There is a complex two-way relationship between mental health, housing and homelessness, where major life events and a person’s circumstances (e.g. mental health status, housing engagement, income, family support etc.) interact so that mental ill-health can lead to homelessness and, vice versa, homelessness may act as a trigger for mental ill-health.
How prevalent is mental ill health amongst those experiencing homelessness?
The Journeys Home survey, a national longitudinal study of factors affecting housing stability which surveyed persons experiencing or at-risk of experiencing homelessness, found that across a range of measures, the greater the level of housing instability reported, the poorer respondents’ mental health circumstances:
- Mental ill health diagnosis was highest in the ‘chronic instability, homeless’ group (78%) and lowest in the ‘stable homeless, with friends or family’ group (61%).
- Serious psychological distress was low amongst all groups but highest in those living in more unstable arrangements, such as the ‘chronic instability, homeless’ group (62%).
Does experiencing housing stress or homelessness impact mental ill health?
There is evidence to support the idea that environmental exposure to stress, such as stress related to experiencing housing instability or homelessness, can lead to mental illness.
An analysis of the Journeys Home survey for the AHURI-Mind Australia Trajectories research project identified that for those who were homeless before they developed a mental illness, the onset of the illness occurred on average nine years after first experiencing homelessness, and that it developed at a much older age than for those whose mental illness was present prior to becoming homeless or for the general population.
The decrease in mental health appeared to be limited to households in the bottom 40 per cent of income bracket, and interventions that can improve housing affordability (e.g. increase of household income, reduce of housing costs) are likely to be the most effective for low-income groups and could reduce inequities in mental health.
The Trajectories research also reveals that people living in private rental or those experiencing housing unaffordability are generally most at risk of mental ill-health under adverse circumstances. Researchers have found that mental health and social functioning worsened for low-to-moderate income households whose housing became unaffordable. The decrease in mental health appeared to be limited to households in the bottom 40 per cent of income bracket, and interventions that can improve housing affordability (e.g. increase of household income, reduce of housing costs) are likely to be the most effective for low-income groups and could reduce inequities in mental health.
Further research found that Australian private renters whose housing became unaffordable experienced a small but significant decline in mental health, while the same change in affordability for home purchasers did not, on average, alter their mental health.
How does experiencing mental ill-heath impact on homelessness?
The Journeys Home survey revealed those whose mental illness was present prior to experiencing homelessness tended to develop mental illness in adolescence and early adulthood, then a long period of time elapsed (eight years on average) before the individual first experienced homelessness.
Behaviours often associated with mental ill-health, such as anti-social behaviour, delusional thinking and the inability to prioritise finances, may make sustaining a tenancy more difficult. For those people living in public housing, these behaviours can trigger anti-social behaviour management policies which sometimes result in eviction.
Social isolation as a result of mental ill-health can further exacerbate housing crises by limiting access to emotional and financial support. Poor physical health is a common symptom of mental ill-health, and can limit a tenant’s capacity to maintain a healthy living environment in the home.