Você está na página 1de 15

Housing And Homelessness 1

HOMELESSNESS AND MENTAL ILLNESS: THE RELATIONSHIP

by [Name]

Course name Tutors name Institution City/State Date of submission

Housing And Homelessness 2 Homelessness and Mental Illness Introduction A housing policy can be thought of as the efforts put in by a given government to transform a housing market(s) for the purposes of achieving social objectives. In most cases, a housing policy is meant to ensure that the general population has access to a home that is affordable. For instance, the British Conservative/Liberal Democratic coalitions housing policy is aimed at increasing the number of affordable housing units; fostering homeownership; making social housing flexible; tackling homelessness (especially for the disadvantaged such as the mentally ill) and making sure that the quality and sustainability of housing units are not compromised. The Scottish government went further by stating that all persons in the country should have a place they can comfortably call a home; that is warm, safe and affordable (Lund 2011 pg. 1- 2). Despite having ambitious housing policies, homelessness still persists in the UK. With this in mind, this paper looks, and evaluates, at how the governments, over the years, have tried in dealing with homelessness and the mentally ill. But first the paper will discuss the relationship between homelessness and mental illness. Homelessness and Mental Illness: The Relationship It has often been acknowledged that homelessness can lead to mental illness; it has also been acknowledged that mental illness can lead to homelessness. Homeless link (2011), in an independent study, found that about 42% of homeless persons seeking homelessness services suffer some form of mental illnesses. In addition, about 18% of those seeking these services had a personality disorder. This research was limited to England only. From these figures, it can be

Housing And Homelessness 3 argued that almost half of all homeless persons in the United Kingdom have some form of mental health needs. Mental illness is twice as common among the homeless population as in the general population (Crisis 2009). This simply means that there is twice likely that a mentally ill person is homeless than is housed. From this figure, it can be argued that the onset of mental health problems can either trigger or be a component of a chain of events that may lead to homelessness. In the same breath, mental illness might as well be exacerbated by homelessness. Moreover, the stresses that come with homelessness can lead to mental illnesses. This demonstrates the intimate association that homelessness has with mental illness. Housing Needs of the Mentally Ill First and foremost, the mentally ill homeless persons need a comfortable place to shelter in and proper accommodation facilities. Provision of shelter and accommodation to the mentally ill above everything else has been found to provide relatively stable housing outcomes for the mentally ill homeless persons (Rees 2009). In addition, it would be pointless to provide other services to them if their basic needs of food, shelter and safety are not met (St Mungos 2008). Therefore, they have to be provided with comfortable places if their rehabilitation is to succeed. Although providing the homeless mentally ill with shelter and accommodation is good enough, it shouldnt be the end since it is not sufficient. These persons also need specialized mental attention. This simply means that mental health services have to be provided to the places where they are housed. Dedicated mental health professionals such as psychiatrists, mental health nurses, psychologists, social and support workers and counselors have to be provided to

Housing And Homelessness 4 the newly housed mentally ill. Mental health services provision will ensure that the mental ill are adequately supported in their quest for a better life. In some cases, these services can make them overcome their mental problems and thus return to their normal, better selves. Thos will make them find their own homes and thus reduce the instances of homelessness (Randall et al. 2007). Other housing needs for the mentally ill include specialized in- house primary care, health promotion programmes, open access mental services (accessible to all at any time, missed appointments are also tolerated), assertive management, street based service provision, holistic and generalist support apart from just clinical diagnosis, talking therapies and full access to mainstream services. Most importantly, the housed mentally ill persons have to be shielded from becoming homeless again. Such assurance that they will forever have a comfortable place to stay will relax their minds. This will go a long way in promoting their mental well being (Randall et al. 2006). What the Government has done and is doing The most comprehensive government intervention dealing with homelessness and mental illness was first witnessed in 1990 when the Homeless Mentally Ill Initiative was launched by the UK Department of Health. This initiative was meant to identify and offer health services to the homeless mentally ill persons that were not under statutory health services. Specialist hostels were also funded so as to provide high level care for these persons. The Housing Corporation was also required to provide move on housing to these persons. The team that was appointed to undertake these tasks had agreed that home provision as well as mental health service provision were needed if the government was serious about dealing with homeless persons with mental health problems. This initiative was first launched in London (where the number of homeless

