspectives of mental health service providers are largely consistent with those of housing providers, and identify a range of support gaps and barriers.

Perceptions of private market landlords who rent to tenants of a Housing First program

The rental of housing units by landlords to participants in Housing First (HF) programs is critical to the success of these programs. Therefore, it is important to understand the experiences of landlords with having these individuals as tenants. The paper presents findings of qualitative interviews with 23 landlords who rented to tenants from a HF program located in a small city and adjoining rural area in eastern Canada and in which approximately 75 % of tenants had been housed for at least six consecutive months at 2 years in the program. Findings showed that landlords are motivated to rent to HF tenants for financial and pro-social reasons. They reported holding a range of positive, neutral, and negative perceptions of these tenants. They identified problems encountered with some HF tenants that included disruptive visitors, conflict with other tenants, constant presence in their apartments, and poor upkeep of units. On the other hand, landlords perceived HF tenants as being mostly good tenants who are similar to their other tenants. Implications for practice in the context of HF programs are discussed.