by Belinda Gazic, Marnie Deller – Mind Australia
This article was originally published in the January 2025 edition of Parity magazine. Learn more about Parity including how to access full editions.
Mental health challenges are a strong predictor of unstable housing throughout a person’s life. Without access to stable, supported accommodation, cycles of unwellness, housing instability and interactions with clinical systems persist. (1) (Brackertz, Borrowman, Roggenbuck, Pollock, & Davis, 2020).
It is not just startling statistics and numbers. Homelessness and unstable housing have a human face. This article illuminates the many challenges of homelessness through the story of Audrey who moved from long-term homelessness to stable social housing provided by the Haven Foundation. (2)
Haven residences offer a pathway out of homelessness and housing instability through a unique model for people experiencing mental health challenges. It offers high-quality individual self-contained apartments in a complex that also fosters a supportive community through shared supports and peer connections. Haven residences provide integrated, long-term social housing and onsite support from qualified mental health support workers and peer practitioners funded by a person’s NDIS plan.
A Haven Resident’s Experience of Homelessness and Unstable Housing
Homelessness is defined by people living in improvised dwellings, supported accommodation for the homeless, boarding houses, staying temporarily with others, other temporary lodgings or in severely crowded dwellings. In 2021 in Australia 122,494 people were estimated to be experiencing homelessness. (3)
Audrey discussed her experience of homelessness and unstable housing before moving to a Haven residence, explaining that, after experiencing difficulties managing her finances and her health, she found herself unemployed and at the end of her rental accommodation lease with nowhere to go. Over the next two years she cycled through psychiatric hospital admissions, emergency housing and residential subacute stays. Throughout that time, Audrey stated that she “felt quite hopeless, broken and very unwell”.
Audrey’s experience of housing instability is not uncommon with cost of living pressure and housing stress across Australia. Many people find themselves priced out of the private rental market with the median weekly rent in Victoria between $450 and $550 per week. (4) This easily swallows up an entire Disability Support Pension of just over $500 per week. (5) People living with mental health challenges may also face additional stigma in accessing a private rental in such a competitive market.
People experiencing homelessness or unstable housing are at higher risk of infectious diseases, developing chronic diseases, mental health disorders and substance abuse disorders. They often experience a lack of access to basic hygiene facilities and health care. Stigma around homelessness may also prevent people from seeking support or receiving the care they need. (6)
During Audrey’s period of housing instability, she reported that she “was very sick and only weighed 40kg” and “had real medication issues”. She struggled to get adequate nutrition, maintain her health, and manage her medication regimen due to the stress of her housing situation.
Access to assistance with finding appropriate housing can be its own challenge. Audrey came across her Haven residence at its initial opening and the organisation was able to support her application. For others, they must endure the crisis-driven and limited resourced mental health and housing systems that are often not able to provide adequate support and a clear pathway into housing and recovery. Many are stuck in temporary housing, cannot be discharged from institutions and/or do not receive mental health treatment to address their needs. (7)
Impacts of Safe, Stable Housing
Audrey has lived in a Haven residence for many years. It was the first time in her life she had stable housing and has been the longest period of time she’s lived in one place since her early childhood. When asked what having a safe, stable home means to her, Audrey explained that she “feels really comfortable” and that “this place filled all my needs”. She continued, “I’m just happy really for a roof over my head, you know, I’m not in a really bad situation or like a boarding home, you know, I’m just happy here”.
Access to stable housing has been found to have a profoundly positive impact on people’s mental health. (8) This is especially true when the housing is long term. Audrey identified that an important aspect of the Haven residence to her is “the fact that I can stay here for as long as I like” and “the fact that I’ve got a locked door”. Audrey explained how much she values her privacy and that “it’s pretty secure at the Haven”.
Another unique feature of the Haven residences is that they offer private, completely self-contained apartments. Audrey expressed how much she “loves her little unit” and that she’s been able to “decorate it the way I want to decorate it”. A common concern for people experiencing housing instability is losing their belongings: Audrey describes her Haven residence as “a safe home to store my possessions”. She also values the central location and that she can easily access local shops and amenities.
Research has shown that individuals who are homeless tend to die 22-33 years earlier than those who have safe housing, mostly due to the lack of access to healthcare. (9). Despite the worse health outcomes for people at risk of or experiencing homelessness, there is also evidence that this effect can be reversed with appropriate housing with improvements in both people’s physical and mental health. (10)
With stable housing and support, Audrey has been able to eat healthily and exercise more regularly. She explained that prior to moving to a Haven residence she “had very poor dental health” and after her move was able to get dentures. Audrey also spoke with pride about how she gave up smoking after being “a pack a day smoker”. She further explained that she “inspired quite a few other people here at Haven to give up smoking”.
