Research Case Study

Impact: Demonstrating why poor housing and mental health are linked

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    Health and wellbeing

Housing estate

Housing conditions have an impact on mental health and Essex research has enabled us to better understand why, supporting a case for public health interventions on housing quality and conditions to improve mental health.

Our research has influenced policy recommendations and lobbying by leading UK charities, including MIND, which has informed the UK Government 2020 Social Housing White Paper.

The challenge

A 2015 briefing paper for Public Health England calculated that poor housing was costing the NHS £1.4billion per year, confirming the importance of seeing housing as a public health issue. Research had long shown a link between poor housing and mental ill health. However, this could equally be accounted for as social drift – people with poor mental health end up in poor housing.

If public health interventions on housing were to be proposed, it was important to demonstrate how poor housing causes mental health issues, which will, therefore, offer possible solutions to the problem.

What we did

Understanding Society is the UK Household Longitudinal Survey (UKHLS) based at Essex. It is built on the British Household Panel Survey (BHPS) which had around 10,000 households.

Using BHPS data, Essex research examined the effects of housing on health and found that over the long term, the mental health of people living in poor quality housing declines, whereas people who move to better quality housing experience mental health improvements.

The research also found that “housing payment problems and entering arrears have significant detrimental effects on mental well-being”, over and above the effects of general financial hardship on mental health.

Further analysis found that affordability of accommodation impacts on mental health. Specifically, housing repossession was associated with an increased risk of mental illness.

Essex researchers began a Knowledge Transfer Partnership project with Tendring District Council to explore the ways in which living in bedsit accommodation impacts on individuals’ mental health.

Other research had already found that people living in Houses of Multiple Occupation (HMOs) are eight times more likely to have mental health problems and there are increasing numbers of young and vulnerable people living in HMOs.

Interviews with HMO residents found that insecurity of tenure can lead to feelings of limited control and increased stress. Some residents reported feeling threatened by other residents, particularly when they were drunk or acting aggressively. Living in HMOs was also felt to be detrimental to efforts to overcome existing drug and alcohol problems. Whilst some residents got helpful support from their property manager or caretaker, others felt particularly stressed by the intrusive and controlling surveillance and security arrangements at the residences.

“This evidence makes it crystal clear that good quality housing is critical to good mental health… without preventative measures to keep people out of homes that are causing or worsening mental health problems, we’ll only see the issue grow…”
MIND Brick-by-Brick report

What we changed

Combined, longitudinal statistical research, plus in-depth qualitative research by Essex has enabled housing to be understood as a social determinant of health, supporting a case for public health interventions on  housing conditions to improve mental health.

The UK’s leading mental health charity MIND launched its Brick-by-Brick report in 2017, which drew heavily on Essex research and informed all its housing campaigns from 2017 onwards.

Citing Essex research, the report said moving to better quality accommodation leads to reduced use of mental health services. It also noted that homeowners with high mortgage debts are at greater risk of mental health problems, that “unaffordable accommodation has a negative effect on mental health and has a bigger impact than general financial pressures or debt” and that repossession “significantly increases risk of experiencing a mental health problem”.

The Brick-by-Brick report directly informed MIND’s response to several national and local government consultations and proposals including: London Housing Strategy (2017), Homelessness Reduction Act (2017), Supported housing funding (2018) and Private rented sector and Social housing: Response to the Government's green paper (2018).

In preparation for MIND’s parliamentary launch of their housing campaign in 2019, MIND commissioned Essex to carry out an update analysis of UKHLS on the links between housing and mental health which confirmed previous findings “people living in both the social rented sector and private rented sector are significantly more likely to have experience of poor mental health than home owners”.

In 2019, MIND compiled evidence reviews for the UK Collaborative Centre for Housing Evidence, circulated as policy briefings. The briefing for Welsh authorities cited Essex research when emphasising “local authorities should consider the active role of landlords within housing and social care strategies…Evidence has highlighted the importance of…recognising landlords as key partners who assist individuals living with mental ill health in general needs housing”.

Essex research also helped inform the UK Government 2020 Social Housing White Paper – a ‘Charter’ for social housing which sets out a range of principles, initiatives and regulation which will compel landlords to meet certain standards.

Many of the commitments made in the White Paper link to Essex research via the findings it provided for MIND’s evidence-based campaigns.