Authors: Melinda Kubisa, Muriel Kirkby, Judith Klavins, Michelle Morris, Dr. Laura Hayes & Lauren Gibson
Event: 2023 The MHS conference - Adelaide
Subject: Finding a Place to Call Home
Type of resource: Conference Presentations and Papers
Presentation 1: Positive futures: A hospital discharge facility for NDIS participants to re-integrate into community.
Authors: Melinda Kubisa & Muriel Kirkby
A trial project for a hospital discharge facility to support the reduction of the length of stay and number of NDIS participants in hospital. The project partnership was a collaboration between the SA State Government through the Department for Health and Wellbeing and Central Adelaide Local Health Network, Uniting SA and a NDIS Provider (CLO) to provide support. The model for Regency Green is underpinned by human rights and person-centred care that creates connection with community and the development of skills for independent living. The model has a well-defined service delivery framework based on clinical governance and the NDIS Practice Standards. House 1-3 are predominately for psychosocial disability with low support needs (1:3) and House 4 for dual disability and higher diagnostic and behavioural complexity. The model is funded by the SA Government and NDIA.
The service opened in August 2022. Results for the 6-month trial demonstrates that capacity of 23 was achieved by December 2022; 26 participants have been in the facility; and 6 have transitioned out. This initiative resulted in 2110 hospital bed days saved.
We are hoping to support the South Australian sector to explore different housing and support models to support high and complex transition models of support that are evidenced based, uphold human rights and ensure clinical governance.
Bigby, C ‘Good Group Homes’ - Every Moment has potential. Effectiveness of disability services, Living with Disability Research Centre, La Trobe University Dennis, C., Adey G, (2022) Transitions 2 Home: Independent Review NDIS Quality and Safeguards Commission (2021), NDIS Practice Standards and quality Indicators.
Presentation 2: My place, My life: Reconnecting with Community.
Authors: Judith Klavins, Melinda Kubisa & Michelle Morris
People living with complex and enduring mental health needs face almost overwhelming barriers moving from long-term mental health inpatient settings to supported accommodation in the community.
The 31 Homes Project has enabled 32 South Australians, from public inpatient forensic mental health and rehabilitation services, to fully transition to new long-term metropolitan and country accommodation in the community. Individuals required Supported Independent Living (SIL) allowance 24-hour, 7 day-a-week, and capacity building in their approved NDIS Plans.
Community Living Options (CLO), the lead Non Government Support provider to the 31 Homes Project participants, adapted their existing disability-based model of care to support people living with a psychosocial disability. Evidence based best practice with person centred active support, recognizes and respects each person’s needs, and has made ‘human rights real’.
Assessment tools and methodologies include positive behaviour support which has over time reduced ‘behaviours of concern’ and increased ‘step downs’ from high intensity support. It has also increased skills, goal attainment and quality of life.
The 31 Homes Project provides sustainable community-based accommodation along with NDIS funded supports to create opportunities for people to make their own decisions about where and how they live their life, including their family, cultural, and community participation.
Sustainable long-term housing for people living with mental health issues requires:
Evidence based best practice approach: person centred active support makes ‘human rights real’.
Funded NDIS Supported Independent Living (SIL) 24-hour, 7 day-a-week and capacity-building.
Access to a flow of timely and appropriate housing
Committed cross sector collaboration/partnerships
Brackertz, N., Wilkinson, A. and Davison, D. (2018) Housing, homelessness and mental health: towards systems change, Australian Housing and Urban Research Institute, Melbourne, at Housing, homelessness and mental health: towards systems change | AHURI
Barnao, M., Ward, T., & Casey, S. (2016). Taking the good life to the institution: Forensic service users’ perceptions of the Good Lives Model. International Journal of Offender Therapy and Comparative Criminology 60, 766-786.
Bigby, C ‘Good Group Homes’ - Every Moment has potential. Effectiveness of disability services, Living with Disability Research Centre, La Trobe University
Bigby, C., Bould, E., Iacono, I., & Beadle-Brown, J. (2019). Predicting good Active Support for people with intellectual disabilities in supported accommodation services: Key messages for providers, consumers and regulators. Journal of Intellectual and Developmental Disability doi.org/10.3109/13668250.2019.1685479
Birgden, A. (2016). Enabling the disabled: A proposed framework to reduce discrimination against forensic disability clients requiring access to programs in prison. Mitchell Hamline Law Review, 42(2), 638-696.
Fisher, A, Jarvis, C, Bellon, M and Kelly G (2022) The accessibility and usefulness of positive behaviour support plans: the perspectives of everyday support people in South Australia. Researchgate.net
NDIS Quality and Safeguards Commission (2021), NDIS Practice Standards and quality Indicators.
Fisher, A., Bellon, M, Lawn, S and Lennon, S (2017) Identifying Current Practices and Supports in Behaviour Management following ABI in South Australian Community Settings: A Delphi Study. Cambridge University Press
Ward, T. (2002). The management of risk and the design of good lives. Australian Psychologist, 37, 172-179.
Presentation 3: “A home for life”: how long term housing and support can reduce hospitalisation for residents.
Authors Dr. Laura Hayes & Lauren Gibson
There is a complex interplay between housing instability and mental health concerns associated with a range of other challenges such as:
• Stigma, loneliness and isolation
• Limited access to required supports
• Low availability of suitable housing opportunities with supports to maintain tenancy
Being able to choose housing that is suited to preferences is a fundamental human right. Evidence suggests high quality supported housing that encourages community integration is key for satisfaction and effectiveness, reduces healthcare costs and increases wellbeing for people living with mental health challenges.
Haven homes provides purpose built accommodation with continual on-site support for residents - a “home for life” in a congregate setting with individual choice and control. However, housing is considered an “expensive” support, so strengthening the evidence around cost offsets would be useful.
We assessed hospitalisation rates and healthcare used by a cohort of residents comparing rates in the 12 months before moving into Haven with rates for a 12 month period after moving in.
We found supported housing in a congregate social setting with continuous access to support reduces hospitalisations substantially, offsetting the costs of provision of this care and enabling residents to remain in the community without disruption to their recovery trajectory.
Understand the complex interplay of housing instability and mental health This presentation will provide evidence that providing high quality housing options constitute good value in supporting recovery
Brackertz, N., L. Borrowman, C. Roggenbuck, S. Pollock and E. Davis (2020). Trajectories: the interplay between housing and mental health pathways. AHURI Final Report, MInd Australia and Australian Housing and Urban Research Institute.
McPherson, P., Krotofil, J., & Killaspy, H. (2018). Mental health supported accommodation services: a systematic review of mental health and psychosocial outcomes. BMC Psychiatry, 18(1), 1-15.