Research to quantify the extent of independent housing need and homelessness and transience among people who experience mental illness, undertaken by the Ministry of Social Development, was commissioned as part of an interdepartmental work programme established by the Ad Hoc Committee on Mental Health in April 2000. Questions of affordability, adequacy and sustainability of housing form the core of the research. A key outcome from the research was the development of a typology focused on the idea of "sustainable housing" for consumers/tangata whai ora. The discussion of the framework provides a backdrop for the presentation of the research findings in which the extent and nature of housing are discussed, the role of support services in the retention of housing summarised, and information about specific groups affected by housing need is put forward. The evidence from the research suggests that there is a need for systematisation of support services for consumers/tangata whai ora and that developing a coordinated inter-agency strategic framework for resource allocation and service provision to this group is a necessary step towards ensuring the sustainability of independent housing.
This paper summarises research undertaken by the Research Unit of the Ministry of Social Development (MSD) between July 2000 and August 2001. The research responded to a Cabinet directive to quantify the independent housing need, and homelessness and transience of consumers/tangata whai ora. (2) Although the immediate function of the research was to inform Government and the initial audience for the findings was government officials, the outcomes from the research have relevance for a wider audience.
An extensive review of the literature (3) identified several key New Zealand documents:
* the Mental Health Commission (MHC) publications establishing the MHC Blueprint for Mental Health Services in New Zealand (1998) and related publications updating progress with service provision;
* the 1998 report, Housing and Housing Support for People with Mental Illness, by Paine;
* the MHC's 1999 discussion paper, Housing and Mental Health: Reducing Housing Difficulties for People with Mental Illness; and
* Bennion's (2000) report, Planning Processes for Providing Supported Accommodation for People with Mental Illness.
The New Zealand research into the experience of mental illness and the effectiveness of services available to consumers/tangata whai ora has taken place in the context of findings that the experience of mental illness and housing difficulties are linked. The widespread acceptance of the link between the two is exemplified by the Mental Health Commission in its 1999 Discussion Paper.
Recovery [from mental illness] requires specific housing arrangements that combine support, a quality physical environment and suitable local environment. These arrangements may include:
* coordination of support, clinical services and housing;
* assistance to make "wise housing choices";
* help from time to time in managing the day to day responsibilities of housekeeping, budgeting and maintaining a house;
* being handy to shops, community facilities, support services and clinical services;
* availability of social support networks (friends and relatives and community);
* meeting needs for living alone or with others;
* empowerment to choose living arrangements; and
* physical comfort, safety and privacy. (Nelson et al. 1998)
The recovery requirements described above were used in conjunction with the Kearns et al. (1991, 1992, 1993) housing stressors, to shape the MSD national survey of 800 mental health service providers paid by the District Health Boards (DHBs). This paper focuses on the findings from this national survey of providers and the group …