People with mental health and substance use problems face particular issues among the homeless population when trying to obtain stable housing. Research into this area suggests that mental illness and housing issues each contribute to the other – homelessness both exacerbates and is exacerbated by mental health problems¹.

Less research, however, has focused on the experiences of this population in rural areas. A recent study² set out to determine the factors that contribute to housing problems for people with mental health and substance use issues in rural areas, and how to assist these people.

Forty people were interviewed. Thirty-nine reported having been diagnosed with a mental illness in the past and 27 reported having problems with alcohol or other drugs at some stage in their life. More than half of the participants were living in private rental accommodation; the remaining participants were residing in public housing. All participants were receiving a form of government support payments.

Current housing problems reported by participants were:

• unavailability of affordable accommodation;
• lack of permanent accommodation;
• poorly maintained accommodation;
• poor access to services and transport; and
• isolation from social and support networks.

Factors that contributed to participants entering unsuitable/unstable housing included:

• cyclical nature of mental health, substance abuse and housing issues – mental illness contributes to housing difficulties, which in turn exacerbates mental illness;
• relationship and family breakdown;
• poor history with housing services or real estate agencies; and
• lack of knowledge of services and agency supports.

Factors that contributed to participants moving out of unsuitable/unstable housing included:

• obtaining a stable income and ongoing employment;
• a solid social network, particularly family networks; and
• agency support, such as drug and mental health services, in providing information, education and practical support – for example, assistance with completing paperwork and dealing with housing agencies.

Many of the factors listed above are common to people with mental health and substance use problems living in both urban and rural areas. There are, however, housing problems that are more prevalent in rural areas, which are outlined below.

Lack of suitable, affordable accommodation

Lack of affordable accommodation was a common problem for participants, particularly those in coastal tourist centres. Factors contributing to this problem for people in coastal regions include:

• A growing number of reasonably well-off people are choosing to reside in coastal regions.
• Large population increases over summer.
• Median property prices have increased while affordable rental accommodation has declined in the coastal areas of this study.

Poor access to services

Approximately half of all participants had no ongoing access to private transport. Transport issues place increased difficulty on people accessing services, including housing, mental health, and alcohol and drug services. Service provision in rural areas is limited compared to urban areas, which means there are less referral options for people. As a result they have to travel further to access services, often with limited transport options. While the study did not look specifically at transport issues in rural areas, it noted that public transport is often limited, particularly where low-cost rental housing and caravan parks are located.

Social networks

Social networks were found to be both helpful and problematic for participants in the study. For example, the “community grapevine” meant that people’s poor rental history and mental health and substance use history can make it difficult for them to obtain rental accommodation from real estate agents. However, local social networks, particularly family networks, were found to be a significant asset for participants in the study in terms of emotional and practical assistance with finding housing.

Information and support

The findings suggest that there is a need for housing information, education and support for people with mental health and substance use issues in rural areas. Agencies within rural areas, such as alcohol and drug and mental health services, have a key role to play in providing people with education, information and assistance in obtaining housing.

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Further reading and resources

• The Australasian Centre for Rural and Remote Mental Health 
• The Centre for Rural and Remote Mental Health 
• Western Australian Centre for Rural Health 
• Rural health publications from The Australian Institute of Health and Welfare
• Mental Health Commission of NSW report: Mental health and homelessness 
• Mental Health Australia report: Home Truths: Mental Health, Housing and Homelessness in Australia 2009