The intersection between housing, homelessness and mental health in a rural/remote setting
In 2015 I authored a paper on the intersection between housing, homelessness and mental health in a rural and remote setting (Darling Downs South West Queensland). I haven't really taken the the time to reflect on how great this project was due to the blur that has been 2015-16. It's not everyday you get to road trip from Brisbane, stopping all stations from Toowoomba, St George, Cunnamulla and Chinchilla in a little over a week. A big shout out to Trish Feehely and Lifeline Darling Downs South West Queensland for giving me this amazing opportunity. This was certainly one of my highlights from 2015-16 and would love to apply myself to projects like this in the future.
'Local Issues, Local Solutions' highlighted the vast differences between rural/remote settings and urban settings in relation to a variety of mental health and housing indicators in addition to anecdotal feedback from local service providers. The paper further delved into the differences between three rural/remote settings and used Cunnamulla, St. George and Chinchilla as case studies to highlight the fact that all rural/remote towns and regions can not be lumped into the one bucket with carbon copy solutions for each. Long story short, applying broad and rigid policies to all rural/remote communities is as shortsighted as applying the same policy statewide. Each of these local communities had it's own subtelies when it came to local housing stock, support service infrastructure, population demographic and history.
Generally the issues encountered by each community fell into one of the below categories. Again, this a very general summary and categorisation of the issues experienced in each community.
Community empowerment: vulnerable communities lack capacity and knowledge to access and maintain appropriate housing and support services.
Sector capacity and capability: the support and housing sector itself doesn’t have timely data to drive decision making in addition to issues with cultural competency and understanding of mental health and behavioural disorders.
Access, coordination and advocacy: Access to housing and support services can be difficult in addition to coordination of support services to ensure tenancies are sustained and positive health outcomes are achieved. Vulnerable community members with complex needs are effected disproportionally.
Structural factors: resources aren’t being directed toward services in rural and remote areas (or are sporadically funded) in addition to current policy environment not lending itself to affordable housing.
A brief review of current best practice and engagement with local service providers put forward the below strategies to overcome each of the issues listed above. Each of the strategies below needs to be considered in the context of the community it is targeted at:
Expand tenancy support and advocacy services: leverage The Advocacy and Support Centre’s newly refunded State-wide Tenants Advice and Referral Service to improve remote and rural coverage.
Provide accommodation support for social housing tenants with complex needs: social housing tenants generally have a higher level of need than people in the private market, significant support is required to stabilise health and tenancy alike.
Assess needs of social housing tenants: engage with social housing tenants to gauge what types of support and resources they require to lead a meaningful life.
Triage and document local community need: Demand for housing and supports are unknown (quantitatively) in each community. This demand cannot be managed without fully understanding the needs of the community.
Cross-sectoral education and development: a variety of community professionals require training in cultural competency and mental health competency to reduce stigma and improve housing and health outcomes.
Private rental market support project: The private real estate market is well placed to house people with mild to moderate complexity, with support from service sector.
Develop cross-sectoral coordination protocols: formalised coordination protocols between settings (prison, hospital, primary care) may provide enhanced coordination of care
Review social housing application process: partner with DHPW to review the social housing application process to improve engagement with vulnerable groups
Advocate for positive policy conditions for affordable housing: Ensure that government policy (all levels) prioritise affordable housing (specifically 1 and 2 bedroom dwellings)
Build the case for more social housing: conduct a cost-benefit analysis to compare the costs of housing our most vulnerable people vs. keeping them homeless
Encourage Indigenous home ownership: engage relevant stakeholders to model ideal ways to encourage and promote home ownership
Research innovative ways to house complex clients: If social housing and emergency accommodation continue to be in short supply, ways to best utilise the local dwelling infrastructure need to be researched.
Explore optimal mental health workforce structure: Identify and leverage similarities between mental health programs across DDSWQ
Advocate for resources to fill gaps in service provision: Document and advocate for increased services regarding drug and alcohol treatment services, disability support services and clinical mental health services
The final paper was submitted to the Department of Housing and Public Works during a round of public consultation relating to the development of a housing and homeless strategy. The 'Working together for better housing and sustainable communities'.
In relation to the findings of 'Local Issues, Local Solutions' the balance between rural/remote and urban settings will continue to be challenging for mental health and housing alike. It is important to ensure that solutions have the flexibility for local implementation and are responsive to local need.