Mental health and housing: making the links in policy, research and practice

Pages21-28
Publication Date01 December 2005
DOIhttps://doi.org/10.1108/17465729200500028
AuthorRobin Johnson
SubjectHealth & social care
Robin Johnson
Senior consultant
RJA Consultancy
Correspondence to:
Robin Johnson
RJA Consultancy
48 Church Drive
Carrington
Nottingham NG5 2BA
robin.rja@ntlworld.com
POLICY
21
journal of public mental health
vol 4 • issue 4
©Pavilion Publishing (Brighton) Ltd
The Victorians, like the Romans before
them, understood that the best way to
improve the health of the general
population was through sanitation and
environmental health. Today, in the 21st
century, the worst of the Victorian slums are cleared and
streets are clean. But mental health is now rivalling
physical health as a cause of public and policy concern
(Layard, 2004). Depression is projected by the World
Health Organisation (WHO, 2001) to become the
leading cause of disability and the second leading
contributor to the global burden of disease by the year
2020. In the UK, depression and anxiety have overtaken
musculo-skeletal problems such as back pain as the most
common reason for new claims for long-term sickness
benefits (Henderson et al,2005), and mental health
problems are estimated to be costing society as a whole
some £77 billion per annum – of which dedicated health
and social care services account for only one sixth
(Social Exclusion Unit, 2004). What, then, is the new
public health agenda in UK mental health policy, and
what is the role of housing and the built environment in
promoting improved mental health?
At first sight, it seems simple. Housing cannot be
regarded as incidental to community care. Goodquality,
safe and suitable accommodation is one of the
cornerstones of well-being, and for many people access
to decent housing can be the key to a better quality of
life, positive relationships with immediate neighbours,
independence and an accepted ‘place’ in the local
community.People with mental health difficulties are
no different in this respect from anyone else in society.
Alongside financial security, constructive activity and a
welcoming family or social circle, goodhousing, with
the appropriate support to help manage the ordinary
tasks of living, is one of the topmost priorities of mental
health service users (Meltzer et al,2002; Rankin, 2005)
and their carers. Yet there is strong evidence to suggest
that people who use mental health services are also at a
distinct disadvantage in the housing market. The
known facts are as follows:
people with mental health problems are twice as likely
as other respondents to report discontent with their
accommodation, and four times as likely to believe
that their accommodation makes their health
problems worse (Meltzer et al, 2002)
people with mental health problems are significantly
under-represented in owner-occupier housing –
generally the most socially valued and secure housing
in the UK (Meltzer et al, 2002)
mental health problems are high on the list of risk
factors for tenancy breakdown (Slade et al,1999);
housing-related problems, in turn, are among the most
Mental health and housing:
making the links in policy,
research and practice
This article documents policy developments at local and national level in England that reflect a
growing recognition of the role of housing and the built environment in promoting and maintaining
mental health. It first considers the evidence for the housing disadvantage experienced by people
with moderate and severe mental health problems and the negative impact of poor housing and
neighbourhood circumstances on mental health. It goes on to explore the expansion in housing-
related support and housing-based solutions in the 1990s, and the revived ambition to integrate
housing with community care and community cohesion initiatives.It concludes by describing the wor k
of the NIMHE housing reference group in co-ordinating policy guidance, promoting positive practice
in communication and co-operation between housing and mental health services, and conducting
research to fill gaps in current understanding.
Key words:
housing
community care
mental health
supporting people
inter-agency working

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