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People with mental health and substance misuse issues who access residential treatment are at greater risk of housing insecurity, and improved discharge planning and service coordination is urgently required, new AHURI research has revealed.

The research, ‘Leaving rehab: enhancing transitions into stable housing’, undertaken for AHURI by researchers from RMIT University, UNSW Sydney and Curtin University, examines housing, health and social care supports for individuals leaving residential treatment for mental health or substance use problems.

‘Failure to adequately plan for and support safe transitions from residential treatment into secure and affordable housing can have catastrophic consequences for individuals leaving care, with strong impacts on their housing security, their health and wellbeing, and their economic and social participation in the community,’ says lead author of the research, Associate Professor Cameron Duff of RMIT University.

‘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 research found that young people with health and social problems can have particular difficulties accessing affordable housing. Young people are often less appealing to community housing providers given their relative income insecurity, while social housing often locks tenants into a particular location, reducing their geographic mobility. For this reason, the report suggests a more portable type of housing assistance for young people might be required.

There is also a strong need to enhance supports 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,’ says Associate Professor Duff. ‘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 research also highlights that while some people’s housing might be secure, insofar as they have security of tenure such as in public housing, this does not necessarily make their housing ‘safe’ or appropriate in terms of their health or recovery—for example, such as living close to other drug users who might influence a patient’s treatment from addiction.

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.

The report can be downloaded from the AHURI website at http://www.ahuri.edu.au/research/final-reports/359