Mental health and the settings of housing support – a systematic review and conceptual model

The purpose of this qualitative systematic review is to examine how the nature and quality of housing affect adults receiving support for mental health problems, focusing on the less considered structural aspects of housing.

A systematic search identified relevant research. Data consisting exclusively of service-user testimony was taken from seven studies based in varied types of accommodation in England. A synthesis was carried out using thematic analysis, and a conceptual model developed based on the themes identified from the data. A literature review examines the context, with relevant material drawn from a variety of disciplines and professions.

There were three main determinants of whether housing was a setting that enabled users to benefit from support and enjoy a good quality of life – “autonomy”, “domain”, and “facilitation”. Secondary themes influenced these primary themes, or described respondents’ condition or feelings in relation to their housing situation. The “Tripod Model” illustrates the relationships between these themes.

Applying systematic review methods to qualitative material proved contentious and challenging. The model produced is a hypothesis based on limited data and requiring further investigation.

The findings suggest that a balance is required to increase the chances of successful and sustainable housing outcomes for service-users.

The model enables a holistic understanding of issues affecting service-users, and the interdependent nature of these. It offers a new typology based on a synthesis of data drawn from a spectrum of accommodation, which gives it a breadth a single piece of research could not encompass.