Housing And Homelessness 5 persons is highest) and later rolled out to other places. With time however, the funding of these specialist hostels was stopped although some of the other services are still being funded by the government (Homeless Link 2009). Before the 1990 intervention though, the Mental Health Act of 1983 was fully in force. This Act is still being applied. Section 117 of this Act instructs that homeless mentally ill persons (especially those who have been hospitalized) have to be given accommodation (care home or hostel or supported housing) as part of their aftercare plan. In addition, this Act dictates that their housing needs (care and attention) has to be arranged for in these homes. In recent times (2008), the Care Programme Approach has been modified to pay special focus to homeless persons suffering from secondary mental illnesses since they are very much a vulnerable group. This new approach stipulates that the homeless secondary mentally ill persons are to be given not only free housing but also free mental health care services as well as community social services under care coordinators (Homeless Link 2009). In 2008, the UK Department of Health (DH) and Department for Communities and Local Government (CLG) published a guide for homeless mentally ill persons entitled Getting through- Access to mental health services that was meant to explain to them how they can deal with their predicament. That same year, a guide for mental health providers was also published by the DH Housing Lin. This was an effort of enlightening these professionals on how they can deal better with homeless mentally ill persons. Around this time, the government also launched a No One is Left Out campaign that was targeted at ensuring there were no rough sleepers in the UK by 2012. Apart from giving these homeless persons shelter, this campaign was also to ensure that the mentally ill rough sleepers are given adequate mental health help (Homeless Link 2009).

Housing And Homelessness 6 Scotland has perhaps the most ambitious housing policy in the world. This is because the Scottish government has significantly strengthened the countrys statutory safety net with the hope that virtually all people in the country that are homeless will be entitled legally to rehousing by the end of 2011. To achieve this, the government proposed the gradual expansion of the conventional priority need principle, which would later be abolished. This simply means all homeless persons in Scotland should have been re- housed by the start of this year; that is, if this ambitious housing policy came to fruition. In the same breath, all mentally ill persons that were previously homeless should have been relocated to a place where their basic needs are met. This marks a very important towards their mental rehabilitation (Fitzpatrick et al. 2010 pg. 4). England and Wales have housing policies that are significantly different from the Scottish policy. Apart from the sporadic expansion of the priority need in early 2000s, they have both been vigorously implementing a sort of homelessness prevention programme in the recent past. The central government has strongly supported a housing options approach that has been growing in popularity. The model works as follows; when a household goes to a local authority seeking a housing assistance, it is subjected to a formal interview. In this interview, the household is given advice that will touch on all its other housing options. In addition, the local authorities may offer services that may include family mediation and provision of rent deposit guarantee that is aimed at discouraging the households from applying for statutory homelessness. All these strategies are meant to ensure that persons dont simply run into homelessness at any given opportunity. For instance, in the year 2008- 2009, about 130000 households were successfully persuaded to opt out of homelessness. The family mediation services can be very effective in discouraging persons from getting out of their families. It should not be forgotten that a majority of the homeless persons are single or separated (Fitzpatrick et al. 2010 pg. 4).

Housing And Homelessness 7 While the Central government makes national housing policies aimed at housing the homeless, much of the actual housing is carried out by the municipalities and local housing agencies with funding from the government. The government though has to ensure that these municipalities and agencies have enough funds, and the legal framework, so that they can adequately meet the housing needs of the mentally ill. Non governmental organizations are also actively involved in helping these housing efforts (Communities 2007). For a long time, council housing has dominated the housing policy of the UK. These council houses are mostly concerned with welfare and housing those lacking homes (Spicker). This simply means that a majority of the homeless people, including the mentally ill, are housed by the local authority housing agencies (with support from the central government). These housing agencies have many programmes that ensure that the well being of the mentally ill persons is not compromised. In general, people in these agencies seek their health needs via a number of routes although the most common one is through General Practitioner. One other common service provider is the National Health Service that has walk- in centres that offer some quick NHS services. These services are provided to all persons regardless of mental status (Randall et al. 2007 pg. 68). Primary care is also provided to the mentally ill in these housing agencies. This care has been effective in assessing the needs of these people as well as knowing best how to deal with them. It should not be lost that moderate and mild mental health problems such as anxiety and depression can be sufficiently managed through primary care. This simply means that poor mentally ill persons are well taken care of in these agencies. There are some areas whereby specialist primary care (conducted by qualified and trained mental health experts) is given fully

