Is Housing First for Mental Health Community Support Possible During a Housing Shortage?

Supported housing programmes for people with chronic mental health needs have shifted towards approaches that rely on housing first, which prioritizes access to a permanent home in the community. How do support programmes with this assumption manage the market constraints of a shortage of affordable housing? The article examines empirical mixed method data (interviews and programme data) about the experience of managing this problem in the Mental Health Housing and Accommodation Support Initiative (HASI) in New South Wales, Australia. HASI provides clinical mental health services, housing support and housing if needed, for people who are not yet living independently in the community. It found that the housing shortage affected the ability of the providers to implement the intended programme design at three early steps in the support: determining eligibility; prioritizing access between people with and without housing; and managing entry to the programme when they did not have housing. As a result, some otherwise suitable applicants were not prioritized for entry into the programme or their entry was delayed until they were housed. The providers adjusted the programme to the housing market realities, which compromised the programme intentions. The policy lessons are that programmes need strategies to provide housing for people who require it; assist people to find or apply for housing; and support people while they wait for housing. These approaches enhance the coherence of programmes, build on integration mechanisms and respond to the housing context.     

The Prevention of Homelessness Revisited

Conceptual and methodological problems plague efforts to prevent homelessness. Attempts to identify individuals at risk are inefficient, targeting many people who will not become homeless for each person who will. Such interventions may do useful things for needy people, but evidence that they prevent homelessness is scant. Subsidized housing, with or without supportive services, has ended homelessness for families and played a key role in ending it for people with serious mental illnesses. Other risk factors may be less important once housing is secured. But programs that allocate scarce housing may simply reallocate homelessness, determining who goes to the head of the line for housing, not shortening the line itself. We recommend reorienting homelessness prevention from work with identified at-risk persons to efforts to increase the supply of affordable housing and sustainable sources of livelihood nationwide or in targeted communities.     

Young People, Housing Benefit and the Risk Society

This paper draws on debates about the risk society to examine the impact of the "single room rent", a restriction in the housing benefit scheme that applies to single people under 25 living in privately rented housing. Drawing on qualitative interviews in six localities in England, the paper examines young people's ability to gain access to and afford privately rented accommodation while receiving housing benefit. It argues that the single room rent restriction has not only cut their housing benefit entitlement but also created more uncertainty for young people. Consequently, it has enhanced rather than ameliorated the risks faced by young people on low incomes in the private rental housing market.     

Making a home, finding a job: investigating early housing and employment outcomes for young people leaving care

This paper presents findings from a new study of outcomes for young people leaving care funded by the Department for Education and Skills. It reports findings for a sample of 106 young people in relation to progress made in housing and employment some 12–15 months after leaving care. The generally poor employment outcomes of care leavers are acknowledged, but ingredients that make for success are also highlighted, including the value of settled care and post‐care careers, sound career planning and, significantly, the value of delaying young people’s transitions from care. Early career paths also interconnect with how young people fare in housing, in developing life skills and with other problems in their lives after leaving care. Housing outcomes were more encouraging and predominantly shaped by events after leaving care, and faring well in housing was the factor most closely associated with positive mental well‐being in young people. Some groups that are at risk of faring badly are identified, including young people with mental‐health problems, young people with persistent offending or substance misuse problems and, in some respects, young disabled people. The implications of these findings for leaving care services are considered.     

Early access and use of housing: care leavers and other young people in difficulty

This paper presents findings from a study of how care leavers access and use housing services, and what they said had helped them to do so. The sample comprised 80 care leavers, and, for comparison, a group of 59 young people (termed ‘in difficulty’) who met certain criteria of disadvantage. Care leavers were found to have fewer crisis transitions and less experience of homelessness, together with a much higher level of autonomy and support in their first accommodation, relative to other young people in difficulty. Several factors are identified that, from the care leavers' point of view, contributed to their better access and use of housing services, including having family and friends to turn to, and leaving care teams that negotiated on their behalf with housing services. The paper concludes that care leavers had more positive housing experiences than other young people in difficulty, helped by the improved preparation for independence and ongoing support available to them from leaving care teams.     