Safe, secure, appropriate and affordable housing is critical for recovery from mental ill-health and for being able to access appropriate support services. (11) Audrey identified that living at a Haven residence has “allowed me to challenge myself to do things that would normally give me great anxiety”. She further explained that she “thinks small community living is ideal”, including “interacting with familiar people”. She concluded, “if it wasn’t for the Haven, I’d probably be still in share living, but having my own little apartment has made me really happy”.
Link Between Stable Housing and Lowered Clinical Support Demand
Mind’s Trajectory research, completed in collaboration with the Australian Housing and Urban Research Institute (AHURI), showed mental health challenges are a strong predictor of unstable housing throughout a person’s life. (12) (People with psychosocial disability often fall into the cracks between mental health, disability and homelessness support services. The lack of suitable housing options for people with mental health support needs leads to people being unable to be discharged safely and the ongoing cycle of clinical engagement.
The Haven model has shown a notable decrease in hospital stays for residents. The average number of days hospitalised per client before moving in was 53.1 days (SD = 111.8). After moving in, the average days hospitalised per client was reduced to 7.4 days (SD = 19.5). (13)
Before moving to Haven, Audrey was engaged in hospital and sub-acute services with an extended stay in a Continuing Care Unit, describing this time as being in a “revolving door in and out of hospital”. Since moving to Haven, Audrey has “never been back to the hospital psychiatric unit”. Having a safe, stable home with the necessary supports at Haven means residents can focus on their wellbeing and recovery.
Having NDIS Supports Integrated into Housing
The integration of psychosocial supports at Haven residences offers a unique opportunity to support people to build their independence while maintaining their wellbeing in a stable tenancy. This support is funded through a resident’s NDIS plan. Each resident’s support plan is individual to their needs but may include support with activities of daily living, building and maintaining relationships, and participating in the community. Under Haven’s support model, residents typically require substantially less funding than other Supported Independent Living (SIL) NDIS options which averaged $356,600 in 2023. (14)
Despite cost effectiveness, those with a psychosocial disability face difficulty accessing the funding they need to stay at a Haven residence. Rigid definitions about what constitutes 24/7 support limit access to dedicated funds to gain tailored home and living supports which assist independence. Integrated support can lead to more independence and actually reduce support needs over time. Audrey said having NDIS support workers has allowed her to engage more in the community. With support workers she is now “doing a whole lot of things that I probably would never done because of my severe anxiety”. This growth is possible due to the integration of supports within her home.
Integration of Individual Living and Community
Haven residences differentiate themselves from other housing with support models because they are designed with fully private apartments – promoting the resident as an independent person with choice and control over their life. Historically, many people with a disability in Australia lived in group homes due a lack of alternatives. (15) Residents in group homes often lack privacy, a choice in who they live with, and are at a risk of harm, neglect or abuse. (16) The independence of the units at Havens allows residents their own safe home while still benefitting from some additional social spaces. Haven residences include communal indoor and outdoor spaces to ensure residents can access shared spaces and participate in group activities and socialising when they choose to. Audrey explained that she’s “really embraced the community spirit of things” and when speaking of the communal spaces said, “it’s just such a nice place to be”.
Peer connections are shown to have a significant impact on people with mental health and wellbeing challenges. Research has shown that social connection has substantial impacts on both people’s physical and mental health and is a vital human need. (17) Audrey spoke fondly of the positive interpersonal relationships she’s formed with her co-residents, stating “we all tend to get along” and “it’s a real community here”. Having this community aspect in her housing has also allowed her to take the initiative and implement activities that are important to her. She explained that she has “put on dinner clubs for all the residents” and “started up can collecting” for recycling.
The Haven residences are staffed by qualified mental health support workers and peer practitioners who use their lived experience of mental health and wellbeing challenges to facilitate increased collaboration and de-stigmatisation. Research has shown that peer support offers unique benefits compared to other forms of support, including an enhanced sense of hope and empowerment, reduction in the impact of stigma, increased self-esteem and improved social functioning. (18) When speaking of the support she receives at her Haven residence, Audrey stated “the best things are that they know you or know me and it’s peace of mind.
Housing Stability Offers Hope for the Future
With stable housing, people can focus on mental health recovery, social and economic participation. Research found around half of social housing tenants reported it had enhanced their social inclusion and job prospects (19). For those with a psychosocial disability, stable housing allows them the space to focus on their recovery. (20) In contrast, people experiencing homelessness are at a higher risk of suicidal ideation and behaviours. (21). With access to stable housing and psychosocial support, people can improve their mental and physical wellbeing. For Audrey, this included her giving up smoking and taking care of her dental needs. Audrey is now forward-thinking and excited to achieve more of her goals. She made a bucket list last year and “I’ve ticked quite a few off…. I’d like to go on a boat up and down the Yarra River”.
