Trajectories of Recovery among Formerly Homeless Adults with Serious Mental Illness
OBJECTIVE:
Recovery
from mental illness is possible, but individuals with co-occurring disorders
and homelessness face challenges. Although a nonlinear recovery course is
assumed, few studies have analyzed recovery over time. This mixed-methods study
examined recovery trajectories over 18 months after enrollment in supportive
housing programs of 38 participants with DSM axis I diagnoses.
METHODS:
Qualitative
interview data were quantified through consensual ratings to generate a
recovery score for four waves of data collection based on eight recovery
domains culled from the literature. Case study analyses were conducted of
participants whose scores varied by one standard deviation or more between
baseline and 18 months to identify which domains were important.
RESULTS:
Most of
the 38 participants (N=23) had no significant change in recovery; seven had a
negative trajectory, and eight had a positive trajectory. Case studies of these
15 participants indicated domains that contributed to change: significant-other
relationships (N=9), engagement in meaningful activities (N=9), mental health
(N=7), family relationships (N=6), general medical health (N=5), housing
satisfaction (N=5), employment (N=2), and substance use (N=1). Except for
mental health and substance use (which contributed only to negative
trajectories), the influence of domains was both positive and negative. Domains
were intertwined; for example, variation in relationships was linked to changes
in meaningful activities.
CONCLUSIONS:
This
study showed little change in recovery over time for most participants and a
decline in mental health for a small minority. Findings underscore the
importance of social relationships and meaningful activities among individuals
with serious mental illness, who experience complex challenges.
- 1Dr. Padgett, Ms. Choy-Brown, and Dr. Mercado are with the Silver School of Social Work, New York University, New York City (e-mail: dkp1@nyu.edu ). Ms. Smith is with the School of Social Service Administration, University of Chicago, Chicago, Illinois. Dr. Tiderington is with the School of Social Work, Rutgers University, New Brunswick, New Jersey.
- Psychiatr Serv. 2016 Feb 14:appips201500126.
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