Sheltered Housing and Community

This paper considers the role of sheltered housing following the introduction of new community care arrangements in 1993 and examines the continuing uncertainty about its exact role as community care continues to develop. It reports on a study conducted in Shropshire, using a postal survey and interviews with older people and service professionals. The study highlights the importance of sheltered housing for older people, particularly in relieving them of concerns about maintenance and repairs, social isolation and security. These factors were crucial for their overall peace of mind and quality of life. While only a small proportion of tenants received help under social services' community care arrangements, the additional support, monitoring and service coordination provided by wardens helped some of them to remain in sheltered housing when residential or nursing home care might otherwise have been necessary. Sheltered housing was overwhelmingly popular with older people — but their satisfaction was closely associated with the availability and quality of the warden service. Although sheltered housing is not currently in vogue in housing policy, the paper argues that it plays a vital role in local provision for older people and needs to be more closely integrated into community care policy, while at the same time preserving the characteristics that make it popular with its residents.     

Audit of advertised housing and support vacancies for people with disabilities in Australia

The introduction of Australia’s National Disability Insurance Scheme (NDIS) has changed the way housing and support are delivered to Scheme participants. NDIS policy reform focuses on coordinated housing and support responses. These responses are guided by the Specialist Disability Accommodation (SDA) Rule, Framework and pricing and Supported Independent Living payments. To date, the National Disability Insurance Agency (NDIA) has only released limited data to understand SDA demand or inform market development. To understand changing housing and support approaches and the impact of NDIS housing policy on market responses, this research had three aims: (1) to examine the locations and characteristics of housing and support vacancies advertised for people with disability; (2) to investigate funding sources for, and providers of, these supported housing options; and (3) to examine the proportion and source of government, nonprofit and private sector funding for housing and support developments advertised. An audit was undertaken of all advertisements on the two main non‐government organisation Websites that list Australian supported housing vacancies. A total of 562 property adverts were reviewed in March 2019. Audit findings are considered in relation to the current NDIS policy context. Possible housing futures and market gaps for people with significant and permanent disability in Australia are discussed.     

Contentment and Suffering: the Impact of Australia's Housing Policy and Tenure on Older Australians

Housing policy in Australia historically has focused on facilitating homeownership and creating some buffer for those households that are not homeowners. This paper explores the implications of this policy for older Australians. What is argued is that housing tenure has become a crucial divide and that older Australians who have not had the good fortune to access homeownership or public / community housing and who are dependent on the private rental sector as a result, often find themselves in desperate circumstances. The argument is developed that the failure to put in place a housing policy which would give all citizens the ability to access adequate and affordable housing, has led to a situation where a substantial and increasing number of older Australians have untenable housing costs and minimal disposal income. The article concludes that the present policy initiatives aimed at addressing the housing affordability crisis will have little impact on the situation of older people who are currently in housing stress.     

购房：制度变迁下的住房分层与自我选择性流动

本文基于2010年广州市的千户问卷调查数据,利用内生转换回归模型,发现了住房市场化改革过程中住房分层机制中的自我选择性：在1998年前的体制内,能力强的人倾向于不购房,而在1998年前的体制外和1998年以后,能力强的人倾向于购房。在1998年前的体制内,不购房者如果购房,其住房等级会下降;购房者如果不购房,其住房等级会上升。在1998年前体制外和1998年后,那些人力资本或政治资本高的居民实际购房时,其住房等级会更高;购房者如果不购房,其住房等级会下降。由此可知,权力机制与市场机制是影响住房分层的结构因素,政治资本或人力资本的高低是住房分层的必要条件,而非充分条件。“政治资本或人力资本高的居民住房等级也高”的论断从某种意义上忽视了居民的自我选择过程。     

Contested Housing Landscapes? Social Inclusion,Deinstitutionalisation and Housing Policy in Australia

Deinstitutionalisation is represented as a major step toward social inclusion through the resettlement of disabled people residing in segregated large‐scale institutions into community‐based homes. By promoting the right to live in ordinary community residential settings, deinstitutionalisation fundamentally changes both the support services and housing arrangements of former institutional residents. In Australia, as in many western countries, debates on community care have tended to focus on the location and nature of non‐housing supports for people leaving dependent care. This focus, however, overlooks the fact that deinstitutionalisation involves a radical rehousing of people in care. This paper explores the character and implications of deinstitutionalisation in Australia as a rehousing process. It is based on a recent national research project that has examined the housing futures of people with intellectual disabilities who have been, or will be, deinstitutionalised. The paper considers the increasingly divergent socio‐political perspectives that have emerged in recent discussions about social inclusion, institutional reform and independent living and their implications for housing and community care policies.     

