Plain English Summary
Background and study aims
While supported accommodation services play a very important role in assisting people with complex mental health problems to live in the community, there has been very little research to investigate how well they work. This is due in part to the logistic difficulties in researching this area. Randomly assigning people to different types of housing support may be resisted by clinicians who feel that people who use the service need a “staged process” where they move from accommodation providing a high level of support to one providing less support as their skills and confidence increase. Such support should also be tailored to a persons clear preferences for the particular services that they want. It also seems that the availability of supported housing stock is more influential than clinical need in determining who is allocated what type of accommodation. These clinical and housing constraints mean that we simply do not know whether or not individuals are following the most cost effective routes to independence. In short, we do not know whether more tailored support delivered to people living in their own homes ( i.e. through floating outreach) is more acceptable, more individualised and more cost-effective than a standard level of support provided in staffed facilities. This study aims to see whether a study testing two models of supported accommodation for people with mental health problems is possible. We will assess the feasibility, sample size and outcomes for a large scale study to compare the clinical and cost-effectiveness of two models of mental health supported accommodation that are commonly used across England; supported housing and floating outreach.
Who can participate?
Adults with mental health problems referred to supported accommodation.
What does the study involve?
Participants are randomly allocated to housing support though staffed facilities or though floating outreach support. They are then asked to agree to three interviews, once when they join the study, once 6 months into the study and once 12 months into the study, where they are asked questions about their activities, satisfaction with different aspects of their life and how they spend their time. Each interview takes no more than 30 minutes. Participants are also asked for permission to collect information from their case records and for a staff member to complete a questionnaire about their abilities, needs, substance use (if any), challenging behaviour (if any) and any specific difficulties they may have. This information is again collected at the start of the study, 6 months later and 12 months later.
What are the possible benefits and risks of participating?
People taking part in the study are offered £20 in recognition of the time they have given to be involved in the study. Other than giving up some of their time to do the research interviews there are no disadvantages to taking part.
Where is the study run from?
Camden and Islington NHS Foundation Trust, East London NHS Foundation Trust and 2gether NHS Foundation Trust (UK)
When is the study starting and how long is it expected to run for?
June 2015 to September 2017
Who is funding the study?
National Institute for Health Research (UK)
Who is the main contact?
Ms Sarah Dowling
Trial website
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
18830
Study information
Scientific title
Quality and Effectiveness of Supported Tenancies for people with mental health problems (QuEST): Workpackage 4
Acronym
Study hypothesis
This study aims to assess the feasibility of a randomised evaluation of two models of supported accommodation for people with mental health problems.
Ethics approval
NRES Committee North West - Liverpool Central, 07/04/2015, ref: 15/NW/0252
Study design
Randomised; Interventional; Design type: Process of Care
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Other
Trial type
Treatment
Patient information sheet
Not available in web format, please use contact details to request a participant information sheet
Condition
Topic: Mental Health; Subtopic: Service Delivery; Disease: Not Applicable
Intervention
Randomisation to one of two existing models of supported accommodation
Follow Up Length: 12 month(s); Study Entry : Single Randomisation only
Intervention type
Other
Phase
Drug names
Primary outcome measure
Number of people who move onto more independent accommodation; Timepoint(s): 12 months
Secondary outcome measures
Number of people who move to the type of supported accommodation they are randomly assigned to, and how long after randomisation this move occurs; Timepoint(s): 12 month follow-up.
Overall trial start date
01/06/2015
Overall trial end date
30/09/2017
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Adult mental health service users referred to supported accommodation in each of the three areas covered by the study. Only service users who are potentially eligible for both supported housing and floating outreach services can be included. Only service users able to give informed consent will be eligible for inclusion.; Target Gender: Male & Female ; Lower Age Limit 18 years
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
Planned Sample Size: 220; UK Sample Size: 220; Description: The intention is to recruit 60 service user participants to be randomised and up to 60 service user participants who decline randomisation. For each service user, we will interview a member of the clinical team making the referral at baseline and the service user's supported accommodation keyworker at 6 and 12 months follow up. We will also interview the manager of the supported accommodation service 6 months after the first participant is randomised
Total final enrolment
618
Participant exclusion criteria
Service users who do not meet Local Authority eligibility criteria for an independent tenancy from where they could receive floating outreach services will not be eligible for the study. There are no other exclusion criteria.
Recruitment start date
01/06/2015
Recruitment end date
31/07/2016
Locations
Countries of recruitment
United Kingdom
Trial participating centre
Camden and Islington NHS Foundation Trust (lead centre)
St Pancras Hospital
4 St Pancras Way
London
NW1 0PE
United Kingdom
Trial participating centre
East London NHS Foundation Trust
Eastone
22 Commercial Street
London
E1 6LP
United Kingdom
Trial participating centre
2gether NHS Foundation Trust
Rikenel
Montpellier
Gloucester
Gloucestershire
GL1 1LY
United Kingdom
Funders
Funder type
Government
Funder name
National Institute for Health Research
Alternative name(s)
NIHR
Funding Body Type
government organisation
Funding Body Subtype
National government
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Feasibility trial results will be submitted for publication in a high-impact psychiatric journal by the end of 2017 and presented at relevant conferences such as ENMESH and the Royal College of Psychiatrists. We will co-host a dissemination event with the National Housing Federation and share our results with the North London Service User Research Forum (SURF).
Intention to publish date
Participant level data
To be made available at a later date
Basic results (scientific)
Publication list
2019 results in https://pubmed.ncbi.nlm.nih.gov/31553550/ (added 17/12/2020)
2019 feasibility RCT results in https://pubmed.ncbi.nlm.nih.gov/31065244/ (added 17/12/2020)