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Research and Practice
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Having a home which is both safe and affordable is extremely important for general health. If you have poor housing or are homeless, it can increase your chances of developing a mental health problem, or can make an existing one harder to recover from.The type of accommodation and support that is most suitable is likely to change throughout life. However, finding a place to live that feels comfortable and supportive can make a huge difference to mental health.
There is plenty of evidence from the UK to highlight the negative links between poor housing and mental ill health:
- Around 62% of homeless people have a mental health problem and many of those struggle with debts, housing insecurity and unemployment
- Children living in poor housing are more likely to have behavioural problems including aggression, hyperactivity and impulsivity
- Children who’ve been in temporary accommodation for more than a year are three times as likely to have mental health problems, including depression and anxiety
- 15% of male and 19% of female sentenced prisoners were not in permanent accommodation before going into custody
- 40% of children in youth custody have been homeless or sought formal housing support
Read Housing and Mental Health (PDF) by the NHS Confederation Mental Heath Network (UK), 6th December 2011
Housing and mental health A guide to housing and mental health, with information about the impact of housing on your mental health, common problems and how to access support. Includes guidance on the pros and cons of different types of housing. Produced by Mind (England)
(Source: Housing and mental health: challenges and opportunities, 2014)
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Publications (date ordered)
Housing and mental health, Mental Health Network, NHS Confederation, 22011, UK A guide to housing and mental health, with information about the impact of housing on your mental health, common problems and how to access support. Includes guidance on the pros and cons of different types of housing.
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Research and Practice
The importance of housing in mental health recovery: a new briefing for mental health providers and housing associations
This Mental Health Network briefing, produced in association with the National Housing Federation, outlines a number of routes that mental health providers and housing associations may wish to explore together to improve quality and reduce costs.
A settled home is vital for good mental health. People with mental health problems are far less likely to be homeowners and far more likely to live in unstable environments.
Support with housing can improve the health of individuals and help reduce overall demand for health and social care services. Ensuring service users have a suitable and settled place to live can aid recovery from mental health problems.
Key points from the report include:
- Good housing is critical for good mental health
- No health without mental health (the cross-government mental health outcomes strategy) stresses the importance of housing for mental health
- Without a settled place to live, recovery can be significantly impeded
- Financial pressure increases the need to innovate and deliver services in more cost effective ways
- Addressing housing need within the care pathway can contribute to meeting the QIPP (Quality, Innovation, Productivity and Prevention) challenge
- By working in partnership, mental health providers and housing associations can deliver better outcomes for service users
The value of integrating housing, care and support This report, aimed at local commissioners of health and social care, tells the real stories of five people who receive integrated care, housing and support. Each service shows local authorities, housing providers, GPs and acute trusts working together to provide an alternative care pathway which reduces the demand an individual has for other services, as well as improving their quality of life. National Housing Federation (UK), 2013
Health, mental health and housing conditions in England (2010) Research looked into the relationships between poor housing conditions, fuel-related debt and other indicators of poverty. We also examined associations with mental health, physical health and disability. This is one of the few social research studies to have investigated the relationship between fuel-related debt and mental health. NatCen Social Research
Psychiatric morbidity and people’s experience of and response to social problems involving rights Balmer N et al, 2010, Health and social care in the community 18(6), 588-597 Psychiatric morbidity has been shown to be associated with the increased reporting of a range of social problems involving legal rights ('rights problems'). Using a validated measure of psychiatric morbidity, this paper explores the relationship between psychiatric morbidity and rights problems and discusses the implications for the delivery of health and legal services. New representative national survey data from the English and Welsh Civil and Social Justice Survey (CSJS) surveyed 3040 adults in 2007 to explore the relationship between GHQ-12 scores and the self reported incidence of and behaviour surrounding, rights problems. It was found that the prevalence of rights problems increased with psychiatric morbidity, as did the experience of multiple problems. It was also found the likelihood of inaction in the face of problems increased with psychiatric morbidity, while the likelihood of choosing to resolve problems without help decreased. Where advice was obtained, psychiatric morbidity was associated with a greater tendency to obtain a combination of 'legal' and 'general' support, rather than 'legal' advice alone. The results suggest that integrated and 'outreach' services are of particular importance to the effective support of those facing mental illness.
Supported housing for people with severe mental health disorders (Review). Chilvers R, Macdonald G and Hayes A, 2010 Oxford: Wiley Dedicated schemes whereby people with severe mental illness are located within one site or building with assistance from professional workers have potential for great benefit as they provide a 'safe haven' for people in need of stability and support. This, however, may be at the risk of increasing dependence on professionals and prolonging exclusion from the community. Whether or not the benefits outweigh the risks can only be a matter of opinion in the absence of reliable evidence. There is an urgent need to investigate the effects of supported housing on people with severe mental illness within a randomised trial.
Housing and Mental Health: A Review of the Evidence and a Methodological and Conceptual Critique Gary W. Evans , Nancy M. Wells, Annie Moch,Journal of Social Issues, Vol. 59, No. 3, 2003, pp. 475--500 h Despite the fact that people invest more financial, temporal, and psychological resources in their homes than in any other material entity, research on housing and mental health is remarkably underdeveloped. We critically review existing research on housing and mental health, considering housing type (e.g., singlefamily detached versus multiple dwelling), floor level, and housing quality (e.g., structural damage). We then discuss methodological and conceptual shortcomings of this literature and provide a theoretical framework for future research on housing quality and mental health.
Housing quality and mental health Evans, Gary W.; Wells, Nancy M.; Chan, Hoi-Yan Erica; Saltzman, Heidi Journal of Consulting and Clinical Psychology, Vol 68(3), Jun 2000, 526-53 This study examined the potential link between housing quality and mental health. First, the development of a psychometrically sound, observer-based instrument to assess physical housing quality in ways conceptually relevant to psychological health is reported. Then 2 different studies, including a prospective longitudinal design, demonstrate that physical housing quality predicts mental health. Possible underlying psychosocial processes for the housing quality–psychological distress link are discussed.
An Overview of Surveys of Mental Health Consumers' Preferences for Housing and Support Services Beth Tanzma, Psychiatric Services, Volume 44 Issue 5, May 199>3, pp. 450-455 The author examined the methodology and results of studies that surveyed mentally ill clients' preferences related to housing and support services to gain an overview of demographic characteristics, current and preferred housing situations, and preferred types of staff supports and social and material supports in a nationally representative sample of clients. Methods: Through mailings to state departments of mental health and local mental health providers and advocates, a national survey of residential providers, and other contacts with mental health agencies, the author identified a total of 43 studies of mental health consumers' preferences for housing and supports conducted between 1986 and 1992. The results of26 of the studies whose methodologies permitted comparison of findings were summarized. Results: Consumers consistently reported that they would prefer to live in their own house or apartment, to live alone or with a spouse or romantic partner, and not to live with other mental health consumers. Consumers reported a strong preference for outreach staff support that is available on call; few respondents wanted to live with staff Consumers also emphasized the importance of material supports such as money, rent subsidies, telephones, and transportation for successful community living. Conclusions: To accommodate consumers' preferences, mental health systems should work toward providing flexible supports corresponding to the episodic nature of psychiatric disability and should expand their advocacy for affordable housing and for increased income for people who depend on disability benefits and other entitlements.