Challenging the exclusion of people with mental illness: the Mental Health Housing and Accommodation Support Initiative (HASI)

Without appropriate support, people with mental illness can be excluded from stable housing and social and community participation. Transitional models of support for people with acute mental illness have addressed clinical symptoms and hospitalisation, but they have not facilitated stable housing and community integration. In contrast, individualised housing models aim to improve mental health, housing and community outcomes. These programs are costly and require collaboration between agencies. This article discusses the evaluation findings of one such program – the NSW Mental Health Housing and Accommodation Support Initiative (HASI). The longitudinal mixed‐method evaluation assessed whether HASI supported people with high levels of psychiatric disability to improve housing, mental health and community participation. We discuss the challenges clients within the program faced prior to joining HASI and the changes experienced while in HASI. We conclude by drawing policy implications for programs supporting people with mental illness to live in the community.     

地理空间与住房不平等:基于CFPS2016的经验分析

与关注中国城镇住房制度改革中的体制性因素和市场能力因素对住房不平等的影响，以及着重以个体的劳动力市场处境予以解释的观点不同，本文认为，居住有很强的空间粘滞性，地理空间差异同样是理解住房不平等问题不可忽视的结构性因素。对2016年“中国家庭追踪调查”（CFPS）数据的分析发现，居民家庭房产的地区差异具有高度的统计显著性。基尼系数按地理空间分解后显示，相对于家庭收入或家庭人均收入的地理空间差异而言，家庭住房资产的地理空间差异更为突出；运用赫克曼两步回归法分析资料发现，地理空间因素不仅影响产权住房的获得，对房产产值的效应也具有高度的统计显著性。这些发现都支持了我们的基本论点：地理空间差异不只是住房不平等的外在表现，而是导致住房不平等的不可忽视的因素。关注地理空间这一结构情境对个体行为的影响及其社会不平等后果不仅有现实的政策意义，也有助于拓展当代中国社会分层研究的视角。     

Do people respond to low probability risks? Evidence from tornado risk and manufactured homes

Whether people perceive and respond to low-probability natural hazards is a research question of considerable policy relevance. We obtain evidence by considering the response of housing choice to tornado risk for manufactured homes. The vulnerability of manufactured housing, combined with its growing share of the U.S. housing market, has led to proposed mandates for community shelters in mobile home parks. Expected utility theory, however, predicts that households should account for tornado risk in their housing choice. We test for an effect of tornado risk on manufactured housing demand using cross-sectional state data, as well as counties in three tornado prone states. We find that people do respond to tornado risk; our estimates indicate that each expected annual state tornado death per million residents reduces demand for manufactured homes by about 3%. The estimated quantity effect is consistent with the market studies of the price elasticity of manufactured homes.     

Effective personalised housing support for people with disabilities – case study analysis

International policy trends favour personalised approaches to housing support for people with disabilities. Previous research is inconclusive about whether these approaches are effective compared to group home support in the way they use government resources and benefit clients, partly because it does not usually consider the experiences of people who use the support. In this research we compared six new, innovative case studies of personalised housing support to previous research about group home support. We included qualitative data about client experiences, in particular regarding social networks, decision making, community service use and participation in domestic tasks. We found that client outcomes were positive in all four categories, while the financial costs to clients and government were similar to group home support. The results offer evidence that current, personalised approaches to housing support can be an effective policy option that allows people with disabilities to make choices about how to live and participate in their communities, without increasing the cost to government.     

Allocating Homes for People with Intellectual Disability: Needs,Mix and Choice

Allocation of housing and support services for people with intellectual disability is based on three major sets of criteria: an assessment of the applicants' needs; considerations of social mix; and the applicants' own choices. This article examines the philosophical and institutional rationales underlying each of these notions and the tensions arising when seeking to achieve a balance between them. The first section of the article is based on a review of related studies in the UK, the USA and Australia, mainly on allocation policies in mainstream social housing. The second section presents original empirical work carried out in the state of Victoria, Australia, in 2007–08, illustrating some of the implications of a new balance that was created between needs, mix and choice in allocation of housing and support for people with intellectual disability. The article argues that the concepts of needs, mix and choice should be redefined in a way which reflects the interdependencies between them. Further, the article calls for more extensive mutual learning between studies of mainstream social housing and housing for people with intellectual disability.     

