INVESTIGATING THE ASSOCIATION BETWEEN FEATURES OF THE ENVIRONMENT AND PARTICIPATION FOR PEOPLE WITH COMPLEX MENTAL HEATLH DIFFICULTIES IN MENTAL HEALTH REHABILITATION SERVICES

Abstract

Background: This research investigates the influence of environmental features on the participation of individuals with Complex Mental Health Difficulties (CMHDs) in supported accommodation. The study aims to understand how physical and social environments affect the daily lives and rehabilitation outcomes of residents. Through a comprehensive literature review, the study highlights the importance of participation and participation-related factors such as motivation, habits, roles, responsibilities, and skills. The literature review emphasises the significance of social participation and explores its influence on creating a facilitative and supportive supported accommodation environment. Methods: The research consisted of two studies: a systematic review and a secondary data analysis. The systematic review aimed to identify participation and participation-related factors in the current literature. The review used available data in the studies to calculate an association between the level of support and participation. The secondary data analysis utilized a dataset from one NHS health board to identify an association between social and physical features of the environment and participation and the level of support. The study employed the Residential Environment Impact Scale to measure the features of the environment and utilized a series of univariate and multivariate regression models. Results: The results found a significant association between social features of the environment, specifically ‘Enabling Relationships,’ and both participation and the level of support. The results also identified a significant association between age and both participation and the level of support. The use of various models highlighted the importance of the features of the environment as a significant independent variable when accounting for various confounding variables. Conclusion: The study highlights the importance of the social environment over the physical environment when assessing participation. Results suggested that individuals with better social environments were more independent and had higher levels of social participation. The study challenges the current consensus on variables used to assess the quality of the support environment and highlights the importance of social features of the environment when assessing participation in supported accommodation. It encourages a shift to more holistic approaches and advocates for the use of reliable measures of the environment.