Impact case study database

Influencing UK charity policy and lobbying

MIND is the UK’s leading mental health charity. In 2017, MIND launched its ‘Brick-by-Brick’ report drawing heavily on Essex research [S1]. Citing Essex research [R1], the report noted that moving to better quality accommodation leads to reduced use of mental health services. Drawing on insights from [R3], it noted that homeowners with high mortgage debts are at greater risk of mental health problems; that “ unaffordable accommodation has a negative effect on mental health and has a bigger impact than general financial pressures or debt”; and that repossession “ significantly increases risk of experiencing a mental health problem”.

The MIND report drew on Essex research [R6] stating “ living in HMOs… made it harder for people to overcome drug and alcohol addictions”; “ many problems were caused by behaviour of other tenants rather than physical characteristics of the buildings”; “ short tenancy agreements and general insecurity can be stressful and limit recovery”; and “ residents have little choice or control over how they interact with other people”. Referring to [R6, R7], the report highlights issues of tenant harassment by landlords, feelings of insecurity by tenants, the limited control residents have over their living space and the impact of close proximity of other residents.

The report called on policymakers to act: “ This evidence makes it crystal clear that good quality housing is critical to good mental health… without preventative measures to keep people out of homes that are causing or worsening mental health problems, we’ll only see the issue grow….” The ‘Brick-by-Brick’ report directly informed several responses by MIND to national and local government consultations and proposals including: London Housing Strategy (2017) [S2a], Homelessness Reduction Act (2017) (also directly citing [R3]) [S2b], Supported housing funding (2018) [S2c], Private rented sector: Longer tenancies (2018) [S2d] and Social housing: Response to the Government's green paper (2018) report [S2e]

Following on from the Brick-by-Brick report (which informed all of MIND’s housing campaigns from 2017 onwards), MIND held a parliamentary launch of their housing campaign in February 2019 attended by MPs including the Parliamentary Under Secretary of State for Mental Health and the Shadow Secretary of State for Housing [S3]. In preparation for this event, and since Essex hosts UKHLS and has experts on housing and mental health, MIND commissioned Essex to carry out an update analysis of UKHLS on the links between housing and mental health which confirmed previous findings “ people living in both the social rented sector and private rented sector are significantly more likely to have experience of poor mental health than home owners” [S3].

In 2019, MIND compiled evidence reviews for the UK Collaborative Centre for Housing Evidence (a UKRI funded multidisciplinary partnership between academia, housing policy and practice), circulated as policy briefings. The briefing for Welsh authorities cited [R5] when emphasising “ Local authorities should consider the active role of landlords within housing and social care strategies…Evidence has highlighted the importance of…recognising landlords as key partners who assist individuals living with mental ill health in general needs housing” [S4 – p32]. The policy brief for UK and devolved governments, research communities and mental health charities [S5] drew on research insights from [R4], [R5] and [R6] and highlighted the role of welfare support, vulnerability of young people on low incomes living in HMOs for financial reasons and the impacts on families of sharing with strangers.

Informing UK Government 2020 Social Housing White Paper

There are currently 4,000,000 social homes in the UK. MIND campaigns for changes to social housing to improve mental health have targeted UK local and national government over a number of years as detailed above. There have also been a range of charities and lobbyists campaigning for change for other reasons including safety, physical health, dignity, rights and so on. There are clearly social and political arguments for improving or changing social housing provision and amongst this plethora of causes and campaigns, it is challenging to untangle the role of evidence in directing a policy with so many implications. Housing is a relatively neglected area in terms of science and evidence-based policy with political drivers traditionally being more prominent and the field being unsuited to controlled experimental research. The MIND campaign is notable for its heavy reliance on science and research, be it entirely observational or qualitative; but this indicates that going forward it may be possible for science to have a greater role in influencing this charged area of policy. The Social Housing White Paper released (after many delays) in November 2020 is clearly responding to many different issues, including Grenfell, which has been a high profile driver of housing politics since the tragedy. Unlike clinical guidelines, White Papers do not directly cite research; but we can trace a reasonable indirect link between a number of commitments made in the White Paper which relate to mental health and housing and Essex research, via the evidence-based campaigns led by MIND.

Interim uptake of Essex research by parliamentarians is evident, firstly in a 2018 POSTNOTE [S6] which used Essex research to establish the link between poor housing and mental health, concluding that landlords could be incentivised to improve quality of housing and that more joint-working across LAs and other providers could further improve conditions. More prominently in 2018, the APPG for Healthy Homes and Buildings undertook a major review which led to a White Paper “Building Our Future” [S7]. This was informed by MIND’s report [S1]: “MIND put forward their analysis of the situation, stating that … the link between poor quality housing and mental health is too strong to ignore.” Recommendations 2.1 and 2.2 of this White Paper indirectly draw on Essex research [R1, R6] via MIND report S1:

• Recommendation 2.1: “ Government needs to commit to the construction of larger numbers of healthy new homes, including greater numbers of quality social and affordable housing, which can help to alleviate issues of overcrowding and poor physical and mental health.”

• Recommendation 2.2: “Priority must be given to ensuring people’s health and wellbeing is foremost when building new homes. There should be increased focus on delivering quality and performance alongside delivery of greater numbers of new homes.”

The APPG White Paper was discussed in Parliament in 2019 [S8] and it was widely anticipated that the Conservative Government’s manifesto promise of a Social Housing White Paper would be informed by the APPG report and the parliamentary debate noted above.

2020 Social Housing White Paper [S9]: this ‘Charter’ for social housing sets out a range of principles, initiatives and regulation which will compel landlords to meet certain standards.

• A strong emphasis in the Charter is ‘empowerment’ of social housing residents “ to support more effective engagement between landlords and residents, and to give residents tools to influence their landlords and hold them to account.” Referring to [R5, 6 and 7], MIND frequently emphasised the importance of lack of choice and control being a factor in deteriorating mental health.

• The Charter acknowledges that “ For residents, knowing you live in a safe, secure building is of paramount importance, for your physical safety and for your mental health.” It commits to “ Tackle anti-social behaviour by enabling tenants to know who is responsible for action and who can support and assist them if they are faced with anti-social behaviour.” Again, drawing on [R7] in particular, MIND had emphasised the impact on mental health of the behaviour of other tenants and that the conditions of social housing made it harder to overcome drug and alcohol problems. Thus the Charter recognises “ from discussions with agencies involved in tackling anti-social behaviour and from recent research studies that, in some cases, the perpetrators of anti-social behaviour suffer from mental health problems or have issues involving alcohol and drug use. In those cases, providing the right support and interventions can have a positive outcome in terms of preventing further offending behaviour.”

• The Charter therefore also sets out a broader plan to integrate mental health support into the social housing system including equipping staff “ to work with people with mental health needs and encourage best practice for landlords working with those with mental health needs” –informed by the MIND briefing to Welsh authorities citing [R5] in stating that “ landlords should be seen as “key partners who assist individuals living with mental ill health.”