# Progress of rehabilitation in assisted living for mentally ill according to STAX-SA taxonomy

## TL;DR

This study examines the progress and mortality of residents in assisted living services for the mentally ill in Finland, finding that most remain at the same support level with little rehabilitation progress.

## Contribution

The study provides internationally comparable evidence on the rehabilitation progress of assisted living residents using the STAX-SA taxonomy.

## Key findings

- 18.8% of residents progressed to less supported AL, 79.3% remained stable, and 1.9% regressed.
- Mortality rate among AL residents was 4.7% over the 3-year study period.
- Progress into less supported AL was rare despite similar clinical characteristics, suggesting a shift toward custodial care.

## Abstract

The transition from institutional psychiatric care to community-based mental health services has resulted in the rapid development of assisted living services (AL) for mentally ill. Focus of the current study is to add internationally comparable evidence-based knowledge on the rehabilitation of AL residents by examining progression and mortality in relation to the level of service provided in AL units.

This study utilized data gathered from a longitudinal study conducted in Finland during the years 2020 to 2022. A total of 340 health- and social care records of residents in AL services were examined over a 3-year study period. Progression (changes in AL service level) and mortality of AL residents were explored through the level of service provided in AL units, by applying the Simple Taxonomy for Supported Accommodation (STAX-SA). Progression was grouped into (1) progressed, (2) stable, and (3) regressed.

During the 3-year study period progression was examined for 95.3% (n = 324) of the AL residents of which 18.8% progressed into less supported AL, 79.3% remained stable and 1.9% regressed into more supported AL. In the entire population (n = 340) mortality was 4.7%.

AL residents progressed into less supported AL services rarely although they had similarities in clinical characteristics. This might indicate that the development of AL services has evolved into a more custodial type rather than rehabilitation. Progress of rehabilitation in AL services should be investigated further by examining AL resident characteristics in relation to the level of service and level of support provided in AL services.