Tackling homelessness directly helps to reduce mental health issues

HAVING a safe and stable home is vital. For the most vulnerable and unwell, cycles of homelessness, unstable housing and poor mental health can become their total life experience. All Australians are at risk of homelessness at transitional periods of their lives, for example when leaving a relationship, losing a job, or being discharged from hospital or prison.

By supporting people at these transitional points in their lives the cycle of homelessness and welfare dependence can be avoided.

The present situation in Australia is appalling. More than one in five people aged 15 to 64 who are admitted to a mental health service are assessed as having significant problems with their living conditions. Thirteen per cent of people with a mental health difficulty have reported being homeless after they were discharged from hospital. The housing assistance needs of Aboriginal and Torres Strait Islander people with a mental health difficulty are five times the rate of non-indigenous Australians.

Yet there is reason to hope. The results of a three-year housing-first pilot by Mission Australia ­offers new evidence that when housing is provided alongside “wraparound” services, it not only helps solve homelessness but also makes sound economic sense.

The Michael’s Intensive Supported Housing Accord project has provided long-term housing combined with holistic case management support to help 74 men to break the cycle of long-term homelessness in Sydney.

After the first year, almost 100 per cent of participants had maintained their tenancy and estimated savings were $8000 a person a year when impacts such as fewer admissions to hospital and police calls are taken into consideration. In addition, programs from the Haven Foundation housing project in Melbourne’s South Yarra (in which this author and his family are involved) have been highly successful in stabilising the lives of people with persistent and serious mental health issues.

Through our work at the National Mental Health Commission, we know that homelessness plays a significant role in those with lived experience of mental ill health. Many homeless people have experienced traumatic events and tragedy in their life. More than half the people who have been homeless have also had a mental health disorder in the previous 12 months.

We also know that having a home is much more than just shelter. A home provides a base to lead a contributing life, and it is a critical foundation for recovery from mental illness. It is also a core human right. People with mental health difficulties need to be secure from the threat of eviction and fear of homelessness. Access to stable and safe places to live must increase as a matter of ­urgency.

The MISHA project demonstrates another essential factor that is a theme of our work at the commission: integrated wrap­around services are critical to ­effective support.

For the men in the pilot program, this included education in home budgeting and bill paying, psychological support and other services specific to their needs.

This last point highlights one other important thing. If we are to reduce and eradicate homelessness among people with mental ­illness and others who are vulnerable, then we need to ensure Australia has a consumer-centred system. This means exploring new models that encourage NGOs and private sector providers to work alongside each other and with government — to wrap tailored support around people, giving them the best chance of avoiding or breaking out of a cycle of social disadvantage and exclusion.

Allan Fels chairs the National Mental Health Commission.