OBJECTIVE. Most homeless persons who have received services for serious
mental illness want to live on their own, but mental health professionals
usually recommend group housing. This study examined the relationship
between the types of residential arrangements preferred by homeless
mentally ill persons and their demographic and clinical characteristics and
perceptions of their health and functional status. METHODS. The study
sample consisted of 118 homeless mentally ill persons living in publicly
funded shelters in Boston who were enrolled in a research demonstration
project that would provide them with housing. Before random assignment to
housing, study participants were interviewed about their interest in
moving, in staff support, and in living with others. Their clinical status
and functional strengths and impairments were assessed using a variety of
objective and subjective measures. RESULTS. Study participants reported a
marked preference for independent living but expressed substantial interest
in staff support. The desire for independent living was associated with a
perceived ability to manage independent living, but was also associated
with current substance abuse. Most indicators of clinical status and
functional ability were not associated with housing preferences.
CONCLUSIONS. Self-perceived functional ability may not be an influence on
housing preferences, except when that ability is perceived as making
independent living more difficult. Symptoms of mental illness did not
appear to interfere with study participants' rational decision making about
where to live. However, the study finding that substance abusers expressed
a desire for independent living suggests the need for caution in adhering
to homeless mentally ill persons' housing preferences, given the problems
posed by substance abuse for their ability to maintain stable community
housing.
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