Profiles of Quality of Life in a Homeless Population.

Quality of life (QOL) is a key indicator in mental health planning, program evaluation, and evaluation of patient outcomes. Yet few studies have focused on QOL in homeless populations. More specifically, research has yet to identify profiles of homeless individuals based on their QOL using cluster analysis. This study developed a typology of QOL for a sample of 455 homeless individuals recruited from 27 community and public organizations in Quebec (Canada). The typology was developed based on QOL scores, as well as sociodemographic, clinical, and service use variables. Study participants had to be at least 18 years old, with current or previous experience of homelessness. A questionnaire including socio-demographics, residential history, service utilization, and health-related variables was administered. Four clusters were identified using a two-step cluster analysis. QOL was highest in the cluster consisting of older women with low functional disability, and relatively few episodes of homelessness. The second cluster with high QOL scores included individuals living in temporary housing with relatively few mental health or substance use disorders (SUDs). The third cluster with low QOL included middle-aged women living in temporary housing, with criminal records, personality disorders, and SUDs. QOL was also lower in the fourth cluster composed of individuals with multiple homeless episodes and complex health problems as well as high overall service use. Findings reinforced the importance of disseminating specific programs adapted to the diverse profiles of homeless individuals, with a view toward increasing their QOL.

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.

Housing for persons with serious mental illness: consumer and service provider preferences.

OBJECTIVE: This study evaluated the housing preferences of a representative sample of consumers with serious mental illness living in seven types of housing in Montreal, Quebec, and compared these with their case managers' housing preferences for them. METHODS: An inventory of all housing for this population was developed in consultation with administrators of three psychiatric hospitals and the regional health board. The inventory included seven categories: housing in a hospital setting, hostels, group homes, foster homes, supervised apartments, social housing (low-income housing or cooperative), and private rooming homes. A stratified random sample of 48 consumers was selected in each category. In all, 315 consumers and their case managers completed the Consumer Housing Preference Survey. RESULTS: Most consumers preferred living in housing that offered them more autonomy than the housing in which they were currently living. Case managers preferred housing that offered some structure, such as supervised apartments. Forty-four percent of consumers preferred to live in their own apartment. More than a third of consumers preferred to live in their current housing. CONCLUSIONS: When evaluating housing preferences, it is important to elicit the viewpoints of mental health consumers as well as their case managers. Special attention should be given to the type of housing where consumers currently live. A variety of housing, not just autonomous housing, is needed to meet the specific housing preferences of individuals with serious mental illness.

[Housing preferences of people with severe mental illness: a descriptive study]. / Les préférences résidentielles des personnes souffrant de troubles mentaux graves : une étude descriptive.

This article presents the results of an exploratory study on housing preferences of 315 people with serious mental illness living in seven types of housing in Montreal. The overall portrait that emerged from the study revealed that 22,0 % of the participants prefer to live in their own apartment, 16,0 % in HLM or OSBL, 14,1 % in a supervised apartment, and 11,5 % in a foster home. In addition, 31,7 % prefer the type of housing they were living in at the time of the study. The authors conclude that a variety of housing resources are necessary to meet the diverse needs of consumers.

[Sexual and physical abuse in women with severe mental disorder: a literature review]. / Sévices sexuels et physiques envers les femmes présentant des troubles graves de santé mentale: une recension des écrits.

In order to better understand women who suffer from severe psychiatric disorders, this literature review of 18 studies examines their experiences of sexual and physical abuse. It is apparent that people with severe mental disorder and more specifically women, are vulnerable to physical and sexual abuse. Homeless women with severe mental disorders are particularly vulnerable. The authors focus on links between reality and practice in the treatment of this clientele in both institutional and community settings.

[Work as a social determinant of health for mental health services consumers.]. / Le travail comme déterminant social de la santé pour les personnes utilisatrices des services de santé mentale (notes de recherche).

Deinstitutionalization policies of psychiatric services have led to a massive return of former psychiatric patients in society. In accordance with social determinants of health and well-being, the authors sustain that actions led outside the hospital environment are the most favorable to mental health services consumers. On the list of the social determinants, work must be placed on top and constitutes a major factor of social integration. Yet, only 15 % of former psychiatric patients succeed in integrating the regular labour market. There is still very little research explaining this reality. Our research team from the GRASP (Groupe de recherche sur les aspects sociaux de la santé et de la prévention)/Centre FCAR whishes to correct this situation by analyzing links between mental health and work with the help of notions relative to social capital, territory, empowerment, intersectorial divisions and recovery.

[Attitudes and beliefs of citizens of Montreal towards psychiatric patients living in a society]. / Attitudes et croyances des Montréalais et Montréalaises à l'égard des ex-patients psychiatriques vivant dans la société.

In the past 50 years, new health policies all over the world have led to the introduction of rehabilitation and deinstitutionalization programs to overcome the depersonalizing effects of asylums. As a result, large numbers of former psychiatric patients are now living and working in society. The public's attitudes and beliefs about these former patients play a central role in their harmonious integration into the community. To find out more about these attitudes and beliefs, we interviewed a representative sample of the population of Montreal Island (n = 899). Our study indicates that a majority of respondents show a favourable attitude towards former psychiatric patients (in terms of recognizing their rights, accepting them in the workplace, creating warm relationships, etc.), but that people still entertain many negative beliefs (seeing mental illness as a deviation from the norm). The study interprets these ambivalent signs of tolerance and fear towards ex-psychiatric patients among Montrealers. An encouraging sign is that a trend towards greater acceptance seems to be emerging among young people in terms of both attitudes and beliefs.