Individuals with schizophrenia living in group-home or boardinghouse
arrangements are more likely to have low levels of global functioning than
those living independently, a new study shows.
Researchers in Queensland, Australia, looked at 3,033 individuals with
schizophrenia living on their own and compared them with 201 schizophrenia
patients in group homes or boardinghouses. The investigators measured the
presence of schizophrenia symptoms with the Health of the National Outcome
Scale, while the shortened Life Skills Profile was used to gauge the global
level of functioning.
Analysis of the data did not indicate that people with schizophrenia in
boardinghouses had more psychiatric symptoms, but rather less opportunity for
social support. They also found that overall functioning was lower for people
living in boardinghouses; however, they remained interested in making social
contact. These results contradict commonly held beliefs in mental health
services, according to the authors.
They said that the data support the recovery literature suggesting that
social support and stability are important in the maintenance of mental
health. The data also support that when mentally ill individuals live with
people of their own choice and in accommodations that suit them, they do
better on all measures.
In an earlier study the authors found that people with schizophrenia who
were discharged to a boardinghouse were far more likely to be rehospitalized
than those who had been discharged to their own homes. The authors believe
there is an assumption that people with schizophrenia live in boardinghouses
because of their level of disability and that this could explain their higher
hospital admission rates. If this were true, the data would have shown that
people living in boardinghouses had significantly worse psychiatric symptoms,
but they did not. It could be argued that a lack of access to a self-selected
supportive social network, meaningful activities, and work are the reasons
people in boardinghouses are more commonly readmitted. If this is supported,
the authors said, it appears that if community health service staff were able
to address these issues, it would be possible to lower the costs of
readmission while also helping their clients lead more satisfying and
meaningful lives.
The authors noted that their research leaves a number of questions
unanswered. There is a need for further research that investigates the reasons
for readmission and mental health status of people with schizophrenia coming
to hospitals from boardinghouses and their own homes. There is also need to
investigate further the unexpected results indicating that although there is
no symptom difference between the two groups, people in boarding-houses seem
to have less opportunity for social support and meaningful activities. Could
this lack of social support and meaningful activities have an impact on their
mental health, increasing their need for readmission?
They concluded that it seems timely that a study be undertaken to explore
the phenomena in an attempt to develop a theoretical explanation of why these
differences exist between the groups. Findings from such a study would have
far-reaching implications in terms of the focus of care for people with
schizophrenia.