A basic need: affordable housing and mental health
By Ian Bradshaw
A new Centre for Mental Health report published today highlights how supported housing can have a substantial positive impact on the lives of people living with serious mental illness, and save money compared to other interventions.
The majority of people living with serious mental health conditions do not need supported housing. But many do need help with their housing costs in the current market. They are 50% more likely to rent than the general population, and there are large gaps in employment rates for people with mental health conditions (65 percentage points for those receiving specialist care). Otherwise they face living in poor quality, and often insecure, homes that can make their conditions worse. Already people with mental health conditions are twice as likely to be homeless as the wider population.
Since 2010, building on previous reforms, the Government has sought to reduce the costs of housing benefits for working age people and promote home ownership. We are worried that the unintended consequences of these policies will be significant.
Concerns about the impact of benefit cuts on individuals are widespread. With the local housing allowance frozen while rents continue to soar these impacts will continue to be seen. At the same time the number of new homes for social rent being built is the lowest ever recorded as homes for first time buyers are prioritised. The extension of the Right to Buy is likely to see greater numbers of existing social homes being sold. As housing association and local authorities’ incomes are squeezed, the local community and advocacy services that vulnerable tenants rely on to help them navigate the housing system and maintain their tenancies will be harder to provide.
According to the Royal College of Psychiatrists, the difficulty of finding suitable accommodation for people leaving inpatient treatment is contributing to the pressure on beds. The costs are large. In London it would be cheaper to pay for a room in the Dorchester for patients who were ready to be discharged than for them to occupy an inpatient bed they didn’t need. Clinical staff report increasing amounts of time spent supporting service users with housing issues that are affecting their health.
Elsewhere in the system landlords potentially face the costs of rent arrears. Councils face increased demands on their homelessness services, and paying for expensive temporary accommodation for those in priority need when alternatives aren’t available.
Many organisations facing reduced resources understandably concentrate on what they see as their core business. But if landlords and local authorities ignore the mental health of their residents, and if health providers ignore the housing needs of their service users, many more people could fall through the gaps and the costs to the whole system will increase.
It is vital that local health and housing services come together to stop people falling through these gaps, to understand and meet the housing needs of people with mental health problems and to avoid making false economies with very serious human costs.
Our additional briefing published today provides a more detailed look at our concerns, and where we think further work is urgently needed.
1. The Five Year Forward View for Mental Health, Department for Health (2016)
2. Sian Rees, Mental Ill Health in the Adult Single Homeless Population: A Review Of The Literature, Crisis, 2009.
3. See this example.
4. See this article.
5. Old Problems, New Solutions: Improving Acute Psychiatric Care for Adults in England, Royal College of Psychiatrists, 2016
6. “Preventing Delayed Transfer of Care and accessing settled Housing: Good practice for inpatient mental health services” London Health Programmes, (2011) p3
7. Old Problems, New Solutions, Royal College of Psychiatrists
8. Temporary Accommodation cost £660m in London alone in 2014/15. See Julie Rugg Temporary Accommodation in London: Local Authorities Under Pressure, London Councils (2016)
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