Community Mental Health Journal

, Volume 55, Issue 7, pp 1218–1225 | Cite as

A Place to Call Home: Hearing the Perspectives of People Living with Homelessness and Mental Illness Through Service Evaluation

  • Julie O’Donovan
  • Karen Russell
  • Pim Kuipers
  • Dan Siskind
  • Rachel A. ElphinstonEmail author
Original Paper


There is an ongoing need to incorporate the perspectives of people in supported community housing to improve the provision of integrated mental health services. This study aimed to explore the satisfaction and experiences of people who have received supported housing and mental health services. We conducted a retrospective, mixed methods study using a data mining approach, analyzing consumer satisfaction survey responses collected on discharge from the service over a 7-year period. Responses from 178 consumers aged between 20 and 62 years were included. Quantitative results indicated that consumers rated the quality of services as relatively high. Analysis of qualitative responses identified seven themes describing people’s views on how they had benefitted from the service. Consumers reported benefits in terms of practical and emotional supports, responsiveness of the team to their needs, socialization and community integration, personal growth and recovery, and finding ‘my place’. Themes of learning and skills development were also important. These results suggest that practical support, together with emotional expressions of care and compassion are most valued by people who participated in this service. This research has implications for service evaluation and for future research, which may include focusing on the key role of connectedness, ‘my place’ and hope for recovery.


Mental illness Housing Recovery Consumer engagement Service evaluation Lived experience 



We would like to thank Mr. Andrew Blythe for his contribution to the study. We would also like to acknowledge Mr. Geoffrey Lau and the MSAMHS leadership team as they provided dedicated research time for the first and second authors to complete this project.


This study was funded by an unrestricted competitive grant from the Princess Alexandra Hospital Research Support Scheme. DS is partially supported by an Australian NH&MRC Grant

Compliance with Ethical Standards

Conflicts of interest

JO and KR are employees of the THT. DS is an employee of MSAMHS which runs the THT. RE is an employee of MSAMHS however, is not involved in running any aspect of the THT service.

Ethical Approval

Ethical approval was provided for analysis of de-identified, retrospectively collected administrative data.


