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Published in: Administration and Policy in Mental Health and Mental Health Services Research 2/2006

01-03-2006

The Use of Housing as Leverage to Increase Adherence to Psychiatric Treatment in the Community

Authors: Pamela Clark Robbins, John Petrila, Stephanie LeMelle, John Monahan

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 2/2006

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Abstract

For people with mental disorder, access to subsidized housing may be used as “leverage” to obtain adherence to treatment. Interview data from 200 outpatients at each of five sites provided the first national description of the use of housing as leverage. Results indicated that housing is most likely to be used as leverage when it is “special” housing, available only to people with mental illness. Most frequently, respondents state that the requirement that they participate in treatment is imposed by their landlord, rather than by a clinician. The use of housing as leverage strongly increases respondents’ perceptions of coercion. Despite this, however, participants who experience housing as leverage are no less satisfied than other participants with the treatment that they receive, and are much more likely than other participants to believe that using housing as leverage is effective in helping people stay well.
Literature
go back to reference Allen J. P., Eckardt M. J., Wallen J. (1988). Screening for alcoholism: techniques and issues. Public Health Reports, 103:586–592PubMed Allen J. P., Eckardt M. J., Wallen J. (1988). Screening for alcoholism: techniques and issues. Public Health Reports, 103:586–592PubMed
go back to reference Allen M. (2003). Waking Rip Van Winkle: Why developments in the last 20 years should teach the mental health system not to use housing as a tool of coercion. Behavioral Sciences and the Law 21:503–521PubMedCrossRef Allen M. (2003). Waking Rip Van Winkle: Why developments in the last 20 years should teach the mental health system not to use housing as a tool of coercion. Behavioral Sciences and the Law 21:503–521PubMedCrossRef
go back to reference Allen M. (1996). Separate and unequal: The struggle of tenants with mental illness to maintain housing. Clearinghouse Review 30:720–739 Allen M. (1996). Separate and unequal: The struggle of tenants with mental illness to maintain housing. Clearinghouse Review 30:720–739
go back to reference *American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC *American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders. American Psychiatric Association, Washington, DC
go back to reference Bonnie, R., & Monahan, J. (2005). From coercion to contract: Reframing the debate on mandated community treatment for people with mental disorders. Law and Human Behavior, 29, 487–505.CrossRef Bonnie, R., & Monahan, J. (2005). From coercion to contract: Reframing the debate on mandated community treatment for people with mental disorders. Law and Human Behavior, 29, 487–505.CrossRef
go back to reference Edgar E., O’Hara A., Smith B., Zovistoski A. (1999). Priced Out in 1998: The housing crisis for people with disabilities. Technical Assistance Collaborative, Boston, MA Edgar E., O’Hara A., Smith B., Zovistoski A. (1999). Priced Out in 1998: The housing crisis for people with disabilities. Technical Assistance Collaborative, Boston, MA
go back to reference Endicott J., Spitzer R. L., Fleiss J. L., Cohen J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbances. Archives of General Psychiatry 33:766–771PubMed Endicott J., Spitzer R. L., Fleiss J. L., Cohen J. (1976). The Global Assessment Scale: a procedure for measuring overall severity of psychiatric disturbances. Archives of General Psychiatry 33:766–771PubMed
go back to reference Ganju V. (1999). The MHSIP Consumer Survey. Texas Department of MHMR, Austin, TX Ganju V. (1999). The MHSIP Consumer Survey. Texas Department of MHMR, Austin, TX
go back to reference Gardner W., Hoge S., Bennett N., Roth L., Lidz C., Monahan J., Mulvey E. (1993). Two scales for measuring patients’ perceptions for coercion during mental health hospital admission. Behavioral Sciences & the Law 20:307–321 Gardner W., Hoge S., Bennett N., Roth L., Lidz C., Monahan J., Mulvey E. (1993). Two scales for measuring patients’ perceptions for coercion during mental health hospital admission. Behavioral Sciences & the Law 20:307–321
go back to reference George L. K., Blazer D. G., Hughes D. C., Fowler N. (1989). Social support and the outcome of major depression. British Journal of Psychiatry 154:478–485PubMed George L. K., Blazer D. G., Hughes D. C., Fowler N. (1989). Social support and the outcome of major depression. British Journal of Psychiatry 154:478–485PubMed
go back to reference Hogan T. P., Awad A. G. (1992). Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychological Medicine 22:347–52PubMed Hogan T. P., Awad A. G. (1992). Subjective response to neuroleptics and outcome in schizophrenia: a re-examination comparing two measures. Psychological Medicine 22:347–52PubMed
go back to reference Korman H., Engster D., Milstein B. (1996). Housing as a tool of coercion. In: Dennis D., Monahan J. (eds) Coercion and aggressive community treatment. Plenum Press, New York, pp. 95–113 Korman H., Engster D., Milstein B. (1996). Housing as a tool of coercion. In: Dennis D., Monahan J. (eds) Coercion and aggressive community treatment. Plenum Press, New York, pp. 95–113
