May is mental health month, a time to focus on efforts to ensure that people with mental health conditions have the resources they need to live in the community. Stable housing and health care are both essential for good mental health, but housing instability and lack of access to health care are all too common among people with mental health conditions. Unfortunately, the President’s Medicaid policies and rental assistance proposals would reduce access to programs that are critical to integrating housing and health assistance in order to improve housing stability and access to health care.
People with serious mental illness make up about 1 in 4 people living in homeless shelters, and over a third received no mental health services in the last year. State and local efforts to integrate housing and health services for people with mental health conditions show great promise to improve these outcomes. Evidence shows that models like supportive housing, which integrates affordable housing with coordinated health and other services, help people with chronic health conditions and histories of homelessness or institutionalization stay stably housed and connected to care in the community.
In order for models like supportive housing to work, however, programs need to connect people to both rental assistance and health care services, and many integration efforts rely on federal programs to do so. Federal rental assistance makes rent affordable for even the lowest-income households, removing cost as a barrier to staying housed. Medicaid provides access to the community-based health care that some people with mental health conditions need in order to stay out of institutions. Communities can then use a mixture of state and local resources and federal grants to cover costs that rental assistance and Medicaid can’t pay for.
Recent Trump Administration policies and proposals threaten to undermine these housing-health integration initiatives by diminishing vital federal resources:
The stress of housing instability and homelessness can worsen health problems like mental illness and make it harder for people to get treatment. Rather than adopting harmful policies, the Administration should work with states to build on the Affordable Care Act’s Medicaid expansion to cover housing support services and voluntary supported employment services that help people with mental illness and other health conditions overcome barriers to stable housing and employment, as Washington State recently did. Also, the President and Congress should fund more rental assistance to meet the growing need for affordable housing and help states use federal grants to fill in the gaps.