Researchers: Galia S. Moran¹, Tzipi Hornik-Lurie², Jon Anson¹

Background: With the implementation of the Mental Health Rehabilitation Act (2000), various housing services have evolved. The purpose of this study is to examine the “supportive community” housing system as compared to hostel housing frameworks. In a mixed methods design we examine rehabilitation and health outcomes of tenants and examine the challenges and advantages from the perspective of staff, directors and financial managers who shifted from a hostel service to supportive community service models.

Method: Mixed-methods.
Quantitative: Examination of an Integrated Database of the Ministry of Health and Social Security.
Qualitative: Interviews and focus groups with hostel staff moving to a supportive community.
Quantitative sample: 975 subjects in a control group, and 975 subjects in the experimental group.
Qualitative sample: 28 participants: 9 in-depth interviews, 19 in focus groups.

Findings: Quantitative Outcomes: The hostel residents’ and supported community residents’ background (nationality, country of birth, age, marital status, socioeconomic status, district of residence) and illness (percentage of mental disability) characteristics are significantly different. On the other hand, there are no significant differences between the two types of housing frameworks in regards to length of stay, hospitalization rates, rehabilitation and employment success.
Summary of qualitative findings: Three main categories:
1. Transition process - barriers, challenges and ways of coping;
2. Changes in organizational structure and teamwork characteristics;
3. Promoting tenant rehabilitation processes and staff-oriented recovery work.

Conclusions: 1. There are gaps between the quantitative and qualitative findings that need to be further clarified.
2. Lack of differences in outcome measures between hostels and a supportive community, support the model as advantageous to hostels. Yet, it is unclear if the uniqueness of the supportive community model is pronounced well enough in practicality.
3. It is recommended to collect data directly from family members.
4. Data on community integration and recovery measures need to be assessed as well (not just clinical/outpatient measures).
5. More research is needed that focuses on the supported community model’s connection with the wider community; for example, allocation and implementation of resources for community activities and community integration.

Recommendations: 1. Policy makers need to address the transition phase - organization preparation and support for staff when transitioning from hostel to supportive community.
2. Need to attend the younger population, Arab population, and those with more severe mental disorders that currently do not appear to use this service, despite the expectation of seeing a diverse population.

Research end date: 07/2019