A Comprehensive Cohort Description and Statistical Grouping of Community-Based Residential Rehabilitation Service Users in Australia

Stephen Parker; Dan Siskind; Daniel F Hermens; Frances Dark; Gemma McKeon; Nicole Korman; Urska Arnautovska; Meredith Harris; Harvey Whiteford

doi:10.3389/fpsyt.2019.00798

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A Comprehensive Cohort Description and Statistical Grouping of Community-Based Residential Rehabilitation Service Users in Australia

Journal article

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A Comprehensive Cohort Description and Statistical Grouping of Community-Based Residential Rehabilitation Service Users in Australia

Stephen Parker, Dan Siskind, Daniel F Hermens, Frances Dark, Gemma McKeon, Nicole Korman, Urska Arnautovska, Meredith Harris and Harvey Whiteford

Frontiers in Psychiatry, Vol.10, 798

2019

DOI: https://doi.org/10.3389/fpsyt.2019.00798

Appears in Thompson Institute Research Collection

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Abstract

community care unit

rehabilitation

residential care

schizophrenia

severe and persistent mental illness

Other Collaborations

Thompson Institute Special Collection

UniSC Diversity Area - Disability and Inclusion

Background: Community Care Units (CCUs) are a model of community-based residential rehabilitation support available in Australia that assists people affected by severe and persistent mental illness to enhance their independent living skills and community involvement. These services have been subject to limited evaluation, and available descriptions of consumer cohorts lack relevance to the understanding of their rehabilitation needs. Method: A clinical assessment battery covering a broad range of relevant domains was completed with consumers commencing at three CCUs in Queensland, Australia, between December 2014 and December 2017 (N = 145). The cohort was described based on demographic, diagnostic, treatment-related variables, and the assessment battery. The comparability of included sites was assessed. This contemporary cohort was also compared to the pooled cohort of Australian community-based residential rehabilitation services emerging from a previous systematic review. Additionally, cluster analysis (CA) was completed in two stages based on the clinician-rated assessments: hierarchical CA (Wards method) to identify the optimal number of clusters, followed by K-means clustering. Results: Dominant features of the cohort were male sex and the primary diagnoses of schizophrenia spectrum disorders. The average consumer age was 31.4 years. Most consumers were referred from the community, had been living with family, and were not subject to involuntary treatment orders. No site-based differences were observed on demographic, diagnostic and treatment-related variables. However, some site-based variation in levels of symptoms and functional impairment emerged. Overall, the cohort was comparable with the Transitional Residential Rehabilitation (TRR) cohort defined in a previous systematic review. Through CA, a three-cluster solution emerged: Cluster 1 (15%) was characterised by higher levels of substance use comorbidity; Cluster 2 (39%) was characterised by higher levels of disability and symptoms; and Cluster 3 (46%) was distinguished by lower levels of general psychiatric symptoms. Conclusions: The cohort was generally comparable to the TRR cohort. Site-based variability in the characteristics of admitted consumers was minimal. The CA solution suggested that three different sub-groups of consumers are admitted to CCUs, which have implications for adapting the approach to rehabilitation. Recommendations include ensuring early availability of interventions to address co-morbidities and pacing rehabilitation expectations to consumers stage of recovery.

Details

Title: A Comprehensive Cohort Description and Statistical Grouping of Community-Based Residential Rehabilitation Service Users in Australia
Authors: Stephen Parker (Author) - University of Queensland
Dan Siskind (Author) - University of Queensland
Daniel F Hermens (Author) - University of the Sunshine Coast
Frances Dark (Author) - University of Queensland
Gemma McKeon (Author) - Metro South Addiction and Mental Health Services (MSAMHS)
Nicole Korman (Author) - Metro South Addiction and Mental Health Services (MSAMHS)
Urska Arnautovska (Author) - Princess Alexandra Hospital
Meredith Harris (Author) - University of Queensland
Harvey Whiteford (Author) - University of Queensland
Publication details: Frontiers in Psychiatry, Vol.10, 798
Publisher: Frontiers Research Foundation
Date published: 2019
DOI: 10.3389/fpsyt.2019.00798
ISSN: 1664-0640
Copyright note: Copyright © 2019 Parker, Siskind, Hermens, Dark, McKeon, Korman, Arnautovska, Harris and Whiteford. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms
Organisation Unit: University of the Sunshine Coast, Queensland; Thompson Institute
Language: English
Record Identifier: 99451352602621
Output Type: Journal article

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