Lessons on Recovery through Examination of a Peer-Based Housing Support Project
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Abstract
INTRODUCTION: Peer-based housing support for people with severe mental illness who are at risk of homelessness is a promising, though understudied, intervention approach. OBJECTIVES: To examine how well an Edmonton pilot project implementing peer-based housing supports addressed factors contributing to independent living and recovery as described within its program design and logic model. METHODS: Retrospective chart review of case files of 5 former clients described activities delivered by peer workers and other pilot project staff. Semi-structured interviews with 4 former clients and 8 mental health therapists characterized factors associated with the expected outcomes in the logic model. Project delivery was compared to the factors that were identified in the interviews to assess the extent to which delivery could achieve the intended outcomes. RESULTS: Case files provided evidence that activities of peer workers not only addressed areas in the program design but extended beyond it, including issues related to medications, wellness, and victimization, among others. Interview data revealed additional factors believed to influence the outcomes of interest. Contrary to the project’s logic model, these factors could be better organized as a “Recovery Wheel” ecological framework with five domains: personal, intrapersonal, interpersonal, institutional, and societal. CONCLUSION: The ecological framework that emerged from this study consolidates and highlights factors identified in published recovery models and reveals others, specifically in the personal domain (cognition, personality, upbringing, and history), that have not previously been included. Results suggest that peer workers contribute to recovery and independent living through application of their lived experience. Further research is required to confirm and expand the Recovery Wheel with a larger and more diverse sample, and to explore how lived experience can be mobilized to promote recovery.