Alternative Housing

Many types of housing for older people that do not fit into traditional categories have been proposed, and some have been activated. A number of models are discussed, including the boarding/rooming house, cooperatives, house-sharing arrangements, hotels, mobile homes, community housing, the "granny flat," group homes, and foster homes. The ways in which each housing type meets basic residential needs are considered, including needs for a familiar environment, independence, privacy, personal security, social interaction, and social support. Most alternative housing models are of low appeal, solutions that are turned to either when other alternatives are unavailable or when personal needs happen to fit a particular alternative especially well. For both reasons, it is important to understand and foster the development of such alternatives, even if the numbers served will never be really large.     

Experiences of homelessness by people seeking asylum in Australia: A review of published and “grey” literature

This review examines the current published and “grey” literature relating to the experiences of homelessness by people seeking asylum within Australia. While many people seeking asylum have experienced homelessness during their flight, inadequate and unaffordable housing are a feature of the settlement experience for a large number of new arrivals to Australia, putting at risk their successful settlement. This study aims to explore the factors influencing access to stable housing. A systematic review of the academic literature and a search of the grey literature identified 11 articles and 20 documents related to homelessness and people seeking asylum in Australia. The academic literature included a variety of methods and approaches to the investigation of the experience of homelessness in Australia. The grey literature was more practice based, including evaluation and research reports, submissions, and newsletters. Findings suggest that experiences of homelessness are multifaceted and have a range of influences, including policy, financial stress, lack of access to education and employment, and a lack of affordable and suitable housing. Any solutions to address homelessness need to be similarly diverse. Discrimination from real estate agents and employers was also identified as a barrier to housing for many people seeking asylum, an issue that will need to be addressed at a systematic level. The lack of research published in the academic literature means that although there may be some programmes or solutions operating in the community, as demonstrated in the grey literature, this information is not being shared beyond organisation websites or subscriber lists, resulting in a lack of coherency or sharing of solutions. This review highlights the need for further attention to the factors influencing homelessness in asylum seekers, the experience of homelessness, and how these can be addressed by government and non-government led strategies and policy development.     

The unregulated private rental sector and the impact on Israeli housing market

Israel’s rapid population growth, deriving from its unique demographics, is generating a consistent rise in the demand for residential housing. The low interest rate environment in Israel since the beginning of the last decade has also contributed to the rise in demand for housing, which exceeded the available supply and led to a continuous rise in the price of housing. The various government programs all attempted to halt the rising prices, with no long-term success, if any. Policymakers focused on making ownership of housing affordable for young couples but directed their activity at repressing the demand for housing among investors and housing upgraders. This interpretive article focuses on analyzing Israel’s housing policy and indicates the built-in failure engrained in this policy, as the demand for housing in Israel is a rigid demand deriving from the country’s demographics and values and therefore attempts at repressing it are futile in essence. The housing policy aimed at making housing affordable for young people must examine, before it is finalized, their overall incentives to own housing on one hand and the obstacles they encounter that prevent them from opting for rentals on the other, and accordingly formulate the features and different terms of the policy. The research conclusion indicates the need to implement a public policy that will promote the rental alternative as an efficient way of meeting the demand for housing on one hand and of curbing the price of housing on the other.     

Question worth 20 million lives: Why federal housing assistance has not had its Obamacare

The equitable character of a policy determines its progressiveness, yet some domestic policies are more equitable than others. The question of how and why this is the case is addressed by studying federal housing and health policies in the United States, a critical case known for its rampant inequalities in both sectors. Although social equity is a fundamental aspect of welfare provision, explaining differences in coverage and government support among policy areas remains a weakness in the literature. This comparative historical analysis shows that both housing assistance and health care suffered from inequities almost as early as their inception. But a progressive reform took shape with the Affordable Care Act (ACA) and extended coverage to 20 million people formerly uninsured. This essay tackles an unsolved puzzle: Why has such grand policy reform never taken place in housing where more than 20 million people are eligible for assistance but do not receive help? We found that it is largely explained by housing assistance distinctiveness with regard to its weak constituency, racial connotation and low public concern. We conclude with the analytical payoffs of studying social equity, both for political scientists and observers of social affairs.     

Housing and Mental Health: A Review of the Evidence and a Methodological and Conceptual Critique

Despite the fact that people invest more financial, temporal, and psychological resources in their homes than in any other material entity, research on housing and mental health is remarkably underdeveloped. We critically review existing research on housing and mental health, considering housing type (e.g., single-family detached versus multiple dwelling), floor level, and housing quality (e.g., structural damage). We then discuss methodological and conceptual shortcomings of this literature and provide a theoretical framework for future research on housing quality and mental health .