What are the ingredients for Intensive Home Support? When and how does it work according to clients?

Introduction: Deinstitutionalization in mental health care for individuals with severe mental illness (SMI) has been a continuous process in Europe since the 1970s. In the 1980s, the supported housing (SH) sector emerged as an alternative stay for long-term stay in clinics. In recent years, more people with SMI currently live independently in their own homes in the community. In the Netherlands, the deinstitutionalization process was given an impulse by the Dannenberg Commission's report in 2015 in which the residential SH sector needs to be renewed with the goal of greater autonomy through more flexible and intensive offers in the community: Intensive Home Support appeared. This qualitative study about IHS aims to investigate how (un)intended interventions guide desired outcomes such as recovery, social inclusion, and participation. We attempt to answer the following research questions: (1) What are the important ingredients of IHS according to clients?; (2) How does IHS works for these clients?; and (3) Under what circumstances does IHS work for these clients? Methods: We conducted longitudinal semi-structured interviews with 42 clients of three organizations for SH about their experiences with IHS, participation in society, and living independently. The transcripts were analyzed according to the CAIMeR-theory (a further development in realist evaluation) and thematic analysis. Results: We found 8 ingredients for IHS according to clients: (1) working alliance between support provider & client; (2) citizenship & autonomy; (3) significant others; (4) recognition & acknowledgment; (5) mental & physical health; (6) being part of society; (7) housing & living environment; (8) influence of government decisions on client’s life. Discussion: At the time of submitting this abstract, the paper is still work in progress. Discussion points will be available for discussion at the conference.