From institutions to homes: Evaluation of a housing with supportive services intervention for people with psychosocial disabilities with histories of homelessness
Bibliographic record
Abstract
Long-term institutionalization of people with mental health conditions persists globally despite emerging rights-based reforms and a shift towards community-based care. In India, efforts to facilitate community-based alternatives are emerging. This paper evaluates the outcomes of a multi-site implementation of Home Again, a housing with supportive services intervention developed in India, for people with mental health issues who are long-term residents of state psychiatric facilities. Using a single group repeated measures design, changes in key outcomes were assessed for 214 participants enrolled across nine sites in India and one in Sri Lanka over a 12-month period. Statistically significant improvements were observed in disability, quality of life, community integration, clinical symptoms and hope. Qualitative findings underscore participants' complex experiences navigating the transition, marked by a delicate balance between freedoms and constraints. The study highlights the feasibility of implementing the intervention in diverse settings, its impact on participant outcomes, and the need for comprehensive strategies to address systemic barriers to full inclusion. The experience offers insights for scaling up complex, multi-faceted interventions for marginalized populations in resource-limited settings. • Home Again improved outcomes in disability, quality of life, community integration, symptoms, and hope across among those institutionalised long-term multiple sites • Participants from government institutions showed greater improvements in disability, symptoms, and hope than private facilities • Qualitative data reveal complex navigation between newfound freedoms and lingering constraints due to social norms • Duration of prior institutionalization predicted disability outcomes, suggesting benefits of early transition
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".