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Bad living conditions shape our mental health for years to come



Australia carries a huge and increasing psychological burden. At the same time, the housing disadvantage is increasing in Australia. Our latest research shows that trends are related. A systematic review of the evidence shows that depriving housing is harmful to mental health and the impact will remain with you, even if your living situation may have improved. For example, life in a crowded home from birth to early childhood is associated with midlife depression.

How many people are affected? One in five Australians suffer from a mental disorder in a given year and nearly half suffer from mental illness during their lifetime. Mental health accounts for more than AUD 9 billion of public and private spending in Australia, and 4.2 million Australians received mental health recipes in the years 201

7-18.

As far as housing is concerned, up to 1.1 million Australians live in homes in very poor condition.




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Building the link between housing and mental health

In recent years, several high-quality Australian and international studies have attempted to understand the relationship between housing and mental health. A small part of this evidence base has attempted to accurately quantify the impact of housing on mental health over a longer period of time. We have collated the results of such longitudinal studies and conducted a systematic study to determine whether housing deprivation can lead to a deterioration of mental health home ownership, subjective perception of inadequate housing, eviction, or poor physical housing. Our systematic review of international evidence shows that, irrespective of the consideration of living disadvantages, there is a link with poorer mental health in the future.

In the studies we studied, sample sizes ranged from 205 to 16,234 individuals. The follow-up period ranged from one year to 34 years in all stages of life – birth to adulthood and age. Although studies on the two extremes of homelessness and serious mental illness were deliberately ruled out, each study confirmed a link between at least one marker of disability and poor mental health.

The psychological consequences included higher probabilities for depression, stress and anxiety. The studies included in the review identified these results across all age groups, from very short follow-up periods of about two years to relatively long periods of time over decades.

These findings make sense. Living is a central part of our lives. For most of us, it's the biggest expense. It shapes our experiences; it is both a financial asset and a home.

This means that insecure living can be very destabilizing for families and individuals.




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Our paper reveals a wide variety of mechanisms by which housing affects mental health outcomes (such as anxiety and depression) at different stages of life. For example, physical housing problems such as moisture or cold affect mental health in different ways than housing-related financial insecurities. However, there is evidence that physical housing and affordability issues can work together to increase the impact on mental health.

Housing problems on the rise

Australian housing is changing and becoming less secure. More and more Australians are renting privately. Many young people will never own their own home.

At the same time, our public housing can only provide a safety net for the most vulnerable people with high and complex needs. Waiting lists are long. And we see no substantial commitment by the government to reduce this lack of social housing.

In addition, the quality of our apartments in the entire housing stock deteriorates. The Australian Healthy Living Index is a composite measure of the affordability, safety, quality, location and accessibility of housing. The index shows an increase in housing dwellings in our total housing stock since 2000, including a significant increase for low-income private tenants.

Increase in unhealthy housing in Australia from 2000 to 2016.
Adapted to an Australian geography of unhealthy housing

Due to the growing inefficiency of housing, many of us simply can not keep up with basic maintenance and repair work. Paving solutions mean that some of us live in cold and damp homes, in houses that leak in the rain, in homes that can not accommodate growing families, or in homes that may not meet our needs as our mobility decreases. At the extreme end, 116,427 of us were homeless on the night of the census.




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According to current estimates, every ninth household has priceless housing. Up to 1.1 million Australians have apartments in very poor condition (or even expired).

Given the extent of housing deprivation, its role in promoting poor mental health is likely to be of great concern to all of us. This indicates that a large number of Australians are suffering from mental health problems associated with, or worsening, inadequate housing.

The changes in tenure and quality in the housing sector have been widely discussed. The psychological consequences of housing must also be discussed and even prioritized.




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Investing in Mental Health Housing

The Australian Government's most recent research funding initiative, the Medical Research Future Fund, has a Million Minds Mental Health Research Mission. It aims to support the study of the causes of mental illness as well as the best strategies for early intervention, prevention and treatment. Our systematic review suggests that both research and public investment to improve mental health must take into account the affordability, quality and condition of people's living space.

Living plays a central role in our lives. Affordable, safe and in good condition, it provides a foundation for our full participation and contribution to society.

If we discovered a risk-free drug that protects people's mental health, we would demand that it be widely available. When we think about what housing policy might look like, what if we considered decent housing a form of mass medication? A protective net? Would not it be something we invest in and that we would all prescribe?




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