Housing and Support Program (HASP): Final Evaluation Report

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6 Section 1 Introduction Table 1.2.1 Summary of the services provided by disability support workers (Warner et al. 1998) Final Evaluation Report Support type Content Within the home (i) Emotional support Companionship, someone to talk to, watch TV with, planning and goal-setting (ii) Practical support Household tasks – cooking, cleaning, writing letters, claiming benefi ts, paying bills Outside the home (i) Social support Having a meal in a cafe or drink in a pub, going for walk in a garden or park, going to bingo, going to church, assessing local social networks (ii) Practical support Using public transport, shopping, visiting GP, mental health appointments, etc (iii) Leisure activities Taking part in sports – swimming, aerobics, bowling, fi shing, going to football games, etc Liaison (i) Liaison with agencies Working with statutory agencies, such as housing, mental health, disability services, support agency, employment (ii) Liaison with family Building relationships with family, friends and other natural supports Other studies (Harrington-Godley et al., 1988; Mak & Gow, 1996; Clarkson et al., 1999; Lord & Hutchison, 2003) report a similar range of support interventions, including assistance with budgeting, personal hygiene, building social networks, promoting links to family/friends, providing psychological support, advocacy and advice. It is also clear that support workers provide a sense of psychological assurance for people with severe disability – they tend to be available at weekends and out of hours when health professionals cannot be contacted (Oliver et al., 1996). In effect, support services compensate for the lack of family networks and other natural support systems for those with psychiatric disability living in the community (Oliver et al., 1996). Support workers are frequently expected to serve as ‘bridges’ between the world of professional service providers and the world of clients (Wadsworth & Knight, 1996). It does appear that the services provided by disability staff and clinical staff are on a continuum of service provision, rather than being separate or parallel services. While there are some activities that are clearly the domain of clinical staff and some the domain of support staff, there is likely to be some overlap in service provision. For example, Case Managers and support workers are likely to engage in providing emotional support to clients, albeit at different levels. 1.2.2 Outcomes for clients living in independent housing with support services While governments in Australia and overseas are promoting involvement of the non-government sector in the provision of support services to people with psychiatric disability, there has been limited evaluation of the services provided by the NGO sector. Notwithstanding this, a small amount of literature has emerged from work carried out in North America, England and Australia. The table below provides a summary of the key fi ndings from these evaluations.
Table 1.2.2 Outcomes for clients moving to supported accommodation — summary of research Author (Year) Country Mak & Gow (1996) Hong Kong Clarkson et al. (1999) England Anthony et al. (1999) USA Prince (2006) USA Morris et al. (2005) NSW, Aust. Deslandes & Kilner (1997) SA, Australia Carter (2008) VIC, Australia Meehan et al. (2011) QLD, Australia Sample (Follow-up period) N=64 32 treatment & 32 controls (18 months) N=37 (6 months) N=21 (20 months) N=315 (3 months) (HASI) N=100 (12 months) (Individual Tenant Support Program) N=32 (24 months) (NEAMI) N=28 (12 years) (Project 300) N=181 6, 36 & 84 months Details of support provided One ‘after-care’ worker for the 32 clients in treatment group 35 hours of support per client per month (only 8 hours in direct contact) 26 hours per month provided by a mixture of professional and non-professional staff A range of programs – hours of contact not recorded Not stated – ‘based on client needs’ Not stated – ‘provided support to tenants on a fl exible basis’ (Up to 21 hours per week) Not stated – Support ‘client-directed’ Each client received 20 hours per week (range = 0-86 hours) Findings 12.5% of treatment vs. 46.1% of control clients rehospitalised Control clients spent 1640 days longer in hospital than clients in treatment group No difference in symptoms No difference in overall functioning (GAF scores) Signifi cant decrease in depression and anxiety No changes in client satisfaction with services Social contacts decreased over study period 10 of the 21 clients engaged in communitybased employment 37% reduction in costs in follow-up year 96.4% of time spent in community versus hospital Support hours decreased from an average of 33.9 to 26.2 per month by year 2 Support services provided by Case Managers Services that enhanced daily structure decreased readmission Interventions more effective in individuals with 4 or more prior hospitalisations Support provided by NGOs Reduction in the need for inpatient care 90% decrease in hospital days Support provided by NGOs, including service users, service providers and community-based organisations Project used a model of support based on Direct Care Workers Limited options for community integration Support provided by NGOs Program offered shared living arrangement where up to three clients shared The need for hospitalisation reduced Support provided by NGOs Reduction in hospital admissions Cheaper than other alternatives No change in symptoms and functioning Reduction in need for support over time Housing and Support Program (HASP) 7
Page 1 and 2: Department of Psychiatry (UQ) and S
Page 3 and 4: Final Evaluation Report of the Quee
Page 5 and 6: • Community integration While eig
Page 7 and 8: List of contents Executive summary
Page 9 and 10: Section 1 Introduction Since the 19
Page 11 and 12: 1.1.1 HASP — Management Structure
Page 13: 1.2 Housing and supports - previous
Page 17 and 18: activities, while others tried to c
Page 19 and 20: 1.2.6 Section summary It is clear f
Page 21 and 22: Section 2 Method 2.1 Design The stu
Page 23 and 24: 2.2.1.2 Clients unavailable to part
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Page 27 and 28: 4) Data collected from mental healt
Page 29 and 30: 2.4 Procedure 2.4.1 Clients - proce
Page 31 and 32: All focus group discussions and ind
Page 33 and 34: However, it was clear that the deve
Page 35 and 36: Importance of the Supports Facilita
Page 37 and 38: Accountability There was a percepti
Page 39 and 40: Support workers highlighted issues
Page 41 and 42: 4.1.2 Client perceptions of support
Page 43 and 44: In general, Case Managers expressed
Page 45 and 46: 4.2.2 Client perceptions of the amo
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Page 49 and 50: 4.2.8 Amount of support required in
Page 51 and 52: 4.3.2 Living arrangements The major
Page 53 and 54: 4.3.7 Housing in HASP — compariso
Page 55 and 56: The majority of HASP clients (76%)
Page 57 and 58: 5.2 Satisfaction with key life doma
Page 59 and 60: 5.7 Depth of friendships We explore
Page 61 and 62: 5.11 Community involvement Clients
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etter functioning). However, while
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6.7 Physical and mental health Link
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6.10 Section summary The average ti
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7.2 Comparing HASP with inpatient/r
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of applications, increase Case Mana
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available when and where needed by
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8.4 The ability of the program to m
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Section 9 Recommendations 1. More i
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Section 10 Reference list Anthony,
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Shepherd, G., Murray, A. & Muijen,
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Housing and Support Program (HASP)
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Housing and Support Program (HASP): Final Evaluation Report

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