Housing as an essential precondition of successful drug treatment
Substance misuse, poor health and homelessness are often found together and are directly linked to early death. Recent research by the Museum of Homelessness reported in Inside Housing found nearly 1,000 people died while homeless in 2020; a 37% increase on numbers in 2019. The confirmed cause of death in 36% of those cases was substance misuse. While the research found the ‘Everyone In‘ initiative during the height of the Covid pandemic helped protect homeless people from Covid risks, it did not prevent deaths rising overall. Clearly temporary emergency accommodation is no substitute for a safe, permanent home. So what can we do to improve the housing situation long-term for some of the most vulnerable people in society?
The Dame Carol Black report
Dame Carol Black’s recent report recommends that the Ministry for Housing, Communities and Local Government (MHCLG), and the Department for Health and Social Care, work together to gain a better understanding of the types and levels of housing-related need among those with substance misuse problems. The report is well overdue and may help change the simplistic “too many people, not enough homes” generic rhetoric to a more accurate “too many people with high support needs and not enough homes” debate.
MHCLG has estimated that almost two-thirds of people who sleep rough have a current drug or alcohol problem and drug services report that up to a third of people in substance misuse treatment have housing needs. However, year-on-year cuts to inpatient detoxification and residential rehabilitation services, outreach programmes, recovery support and psychosocial interventions have shifted more of the vulnerable towards supported housing settings. This means those of us who provide supported housing have a key role to play in delivering meaningful support that meets the complexity of those individual’s needs.
Accessing safe housing for those in recovery
We know that access to safe housing is an essential pre-condition for the success of any treatment programme. So our response has been to provide a network of housing that is ‘street accessible’, transitional in nature and supported by evidence-based, therapeutic programmes. This approach fulfils the first three core principles of ‘Housing First’, namely recovery orientation, individualised support and social/community integration. Now, by highlighting the critical role of housing in substance misuse treatment, we hope Dame Carol Black’s report will push the other two essential principles – immediate access to permanent housing with no housing readiness requirements and greater consumer choice and self-determination – further up the agenda. If so, we can look forward to genuine transformation in the supported housing sector, thus reducing avoidable deaths and giving our tenants the best possible opportunity to tackle their problems and change their lives. Until then, we will continue to provide our own safe spaces and nurturing environments for people to change their behaviour. Everyone deserves the opportunity to not only live but thrive in their own independent lives.
