Housing for People with Mental Health and Substance Use Problems

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Decent, safe, affordable housing is one of the most important factors that affect our mental health. Poor housing, such as housing that’s too expensive, run-down or over-crowded,  can lead to poor overall health. It can also make recovery from mental health or substance use problems much more difficult.

The bigger picture

Housing is about more than a place to sleep. It’s tied our physical well-being, mental well-being and social well-being. Housing is an affordable safe space that protects us. It’s a secure, private space of our own. And it’s a place to gather with members of our communities. Good housing can help rebuild and maintain independence, day-to-day routines, confidence and social networks. Research shows that people living with a mental illness who live where they want to are more likely to have a job, social supports and a higher quality of life than those whose housing doesn’t meet their needs.

Of course, housing is deeply tied to the bigger social picture. Housing is linked to income, which is linked to education and experience, and so on. A positive change in housing can help influence positive changes in other factors that affect our well-being. Housing isn’t just about a house—it’s part of a path to safety, security, connectedness and acceptance.

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What does quality housing for people with mental illnesses or substance use problems look like?

Of course, different people have different housing wants and needs. But in general, the following are important parts of quality housing:

  • Choice—Being able to choose where you live is one of the most important factors in housing. It’s even been shown to improve recovery from a mental illness. Choice also means that people can choose who they live with.

  • Stability—Stable housing is housing that has no time limit—you can stay for as long as you want. Supports may be tied to housing, but many people need different levels of support at different times. So some people must move when they need different supports. They may also move between supported and independent housing. Even when it’s done with the best intentions, moving can still be very disruptive and unsettling. Moving often can have a big impact on wellness. People who must move between different types of housing may have to build new routines and networks every time they move.

  • Cost—Good housing is housing you can pay for and still afford things you need to live. Housing isn’t affordable when housing costs (rent or mortgage, plus basic utilities) are more than 30% of your income before taxes.
    People living with a mental illness have some of the lowest job rates in Canada. And it can be very hard for people to sign up for government assistance programs, so people who qualify may not get the help they need. BC has far fewer affordable housing options available now than in the past. As the number of affordable housing options drops, the cost of rent rises. Many people just can’t afford a place to live.
    Rising housing prices may have a particularly harmful effect on people who receive government income assistance because the amount of assistance they receive doesn’t always match the real cost of housing. In some parts of BC, the “shelter allowance” (the portion of income assistance that’s meant to cover housing costs) is much lower than the real cost of housing. This means many people must choose between housing and other basic needs like food.

  • Support—People should be able to access the same support services even if they move—ideally, your supports shouldn’t be tied to your housing. These support options should be based on a person’s needs, so you have flexible levels of support as your needs change.

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What types of housing are available?

In addition to renting or owning a home, there are different housing choices to help people living with a mental illness or substance use problem:

  • Licensed community care includes homes that offer 24-hour, live-in care and support services. These homes are licensed by health authorities and must meet certain standards.  The goal of licensed community care is to help some residents develop the skills and networks to move into supported housing. People who have just left the hospital may stay for a short period of time before they move into longer-term housing. But some people find a stable, permanent home in licensed care. With these supports, they can live safely, participate in their community and flourish.

  • Supportive housing means you can access support services during the day, and these services are linked to your housing. Different programs offer different services. You might find supports to help you manage your care and treatment, do day-to-day tasks like cleaning and cooking, and socialize.

  • Supported housing offers different kinds of support services, but these services aren’t linked to your housing. You receive the support services you need from outside organizations, and you can access the same services if you move. Supported housing is meant to be permanent. There are a lot of different types of supported housing. It includes group homes, apartment buildings owned by organizations and individual apartments rented through the private market by an organization.

  • Semi-independent living is a stepping stone between supported housing and living on your own. With semi-independent living, you learn skills that increase your independence, like how to take care of your money, how to look for a job and how to take care of your home. You still have access to support services, but you may have a shorter amount of time with a support worker than in a supported housing program.

  • Subsidized housing is housing that the government or other organizations helps pay for. In BC, subsidized housing is operated by the government, non-profit organizations and housing “cooperatives.” The rent you pay is based on your income, or you get help to cover the difference between what you can afford to pay and what your rent actually costs. Subsidized housing only refers to the cost of the housing, not the level of support services you might also receive. A housing subsidy is similar except that it follows a person instead of a housing unit, so then that person can rent in the regular housing market.

  • Emergency shelters offer a place to stay for a short period of time. Shelters in BC are operated by non-profit and community organizations as wells as government organizations. Some shelters operate year-round, while others are only open during winter months or during bad weather.

  • Harm reduction housing means that you can find housing even though you’re dealing with issues that would otherwise stop you from finding a place to live. Harm reduction models also offer links to other support services like health care workers or mental health teams. The goal of harm reduction is to offer stable housing first. Once you have stable housing and good support, you can look at health and well-being options that work for you. For example, people actively using may not qualify for housing. A harm reduction model would let them use substances and keep their housing, but it would offer supports. People living with a mental illness may also not qualify for housing if they aren’t receiving treatment. Harm reduction would offer housing whether they have a treatment plan or not.

  • Low-barrier housing is a type of harm reduction housing. It’s usually shorter-term housing to help people move from homelessness to permanent housing.

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Where can I find more information?

If you or someone you love could benefit from supported housing, it’s a good idea to talk to your doctor, mental health practitioner or mental health team. They may refer you to a program that fits your needs. Other places to find information include:

Visions: BC’s Mental Health and Addictions Journal
Different issues of Visions looks at housing and homelessness as it affects people living with a mental illness or substance use problem. You can learn more about the issues around housing and homelessness, read personal stories and find information on project and programs around the province. To read Visions online, visit www.heretohelp.bc.ca/visions.

Your local health authority
Health authorities in BC offer different housing services, including licensed community care and support programs. To find contact information for your local health authority, visit www.health.gov.bc.ca/socsec/

Canadian Mental Health Association branches
Many CMHA branches in BC offer supported housing programs. They can also help you find other supported housing programs. For a list of CMHA branches, visit www.cmha.bc.ca/localhelp and click on “CMHA Branches.”

Residential Tenancy Office
The Residential Tenancy Office helps renters (also called “tenants”) and landlords understand their rights and responsibilities and helps resolve problems. For more information, visit www.rto.gov.bc.ca.

Tenant Resource & Advisory Centre
Tenant Resource & Advisory Centre (TRAC) offers information on tenancy agreements, renter’s rights, dispute resolution and other issues. They publish the Tenant Survival Guide, an easy-to-read guide to tenancy in BC. The Tenant Survival Guide is available in English, Spanish and traditional Chinese. They also offer a Tenant Infoline (in English only). For more information and to read the Tenant Survival Guide, visit www.tenants.bc.ca. To speak to someone on the Infoline, call 604-255-0546 (in Greater Vancouver) or 1-800-665-1185 (toll-free in the rest of BC).

YIMBY—Yes in My Backyard!
The YIMBY toolkit from Pivot Legal Society makes the case for supporting housing developments in our neighbourhoods. You’ll find more information about the right to housing, the human rights legislation behind YIMBY, case studies from Lower Mainland communities and organizations, and strategies to make your own neighbourhood more inclusive. For more, visit www.pivotlegal.org/homes_for_all.

 
BC Housing

BC Housing is a government agency that helps people with a range of housing needs, from shelters to home ownership. They also offer programs like the Rental Assistance Program, which helps low-income families make their rent payments. For more information, visit www.bchousing.org or call 604-433-1711 (in Greater Vancouver) or 1-866-465-6873 (toll-free).

 
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