{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T19:16:49Z","timestamp":1772738209823,"version":"3.50.1"},"reference-count":29,"publisher":"CSIRO Publishing","issue":"5","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":3142,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,10,2]]},"abstract":"\n Objective<\/jats:title>\n The Doorway program is a 3-year pilot integrated housing and recovery support program aimed at people with a severe and persistent mental illness who are \u2018at risk\u2019 or actually homeless. Participants source and choose properties through the open rental market, with appropriate rental subsidy and brokerage support. This arrangement is highly innovative, differing from widely favoured arrangements internationally involving congregate and scattered-site housing owned or managed by the support program. The aim of the present study was to determine the effects of the Doorway program on participants\u2019 health, housing, service utilisation and costs.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A pre-post study design was used with outcome measures consisting of a number of question inventories and their costs (where relevant). The principal inventories were the Behaviour and Symptom Identification Scale 32 (BASIS-32), a consumer-oriented, self-report measure of behavioural symptoms and distress, the Health of the Nation Outcome Scale (HoNOS), an interviewer-administered measurement tool designed to assess general health and social functioning of mentally ill people and the Outcomes Star (Homelessness) system which measures various aspects of the homelessness experience. Baseline measurements were performed routinely by staff at entry to the program and then at 6-monthly intervals across the evaluation period.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n For 55 of 59 participants, total mean BASIS-32 scores (including as well three of five subscale scores) improved significantly and with moderate effect size. Four of the 10 domain scores on the Outcome Star (Homelessness) inventory also improved significantly, with effect sizes ranging from small\u2013medium (three domains) to large (one domain). Mean usage of bed-based mental health clinical services and general hospital admissions both significantly decreased (with overall net savings of A$3096 per participant per annum). Overall cost savings (including housing) to government ranged from A$1149 to A$19\u00a0837 depending on the housing type comparator.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The Doorway program secured housing for this vulnerable group with additional benefits in client outcomes, including reduced use and cost of health services. These findings, if confirmed in larger studies, should have widespread applicability internationally.<\/jats:p>\n <\/jats:sec>\n \n What is known about the topic?<\/jats:title>\n Beneficial effects of housing and recovery programs (Housing First) on people with severe and persistent mental illness and who are \u2018at risk\u2019, or actually homeless, are being demonstrated in Northern America. These effects include housing security, well being, health service utilisation and cost effects on government. However, these beneficial effects can only be regarded as settled for housing security. The highly innovative Doorway care model in which participants source and choose properties through the open rental market, with appropriate rental subsidy and brokerage support, has not been investigated previously.<\/jats:p>\n <\/jats:sec>\n \n What does this paper add?<\/jats:title>\n This paper adds new data on the Doorway care models, it\u2019s effects and costs, particularly with regard to participant behavioural distress and social functioning.<\/jats:p>\n <\/jats:sec>\n \n What are the implications for practitioners?<\/jats:title>\n The beneficial effects of this innovative model, if confirmed in larger studies, should have widespread applicability internationally.<\/jats:p>\n <\/jats:sec>","DOI":"10.1071\/ah16055","type":"journal-article","created":{"date-parts":[[2016,10,20]],"date-time":"2016-10-20T17:24:14Z","timestamp":1476984254000},"page":"573-581","source":"Crossref","is-referenced-by-count":12,"title":["Evaluation of an integrated housing and recovery model for people with severe and persistent mental illnesses: the Doorway program*"],"prefix":"10.1071","volume":"41","author":[{"given":"David R.","family":"Dunt","sequence":"first","affiliation":[{"name":"ACentre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Vic. 3010, Australia."},{"name":"HCorresponding author. Email: d.dunt@unimelb.edu.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew W.","family":"Benoy","sequence":"additional","affiliation":[{"name":"BNous Group, Level 10, 485 Bourke Street, Melbourne, Vic. 3000, Australia. Email: Andrew.Benoy@nousgroup.com.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Phillipou","sequence":"additional","affiliation":[{"name":"CDepartment of Mental Health, St Vincent\u2019s Hospital, Level 2, 46 Nicholson Street, Fitzroy, Vic. 3065, Australia. Email: Andrea.phillipou@svha.org.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura L.","family":"Collister","sequence":"additional","affiliation":[{"name":"DMI Fellowship Wellways, Fairfield Place, 276 Heidelberg Road, Fairfield, Vic. 3078, Australia. Email: lcollister@mifellowship.org"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth M.","family":"Crowther","sequence":"additional","affiliation":[{"name":"DMI Fellowship Wellways, Fairfield Place, 276 Heidelberg Road, Fairfield, Vic. 3078, Australia. Email: lcollister@mifellowship.org"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julian","family":"Freidin","sequence":"additional","affiliation":[{"name":"EHomeless Outreach Psychiatric Service, Department of Psychiatry, Alfred Hospital, PO Box 315, Prahran, Vic. 3181, Australia. Email: Julian.freidin@gmail.com"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David J.","family":"Castle","sequence":"additional","affiliation":[{"name":"FSt. Vincent\u2019s Hospital, Melbourne, Nicholson Street, Fitzroy, Vic. 3065, Australia. Email: David.castle@svha.org.au"},{"name":"GThe University of Melbourne, PO Box 2900, Fitzroy, Vic. 3065, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2016,10,21]]},"reference":[{"key":"2025121501232275100_R1","unstructured":"Nous Group. Doorway \u2013 Summative Evaluation \u2013 November 2013. Melbourne: Nous Group; 2014. 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