Is Housing First for Mental Health Community Support Possible During a Housing Shortage?

Supported housing programmes for people with chronic mental health needs have shifted towards approaches that rely on housing first, which prioritizes access to a permanent home in the community. How do support programmes with this assumption manage the market constraints of a shortage of affordable housing? The article examines empirical mixed method data (interviews and programme data) about the experience of managing this problem in the Mental Health Housing and Accommodation Support Initiative ( HASI) in New South Wales, Australia. HASI provides clinical mental health services, housing support and housing if needed, for people who are not yet living independently in the community. It found that the housing shortage affected the ability of the providers to implement the intended programme design at three early steps in the support: determining eligibility; prioritizing access between people with and without housing; and managing entry to the programme when they did not have housing. As a result, some otherwise suitable applicants were not prioritized for entry into the programme or their entry was delayed until they were housed. The providers adjusted the programme to the housing market realities, which compromised the programme intentions. The policy lessons are that programmes need strategies to provide housing for people who require it; assist people to find or apply for housing; and support people while they wait for housing. These approaches enhance the coherence of programmes, build on integration mechanisms and respond to the housing context. [ABSTRACT FROM AUTHOR]