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Predictors of successful move-on to more independent accommodation amongst users of the community mental health rehabilitation team: a prospective cohort study in inner London

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Abstract

Purpose

In England, community mental health rehabilitation teams play a major role in supporting people with complex mental health needs to progress from inpatient to community settings and from more to less supported accommodation. We aimed to conduct the first study to investigate longitudinal outcomes for users of a community rehabilitation team and identify service user characteristics associated with successful progress along the rehabilitation pathway.

Methods

We used routinely collected clinical outcome data relating to all 193 users of a community rehabilitation team in inner London, transferred to the team between June 2013 and May 2018, with a cut-off data-collection date of 20th June 2019. We estimated the proportion who moved on to more independent accommodation successfully, with no breakdown in the placement. We conducted multivariable Cox proportional hazard regression to investigate associations between service user characteristics at transfer and successful move-on.

Results

Overall, 43/193 (23%) service users achieved successful move-on during a median follow-up of 51 months (IQR 32–63). This was more likely for those who were residing in more highly supported accommodation (HR 3.90; 95% CI 2.01–7.54) and those who had better functioning (HR 1.04, 95% CI 1.02–1.06) at transfer, while those with a serious physical health condition were less likely to achieve successful move-on (HR 0.44, 95% CI 0.21–0.95).

Conclusion

Most supported accommodation services aim to offer time-limited support, but most service users do not progress successfully to more independent accommodation within 4 years. Investment in interventions that improve functioning and physical health may facilitate successful move-on.

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Acknowledgements

We would like to thank Rebecca Jones for her helpful advice regarding data analysis.

Funding

This study was not funded by any agencies or institutions.

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Authors and Affiliations

  1. Division of Psychiatry, University College London, Maple House, 149 Tottenham Court Road, London, W1T 7NF, UK

    Karen Pui Kei Chan, Artemis Igoumenou & Helen Killaspy

  2. Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4 St Pancras Way, London, NW1 OPE, UK

    Kay Kathryn

Authors
  1. Karen Pui Kei Chan
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  2. Kay Kathryn
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  4. Helen Killaspy
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Contributions

KPKC, HK, and AI and participated in the study design. KK collected and collated the data which were analysed by KPKC. All authors were involved in the interpretation of the data. KPKC drafted the article, which was reviewed and revised by all authors. All authors approved the final version of the manuscript and agreed their accountability in ensuring that any questions related to the accuracy or integrity of any part of the work were appropriately investigated and resolved.

Corresponding author

Correspondence to Karen Pui Kei Chan.

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Conflict of interest

The authors declare that they have no conflict of interest.

Availability of data and material

All data supporting our findings will be shared on request made to the corresponding author.

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Chan, K.P.K., Kathryn, K., Igoumenou, A. et al. Predictors of successful move-on to more independent accommodation amongst users of the community mental health rehabilitation team: a prospective cohort study in inner London. Soc Psychiatry Psychiatr Epidemiol 56, 75–84 (2021). https://doi.org/10.1007/s00127-020-01910-z

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  • DOI: https://doi.org/10.1007/s00127-020-01910-z

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