By Deborah Stephenson, Associate Director of Accommodation Services, Rethink Mental Illness

As the Treasury considers its priorities for long term funding, the case for investment in mental health supported housing is stronger than ever.

This year’s Comprehensive Spending Review takes place in a unique set of circumstances. The economic challenges and uncertainty caused by the pandemic mean that the bar for government investment - high at any time – is likely to be raised again.

We can expect choices to be taken that lead to returns on investment elsewhere, or that compliment existing priorities. There is no better example of this than investment in mental health supported housing.

Rethink Mental Illness has long campaigned on the benefits of supported housing for people severely affected by mental illness. We successfully persuaded the previous government that proposed reforms to Housing Benefit would have made tenancies more insecure, limited access, and reduced investment.

Despite that success, serious challenges remain for the supported housing sector. Funding for ‘support costs’ – which in simple terms pay for the support that tenants’ need to help their recovery on issues not related to housing – has fallen dramatically since the ring fence around the money given to local authorities for this purpose was removed.

Against a broader backdrop of cuts to local authority budgets, this has meant that many services are tendered for with limited amounts of funding to pay for that support. It can be challenging to deliver the amount of support that people living with long term and enduring mental illnesses need within these financial constraints, and it goes against the principles contained in the Care Act for the type of support that should be available for people living experiencing mental illness.

In turn, this can result in increased costs elsewhere, ranging from people who become more unwell needing increased clinical support, to increases in anti-social behaviour requiring interventions from the police. Additional investment from government would help providers and commissioners deliver more tailored support for people most severely affected by mental illness, boosting their chances of recovery, and helping reduce those wider costs.

The argument that suitable housing is key to recovery from a mental illness is not new. Our Communities that Care report rightly identified it as one of the central pillars that must be in place for people severely affected by mental illness to live happy, fulfilling lives in the community, and we know that lack of suitable accommodation is a key driver of delayed discharges from hospital. Whilst this has always been true, the importance of acting on this principle has never been more acute.

From next year, we will begin to the see the roll out of the NHS Long Term Plan and the Community Mental Health Framework. This is a once in a generation opportunity to transform the clinical care that people severely affected by mental illness receive with unprecedented levels of investment. However, it is predicated on the local authority funded services that our beneficiaries need also being in place. Housing is a crucial element of this. Without a safe and secure home, there is only so much that even the best clinical treatment can do.

Similarly, we anticipate that as we approach the two year anniversary of the Mental Health Act Review being published, we will soon be moving on to the next stage of the consultation on its reform. The review was clear that unstable housing can be a trigger for crisis and that adequate resourcing of alternatives to detention was also needed. It’s clear here too that if the reform of the Act is to achieve its desired ends and reduce the number of detentions, investment in supported housing is needed.

Last week the CQC also published its report on mental health rehabilitation services. There was a small but welcome reduction in the number of area placements for people living with some of the most severe and enduring forms of mental illness. However, in the longer term the availability of local authority funded support housing services with appropriate care packages will be key to both preventing people being placed out of area and bringing them back home.

The pressing need for investment in mental health supported housing is clear and we have submitted our own evidence to Government on its benefits, including reduced inpatient costs resulting from placements in our services. We hope that the chance to realise its potential for people severely affected by mental illness, and to use it to help deliver other priorities, will be realised at the CSR.