In 2017 the Research and Evaluation team here at Mind reviewed over 200 articles and reports about housing and mental health. They also conducted 21 in-depth interviews with people with a wide range of mental health problems and different housing situations. The result of their findings was Brick by Brick, a review of mental health and housing. It explores the issues under 6 headings which include: -
Housing quality and neighbourhood
There is a strong association between bad housing and poor mental health, particularly in children. Problems with mental health can persist even after someone moves out of bad housing. Conversely good quality housing is key in maintaining good mental health. There is a particularly strong evidential base for the negative impact of damp, cold and mouldy property on people’s wellbeing. Overcrowding and the general characteristics of a neighbourhood are also issues which have an effect on mental health. Many of these housing problems do have solutions with energy efficiency initiatives and smart housing design having a part to play.
Everyone knows there is a housing crisis with high quality housing in short supply. Less well known is the fact that this crisis hits those with mental health problems particularly hard. They are at a disadvantage in being allocated social housing because they are assessed by local authority staff or contractors with no mental health expertise or training and their vulnerability is often downplayed to deny them housing. The process of applying for housing can be a bewildering and stressful process and vulnerable people are given very little effective support in navigating the system. The private rented sector has the highest concentration of poor housing. ‘Slum landlords’ exploit the vulnerable who have little or no power to challenge them. Additionally people with mental health problems face outright discrimination with some landlords refusing to let to them. There is often no security of tenure in this sector, with landlords able to terminate tenancies simply by serving a notice.
Moving and losing a home
People with mental health problems are much more likely to move home than those with physical problems or no health problems at all. There are complex reasons for this including the fact that they are more likely to live in sub-standard accommodation which in itself makes them more likely to move. Residential instability can itself have an effect on mental health impacting likelihood of experiencing crisis, suicidal behaviour and life expectancy. People with mental health problems are more likely to be evicted from their home. This can be for financial reasons or relate to disproportionate anti-social behaviour enforcement. Some people with mental health problems can get caught up in a cycle of eviction where they are evicted, present themselves as homeless, are rehoused in temporary accommodation, get evicted etc. Eviction can cast a heavy shadow. Even for people who do not get evicted, the threat of it can impact significantly on their wellbeing, and people living in areas where there are high levels of eviction feel an impact. A high proportion of homeless people have mental health problems particularly personality disorders and psychosis. Homelessness can exacerbate these problems.
The overall picture is unsurprisingly complex. The impact of stigma, a lack of financial security, poor quality accommodation or the sheer shortage of available housing, and the barriers that exist to getting advice and support can have a devastating impact on mental health. Together they are creating a toxic environment which is having a disastrous long-term impact on some of the most vulnerable people in our society.