Connecting Housing, Health, and Social Supports for People Leaving Treatment: Housing Policy Lessons from Australia

This article presents housing policy and practice recommendations for enhancing the coordination of housing, health, and social care supports for individuals leaving institutional settings. Our recommendations are derived from empirical research conducted in Australia’s two most populous states (Victoria and New South Wales) between October 2019 and March 2021 among people leaving residential treatment for mental health and/or alcohol and other drug (AOD) use issues. The period immediately following discharge from these settings is known to involve significant risk of housing insecurity, particularly for vulnerable individuals with complex health and social care needs. In conducting this research, our goals were to identify models of best practice in discharge and transition planning, and to propose strategies for enhancing coordination between residential treatment providers and key social and housing support services to mitigate the risk of homelessness for individuals leaving these settings. This article presents key research findings and recommendations for improving service coordination and transition planning across diverse institutional settings. Our linked data analysis indicates a strong correlation between the volume and frequency of service usage across mental health and AOD treatment settings and the risk of housing insecurity among service users. This finding is consistent with national and international research which has consistently found that frequency and volume of service usage, particularly for mental health, housing, and/or AOD services, strongly predicts housing insecurity over the life-course (see Duff et al., 2021 for a detailed review). Our analysis suggests the need for enhanced measures to identify high-volume service users and to more explicitly tailor housing and social support responses to their needs. This further suggests the need for site-specific policy development and service design efforts to facilitate the delivery of more effective transition planning supports for individuals leaving mental health and/or AOD treatment settings. In particular, we would recommend more effective integration of housing supports within the delivery of mental health care, particularly in inpatient psychiatric care, and in the delivery of community-based AOD treatment, particularly residential rehabilitation services. Interviews with service providers in each of these settings revealed significant discrepancies in the delivery of community-based mental health services, and considerable strain upon psychiatric services in hospital settings, particularly in Melbourne and Sydney’s largest hospitals. We also identified significant gaps and problems in the integration of housing supports into mental health care, despite the obvious need for such coordination, particularly among more vulnerable cohorts. A similar picture emerges in our analysis of AOD treatment services in New South Wales and Victoria, with a mix of public and private care provision, and a great diversity of treatment models and pathways. Here too, the level of integration of housing supports into the delivery of treatment services is variable. following