The ‘supported housing’ sector has grown exponentially in the last five years, with as many as 30,000 units estimated to be operating in England alone, catering for more than 150,000 households and individuals; this is 62% higher than in 2016. Yet funding to meet this need has risen by less than £100m. Supported housing, also known as ‘exempt housing’ because it is not subject to government caps on housing benefits, caters largely for vulnerable populations who cannot get housing elsewhere – prison leavers, rough sleepers, refugees and migrants and those with substance misuse issues. The levels of social need and mental health issues are very high. Yet – while being able to charge sky-high rents paid for by the state – many social housing organisations provide only a minimal level of support, with understaffing being a major issue. In October, the homelessness charity Crisis described the sector as ‘controversial’ and ‘dangerously under-regulated. I have worked at Riverside housing, which is no exception.
Failing mental health needs
More than anything, this supported housing is a reflection of the failure of mental health services in Britain. Between January and July 2021, 1.47 million people, the majority of them adults, were in contact with a mental health service. In the same period, 21,592 people were subject to the Mental Health Act, including 16,164 people detained in hospital. Severe diagnoses such as psychosis have seen a sharp increase over the pandemic. Riverside Housing is just one of the many ‘supported social housing’ organisations that seek to capitalise on these statistics; it saw its profits soar by 70% from £28.8m to £49m over the year to the end of March 2021. This is how it works. Once Riverside receives a referral by from a council or mental health ward, it has to decide whether to accept the individual into its supported housing scheme. There is a conflict of interest here. As on one hand, due to the lack of properly funded mental health and rehabilitation centres, there are many complex needs and possible hostile behaviours that aren’t suited for what Riverside can offer. On the other, vacant rooms cost Riverside £6.7m in 2020 so it is in its interests to fill them. In doing so, the supported housing system in essence is failing to help so many extremely vulnerable people with poor mental health who are left with little or no choice about the environment they end up in or who their neighbours might be. The consequences can be horrific – I’ve seen fights, overdoses – on occasion leading to death — women coerced into selling sex to abusive buyers, to obtain a quick drug fix for the day. Many cannot afford to move out as they would not be able to afford rent once their housing or LHA benefits became subject to the cap. Those without settled immigration status risk being deported once they move out of supported housing. Many have been in some form of supported housing for years as they are passed pillar-to-post around the ‘care’ system, a life journey that holds out no chance of recovery or escape. This systematic form of psychological abuse numbs and atomises both workers and patients.
Workers, on the front lines of mental health
Community Mental Health Teams (CMHT), who manage most non-domiciliary care, are chronically understaffed. Some Care Coordinators can have up to 50 individuals under their supervision at once, and are responsible for their medical reviews, initiating move-on processes and administering ant-psychotic medication. The sheer volume of caseloads is unmanageable, alongside the inevitable mountain of paperwork. Supported living services come with a multitude of challenges, whether it’s supporting those with a high level of need, or administering Naloxone, so that those who are overdosing on heroin can make it to hospital; adapting to unpredictable behaviour by residents, or by having to properly dispose of drug paraphernalia found in communal areas of the building. Yet the main training for staff working in this challenging environment comes in the form of ‘E-learning’. This is just more cost-cutting. At the same time, the low wages in the sector make it hard to attract qualified staff. Meanwhile the CEO of Riverside, Carol Matthews, earns a salary well in excess of £200,000 a year.
This shambles is the result of a sector where the welfare of the most vulnerable is dependent on for profit-organisations (which now includes housing associations), with a closer eye on the bottom line than on the complex needs of their residents – sorry, ‘customers’ – who are being failed at every turn.
Alex Scurr