go back to reference Levy, C.J. (2002). For mentally ill, death and misery. New York Times. April 28:2002 Levy, C.J. (2002). For mentally ill, death and misery. New York Times. April 28:2002
go back to reference *LogXact® (2002). Software for exact logistic regression. Cytel Software Corporation, Cambridge, MA *LogXact® (2002). Software for exact logistic regression. Cytel Software Corporation, Cambridge, MA
go back to reference McEvoy J., Apperson L. J., Appelbaum P. S., Ortlip P., Brecosky J., Hammill K., Geller J. L., Roth L. (1989). Insight into schizophrenia: its relationship to acute psychopathology. Journal of Nervous and Mental Disease 177:43–47PubMedCrossRef McEvoy J., Apperson L. J., Appelbaum P. S., Ortlip P., Brecosky J., Hammill K., Geller J. L., Roth L. (1989). Insight into schizophrenia: its relationship to acute psychopathology. Journal of Nervous and Mental Disease 177:43–47PubMedCrossRef
go back to reference Monahan J., Bonnie R., Appelbaum P., Hyde P., Steadman H., Swartz M. (2001). Mandated community treatment: Beyond outpatient commitment. Psychiatric Services 52:1198–1205PubMedCrossRef Monahan J., Bonnie R., Appelbaum P., Hyde P., Steadman H., Swartz M. (2001). Mandated community treatment: Beyond outpatient commitment. Psychiatric Services 52:1198–1205PubMedCrossRef
go back to reference Monahan J., Redlich A., Swanson J., Robbins P., Appelbaum P., Petrila J., Steadman H., Swartz M., Angell B., McNiel D. (2005). Use of leverage to improve adherence to psychiatric treatment in the community. Psychiatric Services 56:37–44PubMedCrossRef Monahan J., Redlich A., Swanson J., Robbins P., Appelbaum P., Petrila J., Steadman H., Swartz M., Angell B., McNiel D. (2005). Use of leverage to improve adherence to psychiatric treatment in the community. Psychiatric Services 56:37–44PubMedCrossRef
go back to reference Moerner M. G., Mannuzza S., Kane J. M. (1988). Anchoring the BPRS: an aid to improved reliability. Psychopharmacology Bulletin 24:112–117 Moerner M. G., Mannuzza S., Kane J. M. (1988). Anchoring the BPRS: an aid to improved reliability. Psychopharmacology Bulletin 24:112–117
go back to reference Newman S. J. (2001). Housing attributes and serious mental illness: Implications for research and practice. Psychiatric Services 52:1309–1317PubMedCrossRef Newman S. J. (2001). Housing attributes and serious mental illness: Implications for research and practice. Psychiatric Services 52:1309–1317PubMedCrossRef
go back to reference O’Hara, A. (2002). Technical Assistance Collaborative, Personal Communication O’Hara, A. (2002). Technical Assistance Collaborative, Personal Communication
go back to reference O’Hara A., Cooper E. (2003). Priced out in 2002. Technical Assistance Collaborative, Boston, Ma O’Hara A., Cooper E. (2003). Priced out in 2002. Technical Assistance Collaborative, Boston, Ma
go back to reference Rao J., Scott A. (1992). A simple method for the analysis of clustered binary data. Biometrics 48:577–585PubMedCrossRef Rao J., Scott A. (1992). A simple method for the analysis of clustered binary data. Biometrics 48:577–585PubMedCrossRef
go back to reference *StatXact® (2003). Statistical software for exact nonparametric inference. Cytel Software Corporation, Cambridge, MA *StatXact® (2003). Statistical software for exact nonparametric inference. Cytel Software Corporation, Cambridge, MA
go back to reference Swartz M., Swanson J., Monahan J. (2003). Endorsement of personal benefit of outpatient commitment among persons with severe mental illness. Psychology, Public Policy, and Law 9:70–93PubMedCrossRef Swartz M., Swanson J., Monahan J. (2003). Endorsement of personal benefit of outpatient commitment among persons with severe mental illness. Psychology, Public Policy, and Law 9:70–93PubMedCrossRef
go back to reference Swartz, M. S., Swanson, J. W., Kim, M., & Petrila, J. (in press). Use of involuntary outpatient commitment or related civil court treatment orders in five United States communities. Psychiatric Services. Swartz, M. S., Swanson, J. W., Kim, M., & Petrila, J. (in press). Use of involuntary outpatient commitment or related civil court treatment orders in five United States communities. Psychiatric Services.
go back to reference Teague G. B., Ganju V., Hornik J. A., Johnson J. R., McKinney J. (1997). The MHSIP Mental Health Report Card: consumer-oriented approach to monitoring the quality of mental health plans. Evaluation Review 21:330–341PubMedCrossRef Teague G. B., Ganju V., Hornik J. A., Johnson J. R., McKinney J. (1997). The MHSIP Mental Health Report Card: consumer-oriented approach to monitoring the quality of mental health plans. Evaluation Review 21:330–341PubMedCrossRef
go back to reference Tsemberis S., Gulcur L., Nakae M. (2004). Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health 94:651–656PubMedCrossRef Tsemberis S., Gulcur L., Nakae M. (2004). Housing First, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health 94:651–656PubMedCrossRef
go back to reference Zelen M. (1971). The analysis of several 2×2 contingency tables. Biometrika 58:129—137 Zelen M. (1971). The analysis of several 2×2 contingency tables. Biometrika 58:129—137
Metadata
Title
The Use of Housing as Leverage to Increase Adherence to Psychiatric Treatment in the Community
Authors
Pamela Clark Robbins
John Petrila
Stephanie LeMelle
John Monahan
Publication date
01-03-2006
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research / Issue 2/2006
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-006-0037-3

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