Improved discharge planning and service coordination is urgently needed, according to the RMIT University-led research for the Australian Housing and Urban Research Institute (AHURI).
Experts from RMIT, UNSW and Curtin University examined housing, health and social care supports for individuals leaving residential treatment for mental health or substance use problems.
Lead author RMIT’s Associate Professor Cameron Duff said failure to adequately plan for and support safe transitions from residential treatment into secure and affordable housing can have catastrophic consequences for people leaving care.
“It can have strong impacts on their housing security, their health and wellbeing, and their economic and social participation in the community,” Duff said.
“Our research strongly endorses the ‘housing first’ model, where a person who is facing homelessness is given a roof over their head even before other forms of psychiatric or drug rehabilitation are provided.”
The peer-reviewed research found accessing affordable housing was particularly challenging for young people with health and social problems.
One potential solution offered was housing assistance that gives youth more freedom to choose where they want to live.
Young people’s often insecure income makes them less appealing to community housing providers, while social housing can be unattractive because it often means relocating far away from social and medical support networks.
Duff said it would be better to have a scheme that allows youth leaving rehab to access affordable housing through a variety of means, including private rental, giving them more freedom of choice.
“It’s about choice and opportunity. Young people who are leaving treatment want the same normal opportunities other young people experience,” he said.
“We found most young people would prefer to choose where they live, so having adequate private rental subsidies would help take some of the pressure off public housing, which is often pretty unappealing for young people.”
There is also a strong need to enhance support for individuals who experience multiple or longer hospitalisations as this can severely disrupt their private rental accommodation.
Housing assistance may be required to sustain individual rental arrangements, for example, by subsidising rent payments for the duration of an individual’s hospitalisation.
“We also found there are inconsistent and sometimes ineffective discharge planning arrangements for people leaving treatment providers,” Duff said.
“A stronger integration of housing, mental health and substance use treatment services as part of discharge planning for each patient would provide the opportunity for clinical and allied health professionals to liaise more closely with community health and housing service providers to address a patient’s housing needs.”
The report also said that security of tenure does not always equal safe or appropriate housing in terms of the health or recovery of the tenant, with many individuals talking about the need for greater choice in housing supports to help their recovery, social inclusion, health and wellbeing.
People who had been discharged from a treatment program often indicated how these nuances were overlooked in care planning and transition discussions, where their existing housing was treated as ‘good enough’ despite misgivings about aspects of the housing.
‘Leaving rehab: enhancing transitions into stable housing’, with RMIT authors Cameron Duff, Nicholas Hill, Rosanna Scutella and Guy Johnson, is published on the AHURI website (DOI: 10.18408/ahuri53211).
Story: Anthony Smeaton and Aeden Ratcliffe