Supported Housing for People with Severe Mental Disorders

Background There has been a significant reduction in the number of people with severe mental illness who spend extended periods in long-stay hospitals. District health authorities, local authorities, housing associations and voluntary organisations are jointly expected to provide support for people with severe mental disorder/s. This 'support' may well involve some kind of special housing. Objectives To determine the effects of supported housing schemes compared with outreach support schemes or 'standard care' for people with severe mental disorder/s living in the community. Search methods For the 2006 update we searched the Cochrane Schizophrenia Group Trials Register (April 2006) and the Cochrane Central Register of Controlled Trials (CENTRAL, 2006 Issue 2). Selection criteria We included all relevant randomised, or quasi-randomised, trials dealing with people with 'severe mental disorder/s' allocated to supported housing, compared with outreach support schemes or standard care. We focused on outcomes of service utilisation, mental state, satisfaction with care, social functioning, quality of life and economic data. Data collection and analysis We reliably selected studies, quality rated them and undertook data extraction. For dichotomous data, we would have estimated relative risks (RR), with the 95% confidence intervals (CI). Where possible, we would have calculated the number needed to treat statistic (NNT). We would have carried out analysis by intention-to-treat and would have summated normal continuous data using the weighted mean difference (WMD). We would have presented scale data for only those tools that had attained pre-specified levels of quality and undertaken tests for heterogeneity and publication bias. Main results Although 139 citations were acquired from the searches, no study met the inclusion criteria. Authors' conclusions Dedicated schemes whereby people with severe mental illness are located within one site or building with assistance from professional workers have potential for great benefit as they provide a 'safe haven' for people in need of stability and support. This, however, may be at the risk of increasing dependence on professionals and prolonging exclusion from the community. Whether or not the benefits outweigh the risks can only be a matter of opinion in the absence of reliable evidence. There is an urgent need to investigate the effects of supported housing on people with severe mental illness within a randomised trial.

Slievabawnogue Housing:Two Dwellings in A Disused Quarry

This project involves the construction of a dwelling in the outskirts of Dublin City. Situated in a disused quarry, the house act as an inhabited bridge, spanning between natural and man made outcrops, service structures and a shared entrance staircase. The houses language derives from the structure necessary to achieve these spans.
The section internally is modeled to present a variety of scales of spaces. More intimate living spaces and bedrooms occur in a lower, north-facing wing. Taller living spaces address the south.

Incorporating rainwater harvesting, wood-gasifying boilers, on site wind powered electrical generation, solar thermal panels and very high levels of insulation the houses are close to energy neutral. The fact that the house is constructed in massive timber construction means that 250 tonnes of carbon are sequestered in its construction. The design includes a 25yar replanting strategy to replace the existing coniferous-forested surrounds with native species in a coppiced planting strategy to allow ongoing fuel for the house, and cash crops to be sold on.

Located in an area of outstanding natural beauty the planning and design of the house involved research into patterns of rural development, the relationship between man made interventions and the natural landscape and the technology of the vernacular. This latter research forms part of the themes being explored under the Kevin Kieran Arts Council / OPW Bursary

Aims / Objectives Questions

1 To design and construct a low energy place to dwell.
2 To investigate the relationship between man-made interventions and new construction in an area of outstanding natural beauty.
3 To derive a language of construction that is contemporary in nature but refers to precedents embedded in the vernacular.
4 To develop a low-carbon form of construction that allows the construction of the house to act to sequester carbon
5 To make a contemporary addition in sympathy with the qualities of the existing site

Climate Adaptation: The future of extra-care housing for the elderly in the United Kingdom.

This paper describes the result of a project to develop climate adaptation design strategies funded by the UK’s Technology Strategy Board. The aim of the project was to look at the effects of climate change in the distant future (2080) on a vulnerable group such as older people with special needs and see how architectural design strategies and technologies may be used today to help mitigate problems ahead caused by climate change.
Older people are the most vulnerable sector of society and are particularly at risk in extreme weather, either excess cold in winter or continual high temperatures in summer. In the UK it is predicted that average temperatures may rise by as much as 8 degrees in Summer by 2080 and there will be a 20% greater chance of extreme weather events. This will place extreme stress on the building stock which is designed for today’s mild maritime climate.
The project took a current proposal for an extra-care home for the elderly designed to 2010 regulations and developed a road map to 2080 using climate models developed by the UK Meteorological Office. This allowed the current design to be assessed using future climatic data, proposals for improvement of the scheme to be made within existing constraints and also a new scheme to be developed from first principals using this data, and projections of new technologies that will be available. By comparing these schemes, the approach allowed a reassessment of the initial scheme, and allowed a new design to be developed that offered a more flexible solution incorporating future retrofit which allows new renewable technologies for heating, cooling and water storage to be added at a later date.

Urban housing and the role of 'underclass' processes: the case of Ireland

Rising levels of urban deprivation and a perception that poverty has become more concentrated in such areas and has taken on a qualitatively different character have provoked a variety of popular and academic responses. The potentially most fruitful set of hypotheses focuses on the unintended of weak labour force attachment and social isolation is perceived to lead to behaviour and orientations that contribute to a vicious circle of deprivation. In examining the value of this conceptual framework in the Irish case we proceed by measuring directly the social-psychological factors which ave hypothesized to mediate the 'underclass' process.

