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Trajectories: the interplay between housing and mental health pathways

Overview

This AHURI research examined housing and mental health pathways for people with mental illness. Using quantitative analysis and consumer consultations, it identified five trajectories: excluded from help, stuck without support, cycling through services, stabilising, and well supported. The study found bidirectional relationships between housing instability and mental health, highlighting system integration needs.

Key insights

Key Insights:

  1. Mental health and housing instability directly influence each other bidirectionally

  2. Five trajectories identified: excluded, stuck, cycling, stabilising, and well supported

  3. Current systems are crisis-driven, fragmented, and lack adequate integration

  4. Social support and health services act as protective mediating factors

  5. Most people recover from mental illness within 1-3 years naturally

  6. Housing affordability stress significantly worsens mental health outcomes for those on low-incomes 

  7. Circuit breakers like public housing access enable trajectory stabilisation and recovery

  8. Policy needs person-centred approaches integrating housing, health, and social support

 

Did this resource draw on transformative evidence?

The document combines both experiential expertise and academic research. It includes extensive qualitative consultations with 130 consumers with lived experience of mental illness and housing issues, plus carers and service providers across Australia. However, it's primarily grounded in academic methodology, featuring quantitative analysis of large datasets (HILDA and Journeys Home), systematic literature reviews, and rigorous research frameworks. The experiential voices inform but don't drive the overall analytical approach.

The document significantly incorporates practice wisdom through focus groups with 109 housing and mental health service providers across all Australian capital cities. These practitioners shared insights about typical client pathways, intervention points, system challenges, and service gaps from their frontline experience. However, this practice wisdom is systematically analysed within an academic research framework rather than being the primary evidence base, serving to validate and contextualise the quantitative findings and consumer experiences.

The document is heavily based on research and evaluation insights. It features rigorous quantitative analysis of two major longitudinal datasets (HILDA and Journeys Home), systematic literature reviews of Australian and international evidence, and comprehensive evaluation of existing housing and mental health programs. The research employs statistical modelling, survival analysis, and controlled comparisons to establish causal relationships. This academic research framework forms the primary evidence base, with experiential and practice inputs providing contextual validation.

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Evidence Summary