Do cognition and other person-level characteristics determine housing outcomes among homeless-experienced adults with serious mental illness?

Academic Article

Abstract

  • Objective: Many persons with serious mental illness (SMI) who have experienced homelessness struggle to sustain stable and independent housing. We know little about determinants of this population’s housing status. This study aimed to identify person-level determinants of housing status among homeless-experienced veterans with SMI, focused primarily on cognition. Method: We administered cross-sectional surveys and detailed cognitive assessments on a convenience sample of homeless-experienced veterans with SMI (n = 90); we also reviewed these participants’ medical records. We captured person-level potential predictors of housing status (demographics, cognition, diagnoses, symptoms, and service utilization) and 2 years of retrospective housing history. Participants’ housing status was conceptualized as the setting (stable housing, other sheltered settings, and streets) they lived in for >50% of the past 2 years. We used the chi-square test and analysis of variance to determine how potential predictors differed by housing status. We used recursive partitioning to identify the combination of potential predictors and corresponding scores that best-differentiated participants by housing status. Results: No between-groups differences (p < .05) in cognition, symptoms, or other person-level factors were found among participants grouped by housing status. Recursive partitioning did not yield a stable model to predict housing status from the potential predictor variables. Conclusions and Implications for Practice: These data suggest that clinical interventions addressing studied person-level factors (e.g., cognitive rehabilitation) may not affect housing status for homeless-experienced veterans. As housing is highly influenced by social determinants of health, policies, and practices that affect contextual factors (e.g., affordable housing supply) may be more likely to improve housing status. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact and Implications—Many persons with serious mental illness who have experienced homelessness struggle to attain and retain housing. Though cognition and other person-level characteristics predict work and social outcomes for this group, these factors were not associated with housing status in this study of homeless-experienced veterans with serious mental illness. Our data suggest that clinical interventions that improve cognition and functioning may not enhance housing outcomes for this vulnerable population. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
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    Digital Object Identifier (doi)

    Author List

  • Gabrielian S; Hellemann G; Koosis ER; Green MF; Young AS
  • Start Page

  • 176
  • End Page

  • 185
  • Volume

  • 44
  • Issue

  • 2