The change in mental well-being over 1 year for people with neurological disabilities and complex needs after moving into individualised housing: an exploratory sequential mixed-methods study

Background Although housing is a social determinant of health, little is known about the well-being of people with a neurological disability after moving into individualised housing from a range of previous living arrangements. This exploratory sequential mixed-methods study explored the change in well-being at 6 and 12 months post-move, addressing the need to better understand well-being trajectories among people with neurological disabilities transitioning to individualised housing. Methods Sixteen participants with a neurological disability completed the Warwick–Edinburgh Mental Well-being Scale, and interviews at pre-move, and 6 and 12 months post-move. Paired samples t-test and reliable change index compared Warwick–Edinburgh Mental Well-being Scale scores. A qualitative collective-case study was conducted for three participants with clinically reliable changes of well-being at 12 months. Results Well-being significantly increased at 6 months post-move (t(15) = 1.85, P = 0.04), with no significant improvements found at 12 months post-move. The Warwick–Edinburgh Mental Well-being Scale item of ‘feeling useful’ significantly increased at 6 months (t(15) = 3.78, P = 0.002) and 12 months post-move (t(15) = 2.42, P = 0.014). Case study analysis revealed an overarching pattern of having a secure base and three sub-patterns: doing more at home, pursuing new opportunities and developing stronger social connections. Conclusions Findings support the transition to individualised housing with results indicating increased feelings of usefulness, an important aspect of well-being. The importance of having a secure base for improved well-being is also highlighted. Further research is needed to understand what sustains well-being in individualised housing.