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.
This study examines how different types of supported accommodation meet the needs of people with mental health problems. Supported accommodation covers a wide range of different types of housing, including intensive 24 hour support, hostel accommodation, and accommodation with only occasional social support or assistance provided. The document focuses on five approaches to providing supported accommodation, including: Care Support Plus; integrated support; housing support for people who have experienced homeless; complex needs; low-level step down accommodation; and later life. The report draws on the expertise of people living and working in these services across England, and presents their views of both building and service related issues. It sets out a number of recommendations, focusing on: quality; co-production; staff recruitment and training; policy informed practice; and resourced, appropriate accommodation.
NHS CLINICAL COMMISSIONERS
Focusing on prevention and early diagnosis, the case studies in this publication demonstrate the impact clinical commissioning groups are making in a wide range of areas including mental health care, early diagnosis of cancer and stroke prevention. They show how CCGs are taking the lead in preventing illness and the causes of ill health – and working to keep people out of hospital where possible; how they are helping to ensure that people are diagnosed earlier and given the support that they need; and they are working across boundaries to build on what people want and need to help them lead longer, healthier lives. More specifically the case studies provide examples of: working proactively with older people living with frailty; addressing preventable early deaths; supporting people to prevent and manage diabetes; reducing hospital admissions in people with COPD; managing c. difficile infections in the community; improving access to health services for homeless people; taking a strategic approach to stroke prevention; addressing early diagnosis of cancer; earlier diagnosis and prevention of HIV; improving early diagnosis and treatment of people with atrial fibrillation; working with the voluntary sector; impact of Living Well; and social prescribing to improve outcomes.