Conclusion
Haven offers affordable, stable housing with support for people with a psychosocial disability to improve their wellbeing. Access to an individual unit within a community of others allows people the opportunity for social connectedness while maintaining their independence. The Haven Foundation has gone on to build several residences across Victoria, with plans for future expansion throughout Victoria, New South Wales, and South Australia. (22) As of December 2024, Haven residences provide a safe home for 188 people across 12 residences in Victoria.
Endnote
- Brackert N, Borrowman L, Roggenbuck C, Pollock S and Davis E 2020, Trajectories: the Interplay Between Housing and Mental Health Pathways: Final Research Report, https://www.mindaustralia.org.au/sites/default/files/Final-Report-Trajectories-the-interplay-between-housing-and-mental-health-pathways.pdf
- Not her real name – we have used a pseudonym for the article.
- Australian Bureau of Statistics 2023, Estimating Homelessness: Census, Commonwealth of Australia, accessed 18 October 2024, https://www.abs.gov.au/statistics/people/housing/estimating-homelessness-census/latest-release
- Department of Families, Fairness and Housing 2024, Rental Report Statistics – June quarter 2024, Victorian Government, accessed 18 October 2024, https://www.dffh.vic.gov.au/publications/rental-report
- Services Australia 2024, Payment Rates, Australian Government, accessed 18 October 2024, https://www.servicesaustralia.gov.au/payment-rates-for-disability-support-pension?context=22276
- National Homeless Collective 2022, Impact of Homelessness on Health, accessed 18 October 2024, https://nhcollective.org.au/impact-of-homelessness-on-health/
- Brackertz N, Wilkinson A and Davison J 2018, Housing, Homelessness and Mental Health: Towards Systems Change, https://www.ahuri.edu.au/sites/default/files/documents/2022-02/Housing-homelessness-and-mental-health-towards-systems-change.pdf
- Ibid.
- Knaus C 2024, Homeless Australians are Dying at Age 44 on Average in Hidden Crisis, Guardian Australia, https://www.theguardian.com/australia-news/2024/feb/05/homeless-australians-are-dying-at-44-on-average-in-hidden-crisis
- Australian Institute of Health and Welfare (AIHW)2024, Health of People Experiencing Homelessness,
Australian Government, accessed 18 October 2024; AIHW 2013, Social Housing Survey Shows Housing Stability Enhances Job Prospects and Social Inclusion, media release, https://www.aihw.gov.au/reports/australias-health/health-of-people-experiencing-homelessness https://www.aihw.gov.au/news-media/media-releases/2013/2013-may/social-housing-survey-shows-housing-stability-enha; AIHW, Psychosocial Disability Support, https://www.aihw.gov.au/mental-health/topic-areas/psychosocial-disability-support
- Brackertz N 2020, op cit.
- Ibid.
- Hayes L, Gibson L, Botchway-Commey E and Ballenden N 2023, Long Term Housing and Psychosocial Support Reduce Hospitalisation for People with Long Term Mental Health Challenges – a Preliminary Report.
- AIHW 2023, op cit.
- Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability 2022, Public Hearing 31: Vision for an Inclusive Australia, accessed 18 October 2024, https://disability.royalcommission.gov.au/public-hearings/public-hearing-31-vision-inclusive-australia
- Community Affairs References Committee 2015, Violence, Abuse and Neglect Against People With Disability in Institutional and Residential Settings, Including the Gender and Age Related Dimensions, and the Particular Situation of Aboriginal And Torres Strait Islander People With Disability, and Culturally and Linguistically Diverse People With Disability: Report, Parliament of Australia, accessed 18 October 2024, <https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Community_Affairs/Violence_abuse_neglect/Report>
- Martino J, Pegg J and Frates EP2015, The Connection Prescription: Using the Power of Social Interactions and the Deep Desire for Connectedness to Empower Health and Wellness, retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC6125010/
- Davidson L, Bellamy C, Guy K and Miller R 2012, Peer Support Among Persons with Severe Mental Illnesses: a Review of Evidence and Experience, retrieved from https://pubmed.ncbi.nlm.nih.gov/22654945/
- AIHW 2013, op cit.
- Brackertz N 2020, op cit.
- Murray RM, Conroy E, Connolly M, Stokes D, Frazer K and Kroll T 2021, Scoping Review: Suicide Specific Intervention Programmes for People Experiencing Homelessness, retrieved from https://pmc.ncbi.nlm.nih.gov/articles/PMC8297158/
- Haven Foundation 2024, accessed 18 October 2024, https://havenfoundation.org.au/.
This article was originally published in Parity magazine. Learn more about Parity including how to access full editions.