Housing And Homelessness 8 to mental ill homeless persons. In these areas, these persons can access these services free of charge and at any time (Randall et al. 2007 pg. 68). There are some larger agencies where the staff has been actively providing psychological and counseling therapies. In most cases, these roles are undertaken by graduate mental health care experts. A majority of them are psychology graduates that have been specifically trained in brief therapy methods that are effective in treating ordinary mental illnesses. The improvement of partnerships among social, voluntary and health sector provision facilitates faster access to sufficient treatment and support for persons with common mental problems. It also ensures that there is effective care for not only the stable and poor mentally ill but also the severe ill persons. It also ensures that services are brought closer to the people that need them most (Randall et al. 2007 pg. 68). There are some agencies that have sought the services of Gateway workers that not only coordinate but also ensure that there is timely access to mental health services. These workers work hand in hand with primary care teams, General Practitioners, A & E departments and NHS Direct to respond to persons that need immediate help: the mentally ill homeless persons (Randall et al. 2007 pg. 68). Issues of Housing the Mentally Ill Housing the mentally ill is a multi faceted process. The person being taken to a new house may not feel comfortable in the new environment which will complicate the whole process. These housing processes are selective as persons have to be eligible first before they are housed. However, the eligibility criteria have always brought about controversies since some persons may feel that they are being targeted. In addition, since these persons need constant

Housing And Homelessness 9 mental care, the government has had the tendency of housing them in a community so that services can be concentrated in the centres. Persons that need intensive mental care have to be housed in intensively supported homes. However, identifying persons that qualify to these houses is very selective such that perhaps some deserving individuals are left out (Johnson 2009). In 2011, the number of homeless persons in the UK increased by about 17%. Moreover, the number of applicants for homelessness has been growing in hundreds of thousands due to the recent recession that hit this region (Grice 2011). Since about a half of homeless persons have mental health problems, this puts a lot of pressure on the governments and housing agencies as they have to establish more houses and mental health programmes for these newly-renderedhomeless mentally ill persons. Apart from finding places for the already homeless persons, the government (through the agencies) is stretched as it has to cater for new persons entering the homeless net. Homelessness has always been linked with alcohol and substance abuse. About two thirds of homeless persons blame alcohol and drug use for their homelessness. In addition, it has been found that persons having drug addiction problems are seven times more likely to lose their homes than the non addicts (Kemp et al. 2006). There is a high positive correlation between drug abuse and mental illness. This implies that chronic drug use is an indicator of mental problems; persons that have mental issues will often try to find solace in drugs, by abusing them. This indicates that dealing with homelessness and mental illness does not just entail the provision of houses to these persons only. Apart from taking care of their mental problems, these persons need to be rehabilitated so that they shun drugs. This can be challenging to the governments and the housing agencies.

Housing And Homelessness 10 Have the Governments been doing enough? Harrott and Mathews (2007) acknowledge that there are an insufficient number of houses in the UK for all households that are in dire need of them. Cole (2007) suggests that this may be due to the diminishing role of social housing schemes. This has led to very high demand yet the supply has remained low. In his own report, Hills (2007) believes that changes in policy, especially concerning social housing, are needed if homelessness is to be truly dealt with. This is because a third of people living in these social houses are categorized in the lowest fifth of the countrys income distribution (Hill 2007, pg. 45). Local authority (social) housing grew popular after the World War I after the government deemed it fit to develop a housing system for the working class. However, this working class tag was to be ditched after the World War II. The subsidies introduced at this time favored massive, high rise house construction. However, after 1970, political support, in terms of funding, for council housing was withdrawn. As a result, social housing took a diminishing role with its main focus shifting to providing welfare and other special needs such as homelessness in the later years (Malpass & Victory, 2010). Many council houses were subsequently sold to Registered Social Landlords and tenants. At the moment, social housing has been eclipsed by rented housing and private home ownership. This has led to some scholars suggesting that it would eventually reach a dead end (King 2006). It can be argued this is the root of homelessness. While social housing shrank, private rented housing expanded. This was due to deregulation. Therefore, it can be argued that the private rented housing grew at the expense of social housing. For a long time, Englands social housing has ensured that the most vulnerable and poorest households have not been ignored when it comes to housing (Conway 2000 pg. 73). Therefore, it has limited the incidences of homelessness (Fitzpatrick & Stephens, 2007; 2008).

