An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure
Introduction People with severe psychiatric disorders (SPD) who experience housing vulnerability have to negotiate discontinuous mental health care pathways including poor access to common rights services and an increased risk of incarceration. To reduce morbidity and improve social integration of...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2022-06-01
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| Series: | European Psychiatry |
| Subjects: | |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933822019599/type/journal_article |
| _version_ | 1797616801581891584 |
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| author | S. Loubiere A. Tinland T. Bosetti P. Auquier |
| author_facet | S. Loubiere A. Tinland T. Bosetti P. Auquier |
| author_sort | S. Loubiere |
| collection | DOAJ |
| description |
Introduction
People with severe psychiatric disorders (SPD) who experience housing vulnerability have to negotiate discontinuous mental health care pathways including poor access to common rights services and an increased risk of incarceration. To reduce morbidity and improve social integration of these people, Médecins du Monde (NGO), in association with the Ministry of Justice and APHM, is piloting the experimentation of an alternative to prison through assertive community treatment (ACT) and independent housing for people with SPS without housing who are referred to the court for immediate appearance.
Objectives
The main objective is to evaluate the effectiveness of the innovative program (AILSI) compared to usual services by assessing the duration of re-incarceration at 18 months of follow up.
Methods
The AILSI project has been certified as a Social Impact Bond, in which private investors support the program, with the guarantee that the French government will reimburse the investments if social impact outcomes are met. To measure the effectiveness and efficiency of the program, a randomized controlled study was designed: 100 patients will be included in the AILSI group (intervention) and 120 in the TAU group (usual services). Four social impact outcomes are identified: inclusion rate, signed leases rate, total length of re-incarceration and total resource use. It is a mixed quali-quanti research, which integrates a matching to administrative health and judicial databases.
Results
Inclusions are ongoing.
Conclusions
The AILSI program and the research methods used are described herein. In addition, detailed information on the limitations and strengths of the SIB system are also discussed.
Disclosure
No significant relationships.
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| first_indexed | 2024-03-11T07:45:31Z |
| format | Article |
| id | doaj.art-a0d23267b66c4292a5cd4bb80c66a3f2 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:45:31Z |
| publishDate | 2022-06-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-a0d23267b66c4292a5cd4bb80c66a3f22023-11-17T05:07:39ZengCambridge University PressEuropean Psychiatry0924-93381778-35852022-06-0165S758S75910.1192/j.eurpsy.2022.1959An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditureS. Loubiere0A. Tinland1T. Bosetti2P. Auquier3APHM, Service Epidemiologie And économie De La Santé, Direction De La Recherche, MARSEILLE, FranceAPHM, Marss, Marseille, FranceMedecins du Monde, Ailsi, Marseille, FranceAPHM, Service Epidemiologie And économie De La Santé, Direction De La Recherche, MARSEILLE, France Introduction People with severe psychiatric disorders (SPD) who experience housing vulnerability have to negotiate discontinuous mental health care pathways including poor access to common rights services and an increased risk of incarceration. To reduce morbidity and improve social integration of these people, Médecins du Monde (NGO), in association with the Ministry of Justice and APHM, is piloting the experimentation of an alternative to prison through assertive community treatment (ACT) and independent housing for people with SPS without housing who are referred to the court for immediate appearance. Objectives The main objective is to evaluate the effectiveness of the innovative program (AILSI) compared to usual services by assessing the duration of re-incarceration at 18 months of follow up. Methods The AILSI project has been certified as a Social Impact Bond, in which private investors support the program, with the guarantee that the French government will reimburse the investments if social impact outcomes are met. To measure the effectiveness and efficiency of the program, a randomized controlled study was designed: 100 patients will be included in the AILSI group (intervention) and 120 in the TAU group (usual services). Four social impact outcomes are identified: inclusion rate, signed leases rate, total length of re-incarceration and total resource use. It is a mixed quali-quanti research, which integrates a matching to administrative health and judicial databases. Results Inclusions are ongoing. Conclusions The AILSI program and the research methods used are described herein. In addition, detailed information on the limitations and strengths of the SIB system are also discussed. Disclosure No significant relationships. https://www.cambridge.org/core/product/identifier/S0924933822019599/type/journal_articleSocial Impact ContractIncarcerationhousing insecuritySevere Mental Disorders |
| spellingShingle | S. Loubiere A. Tinland T. Bosetti P. Auquier An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure European Psychiatry Social Impact Contract Incarceration housing insecurity Severe Mental Disorders |
| title | An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure |
| title_full | An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure |
| title_fullStr | An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure |
| title_full_unstemmed | An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure |
| title_short | An alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation: a potential win-win outcome of reduced recidivism and reduced public expenditure |
| title_sort | alternative to jail by assertive community treatment and housing for people with severe psychiatric disorders and insecure accommodation a potential win win outcome of reduced recidivism and reduced public expenditure |
| topic | Social Impact Contract Incarceration housing insecurity Severe Mental Disorders |
| url | https://www.cambridge.org/core/product/identifier/S0924933822019599/type/journal_article |
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