Support to access high quality housing an essential part of mental health care, says report

People using mental health services should get access to high quality housing support when they need it, according to a report.

More than shelter, by Dr Jed Boardman, found that about a third of people using mental health services have difficulties with housing, while homeless people have high rates of mental ill health. 

The report reviewed evidence about the provision of supported housing services for people with mental health problems in England. It found that there is a range of types of housing support, including help for people to sustain their own tenancies to specialist supported accommodation, hostels and crisis houses.

But it also found there is very limited evidence about what kinds of support are most effective but that most people prefer help in their own homes to being in sheltered or transitional accommodation. Every person’s needs are unique and change over time. Tenancy support, welfare and housing rights advice, education, peer support and self-management help are all widely valued.

There was also limited evidence about cost-effectiveness in relation to housing support. But small-scale studies suggest that housing support can reduce the costs of hospital stays for people who would otherwise require inpatient care. The highest quality evidence is for the Housing First approach for people who are homeless and have multiple needs including mental ill health, which helps people to get independent tenancies rather than using temporary accommodation.

More than shelter says housing support should be a right for people with mental health problems and a bigger priority for mental health services. It calls for improved provision of housing support with a wider range of services for as long as people need them. It argues that housing support should be funded jointly by local authorities and the NHS to ensure that services are delivered in partnership between health, housing and social care providers.

“Support with housing is integral to good quality mental health care,” Dr Boardman said. “It cannot be left to chance. Yet too often housing support falls in the cracks between health, housing and social care, leaving people at risk of homelessness and poorer health. 

“Recent reforms to social security and housing policies have also had a significant effect on people with mental health problems, who are more likely to be on low incomes, to rent and to be at risk of homelessness. We need to ensure that people get timely and effective help when they need it. And we need to carry out robust evaluations of different forms of housing support to find out what people find most helpful and what is best value for money.”

More than shelter was produced by Centre for Mental Health in association with the Mental Health Providers Forum and the Royal College of Psychiatrists. Funding for the research was provided by the Department of Health.