Housing And Homelessness 11 While social housing is concerned with welfare activities such as homelessness, rented housing is mainly concerned with enriching their owners. This shift has led to an increase in the cost of housing. As a result, many people nowadays cannot afford proper housing facilities (UK Housing Policy). There are many cases where people have been forced into homelessness since they could not afford to pay their rents. The governments policy of giving House Benefit has also increased the popularity of rented housing. This is because this House Benefit policy cannot be sustained in the long term (Cowan & Marsh 2001, pg. 325). Therefore, if rented housing is popularized at the expense of social housing, homelessness will continue to persist. The government, through its funding of local council housing, has at least ensured that the homeless mentally ill persons are well taken care of. However, its failure to support the social housing policy is to blame for the cases of homelessness that are witnessed today. The mentally ill persons are mostly incapable of living by themselves. This may imply that most of them cannot afford to pay the high rents (since most of them are incapable of doing well paying jobs). As a result, they are at a high risk of being homeless. Had the government prevented the shrinking of social housing, perhaps the number of homelessness persons would be very low. The mentally ill would have had no problem obtaining shelter. The social housing funding exclusion happened about forty years ago. Therefore the government at the time can be blamed for the current homelessness. On the other hand, the current government has made little effort to improve social housing. In fact, it has been promoting other policies such as rented housing and private homeownership, which a majority of the mentally ill persons that are vulnerable to homelessness cannot afford. The government has not shown any intention to build more council houses or revive the flailing social housing (Mullins & Murie 2006, pg. 55). Therefore, this

Housing And Homelessness 12 paper argues that the government, past- in the 1970s- and present, have not adequately with homelessness and the mentally ill. Conclusion Homelessness is a big issue not only in the UK but also in the whole world. Persons that are homeless lose so much in their lifetime; love, safety and a chance to develop their lives. As the paper has discussed, most of them lose their mental selves. Therefore, the UK governments should be lauded for taking giant steps towards addressing this issue.

Housing And Homelessness 13 References Communities and Local Government. 2007. An International Review of Homelessness and Social Housing Policy. London Conway J. 2000. Housing Policy. The Gildredge Press

Cowan D & Marsh. 2001. A Two Steps Forward: Housing Policy into the New Millennium. Policy Press Crisis. 2009. Mental Ill Health in the Adult Single Homeless Population: a review of literature. London

Fitzpatrick, S. and Stephens, M. (2007) An International Review of Homelessness and Social Housing Policy. London: Communities and Local Government. Fitzpatrick, S. and Stephens, M. 2008. The Future of Social Housing. London: Shelter Fitzpatrick, S.; Pleace, N.; Wallace, A. 2010. Homelessness: Evidence Analysis for the Triennial Review. The University of York Grice, A. (2011, September 9). Numbers of homeless people in UK up by 17 per cent - UK Politics - UK - The Independent. The Independent | News | UK and Worldwide News | Newspaper . Retrieved May 8, 2012, from http://www.independent.co.uk/news/uk/politics/numbers-of-homeless-people-in-uk-upby-17-per-cent-2351644.html

Housing And Homelessness 14 Hariott S and Matthews L. 2009. Introducing Affordable Housing. Coventry: Health and dependencies Hills, J. 2007. Ends and Means: the future roles of social housing in England. London: Centre for Analysis of Social Exclusion. Homeless link. 2009. Policy Briefing: Mental Health. London Homeless link. 2011. Survey of Needs and Provision (SNAP) Ian Cole. What future for social housing in England? (People, Place and Policy online 2007) Johnson, R. 2009. The Impact of Housing Circumstances and Housing Interventions on Mental Health and Well-Being. Journal for Public Mental Health in 2011. Kemp P et al (2006) Homelessness amongst problem drug users: prevalence, risk factors and trigger events' Health and Social Care in the Community 14 (4)

King, P. 2006. Choice and the End of Social Housing.

Lund B. 2011. Understanding Housing Policy. Bristol: Policy Press. Malpass, P. & Victory, C. 2010. The Modernisation of Social Housing in England. International Journal of Housing Policy Volume 10 Issue 1 pg 3-18 Mullins, D. & Murie, A. 2006. Housing Policy in the UK. London: Palgrave

Housing And Homelessness 15 Randall G, Britten J, Craig, T. 2007. Getting Through: Access to mental health services for people who are homeless or living in temporary or insecure accommodation. A Good Practice Guide. London: DoH, DCLG and CSIP Rees S. 2009. Mental Ill Health in the Adult Single Homeless Population. London: CRISIS/PHRU. St Mungos 2008. WhatWorks? Unpublished report. London: St Mungos Understanding Housing Policy Failures. (n.d.). UK Housing Policy. Retrieved May 12, 2012, from http://www.ukhousingpolicy.com/

Você também pode gostar