Mental health and housing : joined up thinking for 21st Century community mental health ....
Joined up research
RJA’s view is that the current division between the Medical Research Council and the Economic and Social Research Council may now have become dysfunctional, as it perpetuates a separation of evidence cultures which ensures that these two important areas do not share assumptions about best evidence.
If we are serious about tackling the social determinants of health, we will need a better integration of the agendas, and the methodological preferences, of these disparate research communities.
Towards a social action paradigm for mental health epidemiology
The methodological issues around studying complex multi-factorial effects, such as the effects of housing and the built environment on mental health and vice versa, are challenging, to say the least. The review on this site of David Halpern’s seminal study, “More than bricks and mortar”, may serve as an introduction for those new to the field.
For a more comprehensive statement on the methodological issues, and the current position in developing a housing and mental health research special interest group, see “An elusive interaction”.
For our summary - originally commissioned by the UK Dept of Health for New Horizons - of the best evidence to date of the impact of housing circumstances and interventions on mental health and illness, and the implications for policy, see Thinkpieces; and for available metrics, see Publications and also the earlier NSIP evidence review.
The Big Idea
Housing is central to community care.
The old debates over whether mental health is essentially physical/genetic or social/environmental are not merely old, but out of date; and interventions need to keep pace with new findings. For example:
Right: Our environment actually turns on and off our inherited developmental genes.
Centre right: In an enriched environment, we continue to grow neural connectivity
Centre left: Recent research on laboratory rats shows that in a stimulating environment - called without irony “enriched housing” - even well-known, single gene diseases (such as Huntingdon’s) have markedly delayed onset and reduced effect.
Left: The barely legible cartoon on the left comments wryly that we often make a point about humans seem more scientific, if instead we make it about rats.