MUNTHE-KAAS Heather Menzies, BERG Rigmor C., BLAASVAER Nora
This review assesses the effectiveness of interventions combining housing programmes with or without case management as a means to reduce homelessness and increase residential stability for individuals who are homeless, or at risk of becoming homeless. A total of 43 studies were included. The majority of which were conducted in the United States, with three from the United Kingdom and one each from Australia, Canada, and Denmark. Included interventions were found to perform better than the usual services at reducing homelessness or improving housing stability in all comparisons. These interventions were: High- and low-intensity case management (including assertive community treatment); Housing First; critical time intervention; abstinence-contingent housing; non-abstinence-contingent housing with high-intensity case management; housing vouchers; and residential treatment. The review concludes that a range of housing programs and case management interventions appear to reduce homelessness and improve housing stability, compared to usual services. However, the review identified risk of bias in the studies due to poor reporting, lack of blinding, or poor randomization or allocation concealment of participants. The review also identified gaps in the research with respect to: disadvantaged youth; abstinence contingent housing with case management or day treatment; non-abstinence contingent housing comparing group vs independent living; Housing First compared to interventions other than usual services, and; studies outside of the USA.
COPEMAN Ian, EDWARDS Margaret, PORTEUS Jeremy, HOUSING LEARNING AND IMPROVEMENT NETWORK
This report shows how housing services are helping to relieve pressure on the NHS by reducing delays in discharging people from hospital and preventing unnecessary hospital admissions. It features 12 case studies to show the positive impact these services have on people’s lives and the cost benefit to the NHS. The case studies highlight services that will benefit people most at risk of delayed discharge, such as older people, people with mental health problems and people experiencing homelessness. The case studies also demonstrate a diversity of housing and health services including: 'step down' bed services for people coming out of hospital who cannot return to their own home immediately; hospital discharge support and housing adaptation services to enable timely and appropriate transfers out of hospital and back to patients' existing homes; providing a new home for people whose existing home or lack of housing mean that they have nowhere suitable to be discharged to; and Home from Hospital services to keeping people well at home who would otherwise be at risk of being admitted or readmitted to hospital. The report also considers the impact and additional savings that could be made by housing providers if this work were to be scaled up.
Presents the findings from an inquiry into the emotional and physical impact of hospital discharge. With the help of 101 local Healthwatch, the enquiry panel heard from over 3,000 people who shared their stories about their experiences of the discharge process, focusing in particular on older people, homeless people, and people with mental health conditions. The findings reveal that there are five core reasons people feel their departure is not handled properly: people are experiencing delays and a lack of co-ordination between different services; they are feeling left without the services and support they need after discharge; they feel stigmatised and discriminated against and that they are not treated with appropriate respect because of their conditions and circumstances; they feel they are not involved in decisions about their care or given the information they need; and they feel that their full range of needs is not considered. The report includes examples of good practice and initiatives and projects designed to help older people, homeless people, and people with mental health conditions resolve the difficulties they experience during the discharge process.