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The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England

Almeda, N; García-Alonso, CR; Killaspy, H; Gutiérrez-Colosía, M; Salvador-Carulla, L; (2022) The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England. PLOS ONE , 17 (3) , Article e0265319. 10.1371/journal.pone.0265319. Green open access

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Abstract

Rehabilitation services have a key role in ensuring integrated and comprehensive mental health (MH) care in the community for people suffering from long-term and severe mental disorders. MH-supported accommodation services aim to promote service users’ autonomy and independence. Given the complexity associated with MH-supported accommodation services in England, a comparative evaluation of critical performance indicators, including service provision and quality of care, seems to be necessary in designing evidence-informed policies. This study aims to explore the influence of service quality indicators on the performance of MH-supported accommodation services in England. The analysed sample includes supported accommodation services from 14 nationally representative local authorities in England from the QuEST study grouped by three main types of care: residential care homes (divided into two subgroups: move-on and non-move-on oriented), supported housing and floating outreach. EDeS-MH (efficient decision support-mental health) was used to assess the performance indicators for the selected services by combining a Monte Carlo simulation engine, data envelopment analysis and a fuzzy inference engine for integrating expert knowledge. Depending on the type of care, six/seven quality domains were sequentially included after a baseline scenario (only technical) was analysed. Relative technical efficiency scores for the baseline scenarios revealed high performance in all the selected supported accommodation services, but the statistical variability was high. Quality domains significantly improved performance in every type of care. The inclusion of quality indicators has a positive impact on the global performance of each type of care. Remaining at the corresponding services more than expected for two years has a negative impact on performance. These findings can be considered from a planning perspective to facilitate the design of pathways of care with more realistic expectations about gaining autonomy in two years.

Type: Article
Title: The critical factor: The role of quality in the performance of supported accommodation services for complex mental illness in England
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0265319
Publisher version: https://doi.org/10.1371/journal.pone.0265319
Language: English
Additional information: Copyright © 2022 Almeda et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Keywords: Monte Carlo method, Ecosystems, Housing, Statistical distributions, Quality of care, England, Psychological attitudes, Statistical data
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10147042
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