The global burden of disease attributable to mental illness is high, and as a result people with serious mental illness are at greater risk of indicators of social exclusion, such as poverty, homelessness and social isolation. Since deinstitutionalisation began in the 1960s, a variety of housing and support models have been used for this group. ‘Housing first’ models are proving superior to ‘continuum of care’ models in achieving positive housing outcomes and improving indicators of social exclusion. Housing first programmes are also believed to be more effective as they offer consumers choice, are not contingent on treatment, and are, therefore, empowering and philosophically compatible with harm reduction and recovery approaches. The physical and social environments have also been found to influence housing satisfaction and well-being outcomes for this group, but are often poorly measured or inadequately defined in the few studies which have been conducted.
As little recent New Zealand research has examined housing, support and environmental effects for people with serious mental illness, this twelve-month prospective cohort study provides a more current account of the experiences of this group. Thirty six participants were recruited from a group of people with serious mental illness referred to the Comcare Housing Service for assistance to obtain independent, community-based housing. An examination of the variables influencing housing and overall well-being ratings was conducted. Peace and Kell’s (2001) sustainability framework, outlining four categories of resources required for this group to maintain housing, was also evaluated.