Last November, housing staff at one housing association were confronted with a tenant claiming to have a bomb in his bag; in another incident, an officer from another housing provider claimed to have been held hostage by a man who believed there was an alien outside his home.
In both incidents, the tenants involved had mental health issues. Housing providers are concerned that growing numbers of tenants with mental health issues are ending up in general needs housing, where they do not receive the help provided in specialist supported housing. A recent survey by Inside Housing reveals a 14% fall in spending by councils on people with mental health issues in supported housing since 2011–12, based on 250 English councils that responded to Freedom of Information requests,
Between 2011 and 2017 there will have been a drop of nearly £7.3m in spend on people with mental health in supported housing by the 47 councils in England that responded fully to the survey. In 2011–12, those councils’ combined budget, including both commissioned services and those they pay for directly, was £50.9m; this year’s budget is £43.6m.
This squeeze on council spending has put pressure on other housing providers, including housing associations. “We have noticed councils are seeking to reduce the amount of specialist accommodation they procure for adults with mental illness,” says Alex Reeve, regional director of London supported housing at housing association Family Mosaic.
Supported housing has been operating within a constricted funding environment for years. Supporting People funding – a national programme for housing related support made available to councils in England – dropped from £1.8bn when it started in 2003 to £1.6bn in 2014–15. That equates to a 38% fall in real terms.
Ministers have given supported housing a one-year exemption from the 1% rent reduction announced in last year’s summer budget, while in September the government said it would transfer top-up money to councils for the service to counter its planned housing benefit cap.
But supported housing providers say the threat of funding cuts has already affected business. Among the 250 councils that responded at least in part to Inside Housing’s FOI requests, there is a wide range of provision for tenants with mental health conditions: some have specialist units, some do not; a handful have floating support for their general needs stock, most do not; others have budgets for specific conditions – such as hoarding – while others have no housing budget at all allocated to people with mental health needs
Chris Hampson, chief executive of Look Ahead, which provides care, support and housing services across London and the south-east, says councils are cutting back on supporting those with less serious mental health issues to concentrate on those with more acute needs. “A lot of the preventative services have been cut back,” says Hampson, who believes further cuts are to come.
This, he says, is short-sighted: “If you take money out of the lower-end preventative services, in the long run more money is spent because people end up back on the streets or in hospital.”
Richard Colwill, media manager at mental health charity Sane, says the FOI results show the budgetary crisis across the board for mental health provision, which is of deep concern for the charity. “Mental health has always been a ‘Cinderella service’,” he explains, and cuts to services are a false economy: if what initially appears to be a tenancy problem is not addressed early, it can develop into a much more complex issue and they can find themselves supporting a customer experiencing mental health issues. “Care in the community only works if there is provision for people in the community,” he says. “Housing is a really big issue for us. Losing a home or being in fear of losing your home can be a trigger to push someone into crisis.”
While most councils have cut spending on mental health in supported accommodation, the FOI responses reveal some exceptions. In 2016–17 Ealing spent £1.6m on mental health in supported housing, up from £1.2m in 2011–12. “We recognise the benefits of supported living in enabling people to live as independently as possible in the borough while getting appropriate care from professionals,” a spokesperson for Ealing says. “We also find that supporting people to live in the local area near to family and friends can have a positive impact on their well-being.”
In Yorkshire, Wakefield council is another bucking the trend, with its supported housing mental health budget growing 15% in the past five years. It is also developing an innovative strategy to address the issue. Wakefield and District Housing has partnered with NHS Wakefield Clinical Commissioning Group to employ mental health support workers to work with tenants. The council, which still manages the local housing register, can give applicants with mental health needs extra priority. Jon Feasey, a service manager for vulnerable adults at Wakefield Council, says the council sees tackling mental health as an important frontline service. “It has a preventative outcome that can create real efficiencies by preventing homelessness.”
Feasey believes the right place for people with mental health needs is in the community but that people need support in their homes – including those with less acute mental health needs who can slip through the net. As well as preventing homelessness, the support can also help reduce unplanned hospital admissions, he says.
This is an edited extract from an article originally published by Inside Housing (£).
World Mental Health Day on 10 October focuses this year on psychological first aid and providing support to those in distress
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