Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness
Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness
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DOI：
10.1007/s10464-005-8617-z
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发表时间：
2005-12-01
影响因子：
3.1
通讯作者：
Tsemberis, SJ
中科院分区：
文献类型：
--
作者：
Greenwood, RM;Schaefer-McDaniel, NJ;Tsemberis, SJ
尽管针对无家可归者和精神疾病患者的由消费者驱动的干预措施有所增加，但几乎没有证据表明这些项目能改善心理状况。本研究追踪了197名无家可归且患有精神疾病的成年人，他们被随机分配到两种情况中的一种：由消费者驱动的“住房优先”项目，或者是在获得住房之前需要接受精神治疗且保持清醒的“常规治疗”。在六个时间点对无家可归的时间比例、感知到的选择、掌控感以及精神症状进行了测量。结果表明“住房优先”与无家可归现象减少以及感知到的选择增加之间存在直接关系；选择对精神症状的影响部分是通过掌控感来调节的。感知到的选择和精神症状之间强烈的反向关系支持扩大那些增加消费者选择的项目，从而增强掌控感并减少精神症状。
Despite the increase in consumer-driven interventions for homeless and mentally ill individuals, there is little evidence that these programs enhance psychological outcomes. This study followed 197 homeless and mentally ill adults who were randomized into one of two conditions: a consumer-driven "Housing First" program or "treatment as usual" requiring psychiatric treatment and sobriety before housing. Proportion of time homeless, perceived choice, mastery, and psychiatric symptoms were measured at six time points. Results indicate a direct relationship between Housing First and decreased homelessness and increased perceived choice; the effect of choice on psychiatric symptoms was partially mediated by mastery. The strong and inverse relationship between perceived choice and psychiatric symptoms supports expansion of programs that increase consumer choice, thereby enhancing mastery and decreasing psychiatric symptoms.