Supported housing combines housing with support services to create a safe place to call home. However, too many people are not getting the quality of experience they deserve. Rethink Mental Illness Policy Manager, Harvey Crawford explores the findings of our new publication, delivered with New Philanthropy Capital.

The report, ‘The long journey home: understanding and improving the supported housing system for people living with mental illness’ aims to improve the supported housing system. 

The important role of supported housing 

It is challenging to maintain good mental health without a safe, stable and affordable place to call home. But for too many people living with a mental illness, this remains out of reach.  

Only 58% of people currently in contact with community mental health services live in stable and appropriate accommodation.  

This is why housing is a priority for Rethink Mental Illness. We work to improve this situation through our influencing and campaigning work, and our own services. 

Supported housing has a pivotal role to play in addressing this challenge. 

These settings can offer a safe environment in which people can: 

• Recover following a mental health crisis and/or stay in hospital 
• Receive support to manage mental and physical health issues 
• Build their confidence 
• Establish goals and develop skills that will help them to live more independently in their local community

Effective supported housing is a good thing for both people and society - reducing homelessness and helping people to leave hospital when they are ready.  

The National Housing Federation has calculated that these services save the public purse a massive £12k-15k per person per year. 

Poor experiences of supported housing 

Too many individuals are still having poor experiences during, before and after their time in supported housing. Many also struggle to access these services in the first place. 

We need to better understand these issues, so that we can be part of the solution. This is the basis for our new report, ‘The long journey home: understanding and improving the supported housing system for people living with mental illness’. 

The publication gets to grips with the challenges and barriers that people with severe mental illness face as they navigate these services, and their causes.  

It is based on a system model developed by our partners at New Philanthropy Capital. System models are a great tool for understanding the complexity of systems, such as the NHS, social care, and housing, and how these interact. 

Key findings: 

• Too many people’s journey begins with a missed opportunity for prevention – unable to access supported, social or private-rented housing, mental health needs can escalate, sometimes resulting in an avoidable hospital stay.  

• People looking to access housing with support are likely to face multiple assessments from parts of the system that aren’t joined up and don’t talk to one another, ‘competing’ for limited resources with others in need. For people ready to leave hospital, this can result in needless additional days in inpatient care at significant expense to the NHS.  

• Even those that secure a place in supported housing may find that environment or support available is of a poor quality or is unsuitable for their needs. In the worst-case scenario, supported accommodation settings may even be unsafe or involve proximity to triggers or stressors such as drugs.  

• It can then be challenging to find suitable accommodation that allows someone to move on from supported housing. Poorly managed transitions sometimes result in people losing access to support, damaging recovery and sometimes resulting in readmission. 

Statistics: 

• The National Housing Federation has identified a 210,000 shortfall in necessary supported housing units across all groups, set to rise to 350,000 by 2045.  

• NHS England statistics show that the number of days of delayed mental health hospital discharge resulting from a lack of available supported accommodation increased by 70% between August 2021 and July 2022. 

This situation is not beyond fixing

The system is not too complex, nor these challenges too entrenched to bring about meaningful change. 

Our new report identifies five enablers, changes to policy or ways of working, that show potential for delivering a better system.  

1. Flexible and innovative uses of capital funding for supported housing – introducing greater flexibility into government grant funding to unlock multi-sector action and new development of supported housing. 
   
   
2. Adequate, sustainable and long-term revenue funding for health and social care – a new approach by government to revenue funding for social care to generate a confident commissioning environment for supported housing. 
   
   
3. Partnership approaches to housing, health and care – embracing the philosophy that housing is everyone’s business, for a strategic and data-driven approach to supported housing at a local, system and national level. 
   
   
4. Modern and joined-up community mental health services – sustaining emerging models of community mental health care, integrating housing professionals and providers as key partners within. 
   
   
5. Pioneering new approaches to improve access to mainstream housing – making creative partnership approaches that support people’s access to social and private renting the norm. 

These suggestions have been drawn from Rethink Mental Illness and NPC’s research to this point, as well as our organisation’s experiences of bringing about this kind of change.

They are also by no means exhaustive, and we are not naïve to the complexity of the challenges. This report represents the beginning of our journey and is intended to provoke discussion about possible solutions. 

If you want to be part of the conversation, email harvey.crawford@rethink.org.