What social workers can learn from service user experiences of bedsits

I recently conducted a research project exploring the links between mental health and bedsit accommodation, that involved interviews with 19 current bedsit residents.

A diagnosis of mental illness was not a criterion for selection but it became apparent that at least five of the respondents had received secondary level care for mental illness. For some, this care was still on going.

Although this is a very small sample, I wanted to raise some of the issues that these interviews brought up with the hope of getting others interested in this issue.

The negative impact of shared accommodation

I don’t think there can be any doubt that our day-to-day surroundings have a significant impact on our wellbeing. Our research findings supported this. When suffering from mental illness however, I believe that this relationship becomes all the more pertinent.

Problems arising from where we live that are manageable when well, may quickly become completely intolerable to someone with a mental health problem. One of the interviewees, a man in his mid-thirties, described the problem of having people sharing the same building, many facing similar challenges. He described the situation as a “clash of illnesses”.

He had moved into a bedsit after having spent time on a psychiatric ward and found the other tenants intolerable. He told his doctor of the problems that he was having and that he knew that he would snap if he had to stay. In the end he assaulted another housemate and ended up in prison for several months.

Although this cannot simply be blamed on the housing alone it highlights how house sharing, whilst mildly annoying to those who are well, may be completely unsuitable for those who are unwell.

The importance of property managers

Experiences of bedsit residents were not all negative however. One respondent, who described two previous suicide attempts in his interview, praised the property that he was currently in and in particular the property’s caretaker and manager whom he felt had helped him considerably in his recovery from depression.

What made the difference? Well, he said that the property was well run, there was a sense of community and he no longer felt so isolated. Another middle-aged man residing in the same property, still very much in the midst of his depression and under the care of a community psychiatric nurse, described how important the property caretaker was to him as he felt there was always someone to chat to or check up on him. 

Housing pressures are hitting hard

The benefit reforms sweeping in from Westminster, coupled with rising prices and increasing demand in the private rented sector, means that finding suitable housing for single people with mental health problems in the community is going to get even harder.

Discharge processes from psychiatric wards do not seem to have ever had housing at the top of their agenda. In the current climate when integrated working seems ever more threatened it is hard to see how this can improve.

The increasing differential between high and low cost housing areas has seen an increase in the ‘dumping’ of vulnerable people  where they can housed cheaply, particularly seaside towns.

Four steps to tackle this issue

Some ideas that may help to tackle this issue:

1. There should be information provision to psychiatric wards/social workers/community psychiatric nurses on suitable landlords whose housing is well managed. It is unrealistic to expect that bedsit accommodation is not used. By providing information on good landlords more suitable buildings may be chosen.
2. Housing should be made a more important discharge issue. This is not just about having a roof over someone’s head; it needs to go beyond that if they are to achieve a sustained recovery in the community.
3. We need to defend integrated working practices. Unsuitable housing could play a key role in someone’s relapse leading to costly readmission. Ignoring the social context into which someone is discharged could be more costly than ensuring suitable housing if arranged at the outset.
4. Ensuring that community mental health teams have adequate capacity, may help to reassure landlords that they were not being encouraged to take potentially problematic tenants who were then not provided with adequate support.

Caroline Barratt is a lecturer in health studies in the School of Health and Human Sciences at the University of Essex. She can be contacted at barrattc@essex.ac.uk or on Twitter at @C_Barratt_