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We must invest in housing-led approaches to mental health
The COVID-19 crisis has underlined the need for housing solutions that work for people with mental health difficulties. There should be no going back to the old way of doing things, writes Aileen Edwards
For many years the most vulnerable in our society with the highest needs have been those most excluded from services.
With high thresholds, long waiting lists, short-term, poorly funded services and tenancy-ready tests, people with multiple and complex needs have been falling through the cracks, year in and year out. Services supporting them have also been significantly undervalued.
A key impact of the current pandemic is the recognition that everyone needs a home to be safe and protect their health, both mental and physical.
A housing-led approach, where anyone without a safe roof over their head is offered a home without having to pass any tests or meet any criteria, has been rapidly implemented across the country.
More than 90% of people who were sleeping rough when the pandemic broke out are now housed. There has also been recognition of the invaluable work care and support workers do for all of us and particularly for the most vulnerable.
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For years, people have been revolving around or excluded from services. Their past trauma and disadvantage are simply exacerbated and accelerated and results in them sleeping on the streets and often using drugs and/or alcohol to get through the day.
Feelings of isolation and abandonment, as well as depression and anxiety, are common. But now housed for the first time for a long time, they are finally able to feel safe and start to engage with the services they need to rebuild their lives and look to the future.
Giving people a home, no questions asked, building their trust, working with them to identify what they want and need and starting to work with them to meet their goals are not new.
Housing First is a tried and tested housing-led model with wraparound support, which has successfully housed people previously failed multiple times by the system, across a number of countries including the UK. The benefits to individuals, communities and the public purse are tremendous.
We know that people who are street homeless are likely to have mental health problems. In a 2014 survey, Homeless Link said this figure was 80%.
On top of this, services are now concerned about an anticipated 30% increase in demand for mental health support as a result of the coronavirus pandemic. In Bristol, we’re the lead partner of the Golden Key programme, which works with a group of people with complex needs.
We’ve been running a small Housing First project helping house 22 people, all of whom have found it impossible to find permanent housing in the past, and many whom have been sleeping rough for years. One client was housed after 32 years on the streets. We were told that most of our Housing First clients were ‘unhousable’ – and yet through our personal approach and the support of partners, they all have homes.
What’s more, our Housing First clients are in a better place to address their mental health problems. Over the past two years we’ve seen the incidence of self-harm, and levels of stress and anxiety, fall significantly.
“Our experiences during the COVID-19 crisis show that we must now invest in housing-led mental health approaches to ensure people have security, safety, choice and control in their lives”
This, alongside an 83% reduction in A&E admissions, shows that when people have a home and the right support, they can address their mental health needs in a more planned and more cost-effective way.
We cannot return to the old way of working. Our experiences during the COVID-19 crisis show that we must now invest in housing-led mental health approaches to ensure people have security, safety, choice and control in their lives.
We know that with long-term, flexible, personalised and psychologically informed support, the most excluded people in our communities can start to feel able to live healthy lives and can finally start to feel valued and included.
Aileen Edwards, chief executive, Second Step
