Trajectories of recovery among formerly homeless adults with serious mental illness

Deborah K. Padgett, Bikki Tran Smith, Mimi Choy-Brown, Emmy Tiderington, Micaela Mercado

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Objective: Recovery from mental illness is possible, but individuals with co-occurring disorders and homelessness face challenges. Although a nonlinear recovery course is assumed, few studies have analyzed recovery over time. This mixed-methods study examined recovery trajectories over 18 months after enrollment in supportive housing programs of 38 participants with DSM axis I diagnoses. Methods: Qualitative interview data were quantified through consensual ratings to generate a recovery score for four waves of data collection based on eight recovery domains culled from the literature. Case study analyses were conducted of participants whose scores varied by one standard deviation or more between baseline and 18 months to identify which domains were important. Results: Most of the 38 participants (N=23) had no significant change in recovery; seven had a negative trajectory, and eight had a positive trajectory. Case studies of these 15 participants indicated domains that contributed to change: significant-other relationships (N=9), engagement in meaningful activities (N=9), mental health (N=7), family relationships (N=6), general medical health (N=5), housing satisfaction (N=5), employment (N=2), and substance use (N=1). Except for mental health and substance use (which contributed only to negative trajectories), the influence of domains was both positive and negative. Domains were intertwined; for example, variation in relationships was linked to changes in meaningful activities. Conclusions: This study showed little change in recovery over time for most participants and a decline in mental health for a small minority. Findings underscore the importance of social relationships and meaningful activities among individuals with serious mental illness, who experience complex challenges.

Original languageEnglish (US)
Pages (from-to)610-614
Number of pages5
JournalPsychiatric Services
Issue number6
StatePublished - Jun 1 2016
Externally publishedYes

Bibliographical note

Funding Information:
This project was supported by grant R01-MH084903 from the National Institute of Mental Health. The authors thank the study participants.


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