A significantly higher level of poverty is found in urban public-sector tenant households. This finding cannot be accounted for entirely by socio-demographic differences. It is the assessment of this net or residual effect that is crucial to an evaluation of vicious circle explanations. Controlling for the critical social-psychological factors we found that net effect was reduced by less than a quarter and concluded that the remaining effect is more plausibly attributed to the role of selection than to underclass processes. Analysis of the changing relationship between urban public-sector tenancy and poverty provides support for this interpretation.

For the main part the distinctiveness of social housing tenants is a consequence of the disadvantages they stiffer in relation to employment opportunities and living standards. Ultimately it is these problems that policy interventions, whatever the level at which they take place, must address.

Policy difference and policy ownership under UK devolution: social housing policy in Northern Ireland

This paper assesses the impact of UK devolution on social housing policy in Northern Ireland from 1999 until 2011, with a particular focus on the administration from May 2007 until April 2011, the first in which the elected elements of the process functioned for the entire period. Housing is one of the responsibilities of the Minister for Social Development. Northern Ireland has had a political commitment to the provision of good quality social housing for many years, both before and after the 1998 Good Friday/ Belfast Agreement and the establishment of the Northern Ireland Assembly and Executive in 1999.
The paper begins with an analysis of factors contributing to policy difference within the United Kingdom under the 1999 devolution settlement, noting that these factors may contribute either to policy convergence or divergence between the four UK jurisdictions. There follow reflections on the concept of ‘policy ownership’ in multi-level states and the benefits of this analytical approach for consideration of housing policy under UK devolution. A review of social housing policy since 1999 is followed by discussion of three key issues from the 2007-11 administration: the governance of social housing; the procurement of new social housing; and improving access to shared space and a shared future. The paper concludes that, in Northern Ireland, the 2007-11 administration marked a transition between a technocratic past and the future policy ownership of the social housing policy field by locally elected politicians. Reflections on wider implications for UK social policy, for UK devolution, and for the complex governance structures of devolved and federal states are also included.

Canada's Compassionate Care Benefit:Is it an adequate public health response to addressing the issue of caregiver burden in end-of-life care?

Background: An increasingly significant public health issue in Canada, and elsewhere throughout the developed world, pertains to the provision of adequate palliative/end-of-life (P/EOL) care. Informal caregivers who take on the responsibility of providing P/EOL care often experience negative physical, mental, emotional, social and economic consequences. In this article, we specifically examine how Canada's Compassionate Care Benefit (CCB) - a contributory benefits social program aimed at informal P/EOL caregivers - operates as a public health response in sustaining informal caregivers providing P/EOL care, and whether or not it adequately addresses known aspects of caregiver burden that are addressed within the population health promotion (PHP) model. Methods. As part of a national evaluation of Canada's Compassionate Care Benefit, 57 telephone interviews were conducted with Canadian informal P/EOL caregivers in 5 different provinces, pertaining to the strengths and weaknesses of the CCB and the general caregiving experience. Interview data was coded with Nvivo software and emerging themes were identified by the research team, with such findings published elsewhere. The purpose of the present analysis was identified after comparing the findings to the literature specific to caregiver burden and public health, after which data was analyzed using the PHP model as a guiding framework. Results: Informal caregivers spoke to several of the determinants of health outlined in the PHP model that are implicated in their burden experience: gender, income and social status, working conditions, health and social services, social support network, and personal health practises and coping strategies. They recognized the need for improving the CCB to better address these determinants. Conclusions: This study, from the perspective of family caregivers, demonstrates that the CCB is not living up to its full potential in sustaining informal P/EOL caregivers. Effort is required to transform the CCB so that it may fulfill the potential it holds for serving as one public health response to caregiver burden that forms part of a healthy public policy that addresses the determinants of this burden. © 2011 Williams et al; licensee BioMed Central Ltd.

Assessing Lifetime Homes Standards and Part M Building Regulations for Housing Design in the UK

The aims of this article are to examine Lifetime Home Standards (LTHS) and Part M of the UK Building Regulations and to discuss how relevant and successful they are. The UK government expects all new homes to be built to LTHS by 2013. This is increasingly important with an ageing population. The home environment can enable independence and provide a therapeutic place for everyone. As Part M of the building regulations are compulsory in all housing and LTHS are mandatory for public sector housing, a review of research articles was undertaken on these standards. The paper begins with a brief background on accessibility regulations, followed by a critical review of the standards that takes the body of literature that has been written around them into account. This review suggests that the standards should be improved and that designers and architects face challenges to creatively incorporate them into housing design.

Anchored in Irish housing tradition, Bog West: Steve Larkin's rural house resonates with its surroundings and tectonically celebrates domestic life

Full length critical peer review article about House at Bogwest by architect Emmett Scanlon writing for A10. Included visit to the house and an interview with Steve Larkin. Photographs by Alice Clancy. Photographs and plans describing House at Bogwest.