The change in mental well-being over 1 year for people with neurological disabilities and complex needs after moving into individualised housing: an exploratory sequential mixed-methods study

Abstract

BACKGROUND: Although housing is a social determinant of health, little is known about the well-being of people with a neurological disability after moving into individualised housing from a range of previous living arrangements. This exploratory sequential mixed-methods study explored the change in well-being at 6 and 12 months post-move, addressing the need to better understand well-being trajectories among people with neurological disabilities transitioning to individualised housing. METHODS: Sixteen participants with a neurological disability completed the Warwick-Edinburgh Mental Well-being Scale, and interviews at pre-move, and 6 and 12 months post-move. Paired samples t-test and reliable change index compared Warwick-Edinburgh Mental Well-being Scale scores. A qualitative collective-case study was conducted for three participants with clinically reliable changes of well-being at 12 months. RESULTS: Well-being significantly increased at 6 months post-move (t(15) = 1.85, P = 0.04), with no significant improvements found at 12 months post-move. The Warwick-Edinburgh Mental Well-being Scale item of 'feeling useful' significantly increased at 6 months (t(15) = 3.78, P = 0.002) and 12 months post-move (t(15) = 2.42, P = 0.014). Case study analysis revealed an overarching pattern of having a secure base and three sub-patterns: doing more at home, pursuing new opportunities and developing stronger social connections. CONCLUSIONS: Findings support the transition to individualised housing with results indicating increased feelings of usefulness, an important aspect of well-being. The importance of having a secure base for improved well-being is also highlighted. Further research is needed to understand what sustains well-being in individualised housing.