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Unit for Social and Community Psychiatry

QuEST: evaluating supported tenancies


Despite the economic cost of supported accommodation for people with mental health problems, and the complex needs of those who use them, there has been very little research to investigate the types of support delivered and their effectiveness.  The QuEST project centres on bridging the evidence gap on the quality and effectiveness of three forms of supported accommodation: Residential Care, Supported Housing, and Floating Outreach.

This project aims to deliver: the first standardised quality assessment tool for supported accommodation; a detailed description of supported accommodation services across England and those who use them; evidence on clinical and cost-effectiveness of these services; detailed accounts of the experiences of the staff and service users working and living within these services; and an exploration of the feasibility of a trial to test the clinical and cost effectiveness of two models of supported accommodation. 

Research Questions

  • To adapt a toolkit that assesses quality of mental health rehabilitation units for the assessment of supported accommodation for people with mental health problems.
  • To describe provision of supported accommodation in England and to investigate service and service user factors associated with positive outcomes and service costs.
  • To explore staff and service users’ perspectives on the purpose and approach in supported accommodation services.
  • To test the feasibility of a randomised evaluation of two supported accommodation models.

Research activities

  • The first stage of the project is to adapt an existing quality assessment tool and an existing patient reported outcome measure of treatment satisfaction for mental health supported accommodation services, through review by a service user reference group, an expert panel, and focus groups with staff and service users from the three main types of supported accommodation in England: residential care, supported housing, and floating outreach.
  • The second stage of the project will be a survey of a nationally representative sample of 90 supported accommodation services in order to describe and compare the types of services, their costs, their users and user experiences of care, and to follow up 450 service users to identify outcomes 30 months later including whether they moved on successfully from the service.
  • The third stage is to carry out in-depth interviews with a subsample of service users and staff to identify the aspects of supported accommodation care they consider most useful and the challenges in providing them.
  • Finally the findings from the earlier stages of the project will be used to design a pilot trial comparing two existing models of supported accommodation (supported housing and floating outreach), and to determine the feasibility of conducting a definite trial in the future.


To follow in due course.

Project website


Dr Sima Sandhu
Prof. Stefan Priebe

Associated papers

Fakhoury, W.K.H., Murray, A., Shepherd, G. and Priebe, S. Research in supported housing. Social Psychiatry and Psychiatric Epidemiology, 2002, 37: 301-15.

Priebe, S., Saidi, M., Want, A., Mangalore, R. & Knapp, M. Housing services for people with mental disorders in England: patient characteristics, care provision and costs. Social Psychiatry and Psychiatric Epidemiology, 2009, 44:805–814. 


Programme Grant for Applied Research, National Institute for Health Research

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