Joining up housing and mental health

The role of housing goes far beyond physical shelter and safety. It introduces people to a community to which they can belong, a space which is their own, a communal setting where they can make friends, form relationships and a place where they can go for support, social interaction and reduce feelings of loneliness and anxiety. Housing  stable, safe housing  also provides a springboard for people to begin to re-integrate with society. An address allows them to register with services, including claiming benefits, registering at a local job centre, registering with a GP, and applying for jobs.

Housing and health, both physical and mental, are inextricably linked. A 2015 blog from the Mental Health Foundation put the relationship between housing and health in some of the clearest terms:

“Homelessness and mental health often go hand in hand, and can be a self-fulfilling prophecy. Having a mental health problem can create the circumstances which can cause a person to become homeless in the first place. Yet poor housing or homelessness can also increase the chances of developing a mental health problem, or exacerbate an existing condition.”

Single homeless people are significantly more likely to suffer from mental illness than the general population. And as a result of being homeless they are also far more likely to rely on A&E services, only visiting when they reach crisis point, rather than being treated in a local setting by a GP. They are also more likely to be re-admitted. This high usage is also costly, and increasingly calls are being made for services to be delivered in a more interconnected way, ensuring that housing is high on the list of priorities for those teams helping people to transition from hospital back into the community.

Not just those who are homeless being failed

However, transitioning from hospital into suitable housing after a mental health hospital admission is not just a challenge for homeless people. It is also the case that people are being discharged from hospital to go back into settings that are unsuitable. Housing which is unsafe, in poor condition, in unsafe locations or in locations away from family and social networks can also have a significant impact on the ability of people to recover and prevent readmission.

Councils are facing an almost constant struggle to house people in appropriate accommodation. However, finding a solution to safe, affordable and suitable housing is vital. Reinvesting in social housing is a core strategy councils are considering going forward to try and relieve some of the pressure and demand. Gender and age specific approaches, which consider the specific needs of women, potentially with children, or old and young people and their specific needs would also go a long way to creating long term secure housing solutions which would then also impact on the use of frontline NHS services (by reducing the need for them because more could be treated in the community). Suitable housing also has the potential to improve employment prospects or increase the uptake of education or training among younger people with a mental illness. It would also provide stability and security, long term, to allow people  to make significant lifestyle changes and reduce their risk of homelessness in the future.

A new relationship for housing and health

A number of recommendations have been made for services. Many have called for the introduction of multi-disciplinary teams within the NHS, recruited from different backgrounds, not only to create partnerships with non-NHS teams, but also to act as a transitional care team, to ensure that care is transferred and dealt with in a community setting in an appropriate way, and to ensure housing is both adequate and reflects the needs of those who are most vulnerable.

In June 2017 the King’s Fund held an online seminar to discuss how greater integration between housing and mental health services could help accelerate discharge from hospital and reduce the rates of readmission for people suffering from mental illness. The panel included Claire Murdoch, National Mental Health Director at NHS England and Rachael Byrne, Executive Director, New Models of Care at Home Group.

Final thoughts

Increasingly the important link between housing and health is being recognised and developments are being made in acknowledging that both effective treatment and a stable environment are vital to helping people with mental illness recover and re-integrate back into their community, improving their life chances and reducing the potential for relapse.

Housing can be an area of life which can have a significant impact on mental health. It can cause stress, and the financial burden, possibility of being made homeless, or being placed in temporary accommodation can have a significant and lasting negative effect on people’s mental health. However, safe and stable housing can also have a significant positive impact on mental health, providing stability, privacy, dignity and a sense of belonging.


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What’s happening to make big data use a reality in health and social care?

data-stream-shutterstock_croppedBy Steven McGinty

At the beginning of the year, NHS Director Tim Kelsey described the adoption of new technologies in the NHS as a ‘moral obligation’. He argued that the gaps in knowledge are so wide and so dangerous that they were putting lives at stake.  It’s therefore no surprise that the UK Government, the NHS, and local governments have all been looking at ways to better understand the health and social care environment.

The effective use of ‘big data’ techniques is said to be key to this understanding. Big data has many definitions but industry analysts Gartner define it as:

“high-volume, high-velocity and high-variety information assets that demand cost-effective, innovative forms of information processing for enhanced insight and decision making”

However, if health and social care is to make better use of its data, it’s important that an effective infrastructure is in place. As a result, changes have been made to legislation and a number of initiatives introduced.

Why is it important to know about big data in health and social care?

The effective use of data in health and social care is a key policy aim of the current government (and will most likely continue under future governments).  The changes that have been made so far have had a significant impact on the policies and practices of health and social care organisations. The vast majority focus on information sharing, in particular how organisations share data and who they share data with.

What changes have been made to support big data?

Care.data

This was the most ambitious programme introduced by NHS England. It was developed by the Social Care Information Centre (HSCIC) and set out to link the medical records of GP practices with hospitals at a national level. It was expected that datasets from GPs’ records and hospital records would be linked using an identifier such as an NHS number or a person’s date of birth. However, due to concerns raised by the public, particularly in regards to privacy, the programme was delayed. The programme has now resumed but new safeguards have been introduced, such as the commissioning of an advisory board and the ‘opt out’ provision, where patients can opt out from having their data used for anything other than their direct care.

The Health and Social Care Act 2012 and the Care Act 2014

The Acts have both introduced provisions that impact on data. For instance, the Health and Social Care Act enshrines in law the ability of the Health and Social Care Information Centre (HSCIC) to collect and process confidential personal data. In addition, the Care Act clarifies the position of the Health and Social Care Act by ensuring that the HSCIC doesn’t distribute data unless it’s part of the provision of health and social care or the promotion of health.

Centre of Excellence for Information Sharing

This initiative came from the ‘Improving Information Sharing and Management (IISaM) project’, a joint initiative between Bradford Metropolitan District Council, Leicestershire County Council and the 10 local authorities in Greater Manchester. The centre has been set up to help understand the barriers to information sharing and influence national policy. They hope to achieve these goals through the use of case studies, blogs, the development of toolkits, and any other forms of shared learning. The centre has already published some interesting case studies including the Hampshire Health Record (HHR) and Leicestershire County Council’s Children and Young People’s Service (CYPS) approach to communicating how they deal with data.

These are just some of the steps that have been taken to make sure 2015 is the year of big data. However, if real progress is to be made it’s going to require more than top down leadership and headline grabbing statements. It’s going to require all health and social care organisations to take responsibility and work through their barriers to information sharing.


Further reading

Read our other recent blogs on health and social care:

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