Home Again is a community-based housing and support program for individuals with persistent mental health conditions who have experienced long-term institutionalization. It enables small groups to live in rented homes within rural or urban neighborhoods, fostering inclusive, choice-based living. Each home has a few residents supported by trained personal assistants, mostly rural women without formal mental health training, who provide individualized, recovery-oriented support. The program offers - social care, healthcare access, case management, and recreational opportunities.

Over 12 months of living in community-based housing, participants showed reduced disability and psychiatric symptoms, and reported better quality of life, greater community integration, and increased hope, especially those from government institutions. The program fostered autonomy, social connections, and a sense of belonging through shared living and daily support from trained personal assistants. Qualitative insights revealed that participants valued freedom, routine, and companionship while also navigating ongoing challenges of identity, stigma, and independence. The model proved scalable and adaptable across settings.

Autonomy, relationships, and choice improve psychiatric symptoms by restoring control, reducing stress, and enhancing self-worth. When people make their own decisions and feel heard, they experience less helplessness and more agency, which is key for recovery. Supportive relationships reduce isolation, provide emotional safety, and buffer distress. Together, these factors stabilize mood, reduce anxiety, and improve functioning by addressing the social roots of psychiatric symptoms, not just their clinical expression.

No studies have reported serious adverse events, but we acknowledge that risks such as community stigma, interpersonal conflicts in homes, and the need for ongoing supervision of non-specialist support staff to ensure safety and continuity of care.