  1. Australian Bureau of Statistics. (2012). Census of population and housing: estimating homelessness, Australia 2011.Google Scholar
  2. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77–101.CrossRefGoogle Scholar
  3. Brolin, R., Rask, M., Syrén, S., Baigi, A., & Brunt, D. A. (2015). Satisfaction with housing and housing support for people with psychiatric disabilities. Issues in Mental Health Nursing, 36(1), 21–28.CrossRefGoogle Scholar
  4. Browne, G., & Hemsley, M. (2010). Housing and living with a mental illness: Exploring carers’ views. International Journal of Mental Health Nursing, 19(1), 22–29.CrossRefGoogle Scholar
  5. Browne, G., Hemsley, M., & St. John, W. (2008). Consumer perspectives on recovery: A focus on housing following discharge from hospital. International Journal of Mental Health Nursing, 17(6), 402–409.CrossRefGoogle Scholar
  6. Chamberlain, C., & MacKenzie, D. (1992). Understanding contemporary homelessness: Issues of definition and meaning. Australian Journal of Social Issues, 27(4), 274–297.CrossRefGoogle Scholar
  7. Fazel, S., Khosla, V., Doll, H., & Geddes, J. (2008). The prevalence of mental disorders among the homeless in western countries: Systematic review and meta-regression analysis. PLoS Medicine, 5(12), e225.CrossRefGoogle Scholar
  8. Folsom, D. P., Hawthorne, W., Lindamer, L., Gilmer, T., Bailey, A., Golshan, S.,…Jeste, D. V. (2005). Prevalence and risk factors for homelessness and utilization of mental health services among 10,340 patients with serious mental illness in a large public mental health system. American Journal of Psychiatry, 162(2), 370–376.Google Scholar
  9. Goetz, J. L., Keltner, D., & Simon-Thomas, E. (2010). Compassion: An evolutionary analysis and empirical review. Psychological Bulletin, 136(3), 351.CrossRefGoogle Scholar
  10. Happell, B. (2008). Determining the effectiveness of mental health services from a consumer perspective: Part 2: Barriers to recovery and principles for evaluation. International Journal of Mental Health Nursing, 17(2), 123–130.CrossRefGoogle Scholar
  11. Harvey, C., Killackey, E., Groves, A., & Herrman, H. (2012). A place to live: Housing needs for people with psychotic disorders identified in the second Australian national survey of psychosis. Australian and New Zealand Journal of Psychiatry, 46(9), 840–850.CrossRefGoogle Scholar
  12. Henry, M., Cortes, A., Shivji, A., & Buck, K. (2014). Part 1: Point-in-time estimates of homelessness. Paper presented at the Annual Homeless Assessment Report to Congress 2014.Google Scholar
  13. Johnstone, M., Jetten, J., Dingle, G. A., Parsell, C., & Walter, Z. C. (2015). Discrimination and well-being amongst the homeless: the role of multiple group membership. Frontiers in Psychology, 6, 739.CrossRefGoogle Scholar
  14. Keogh, C., O’Brien, K. K., Hoban, A., O’Carroll, A., & Fahey, T. (2015). Health and use of health services of people who are homeless and at risk of homelessness who receive free primary health care in Dublin. BMC Health Services Research, 15(1), 58.CrossRefGoogle Scholar
  15. Kirkpatrick, H., & Byrne, C. (2009). A narrative inquiry: Moving on from homelessness for individuals with a major mental illness. Journal of Psychiatric and Mental Health Nursing, 16(1), 68–75.CrossRefGoogle Scholar
  16. Kitson, A., Marshall, A., Bassett, K., & Zeitz, K. (2013). What are the core elements of patient-centred care? A narrative review and synthesis of the literature from health policy, medicine and nursing. Journal of Advanced Nursing, 69(1), 4–15.CrossRefGoogle Scholar
  17. Le Boutillier, C., Leamy, M., Bird, V. J., Davidson, L., Williams, J., & Slade, M. (2011). What does recovery mean in practice? A qualitative analysis of international recovery-oriented practice guidance. Psychiatric Services, 62(12), 1470–1476.CrossRefGoogle Scholar
  18. Malins, G., Oakley, K., & Doyle, R. (2011). Building consumers into service evaluation: development of the MH-CoPES Framework in New South Wales. Australasian Psychiatry, 19(4), 360–363.CrossRefGoogle Scholar
  19. Martens, W. (2001). A review of physical and mental health in homeless persons. Public Health Reviews, 29(1), 13–33.Google Scholar
  20. Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68(3), 438.CrossRefGoogle Scholar
  21. Meehan, T., Stedman, T., Robertson, S., Drake, S., & King, R. (2011). Does supported accommodation improve the clinical and social outcomes for people with severe psychiatric disability? The Project 300 experience. Australian and New Zealand Journal of Psychiatry, 45(7), 586–592.CrossRefGoogle Scholar
  22. Mifflin, E., & Wilton, R. (2005). No place like home: Rooming houses in contemporary urban context. Environment and Planning A, 37(3), 403–421.CrossRefGoogle Scholar
  23. Patterson, M., Moniruzzaman, A., Palepu, A., Zabkiewicz, D., Frankish, C. J., Krausz, M., et al. (2013). Housing First improves subjective quality of life among homeless adults with mental illness: 12-month findings from a randomized controlled trial in Vancouver, British Columbia. Social Psychiatry and Psychiatric Epidemiology, 48(8), 1245–1259.CrossRefGoogle Scholar
  24. Petersen, K. S., Friis, V. S., Haxholm, B. L., Nielsen, C. V., & Wind, G. (2015). Recovery from mental illness: A service user perspective on facilitators and barriers. Community Mental Health Journal, 51(1), 1–13.CrossRefGoogle Scholar
  25. Queensland Mental Health Commission. (2018). Shifting Minds. Queensland Mental Health, Alcohol and Other Drugs Strategic Plan 20182023. Retrieved from Brisbane, Queensland, Australia.Google Scholar
  26. Rae, B. E., & Rees, S. (2015). The perceptions of homeless people regarding their healthcare needs and experiences of receiving health care. Journal of Advanced Nursing, 71(9), 2096–2107.CrossRefGoogle Scholar
  27. Seppala, E., Rossomando, T., & Doty, J. R. (2013). Social connection and compassion: Important predictors of health and well-being. Social Research: An International Quarterly, 80(2), 411–430.Google Scholar
  28. Shelton, K. H., Taylor, P. J., Bonner, A., & van den Bree, M. (2009). Risk factors for homelessness: Evidence from a population-based study. Psychiatric Services, 60(4), 465–472.CrossRefGoogle Scholar
  29. Sinclair, S., Norris, J. M., McConnell, S. J., Chochinov, H. M., Hack, T. F., Hagen, N. A.,…Bouchal, S. R. (2016). Compassion: A scoping review of the healthcare literature. BMC Palliative Care, 15(1), 6.Google Scholar
  30. Siskind, D., Harris, M., Kisely, S., Siskind, V., Brogan, J., Pirkis, J.,…Whiteford, H. (2014). A retrospective quasi-experimental study of a transitional housing program for patients with severe and persistent mental illness. Community Mental Health Journal, 50(5), 538–547.Google Scholar
  31. Tsai, J., Lapidos, A., Rosenheck, R. A., & Harpaz-Rotem, I. (2013). Longitudinal association of therapeutic alliance and clinical outcomes in supported housing for chronically homeless adults. Community Mental Health Journal, 49(4), 438–443.CrossRefGoogle Scholar
  32. Tsai, J., Mares, A. S., & Rosenheck, R. A. (2012). Does housing chronically homeless adults lead to social integration? Psychiatric Services, 63(5), 427–434.CrossRefGoogle Scholar
  33. Tsemberis, S., Rogers, E. S., Rodis, E., Dushuttle, P., & Skryha, V. (2003). Housing satisfaction for persons with psychiatric disabilities. Journal of Community Psychology, 31(6), 581–590.CrossRefGoogle Scholar
  34. Urbanoski, K., Veldhuizen, S., Krausz, M., Schutz, C., Somers, J. M., Kirst, M.,…Goering, P. (2018). Effects of comorbid substance use disorders on outcomes in a housing first intervention for homeless people with mental illness. Addiction, 113(1), 137–45.

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Metro South Addiction and Mental Health ServiceBrisbaneAustralia
  2. 2.Centre for Functioning and Health Research, Metro South HealthBrisbaneAustralia
  3. 3.The Hopkins Centre, Menzies Health Institute QueenslandGriffith UniversityBrisbaneAustralia
  4. 4.School of MedicineThe University of QueenslandBrisbaneAustralia
  5. 5.Recover Injury Research CentreThe University of QueenslandBrisbaneAustralia

Personalised recommendations