Social housing and the rising challenge in mental health

Social housing, once intended for a broad cross-section of society, is now largely reserved for those in the highest categories of housing need. The Housing Ombudsman highlights the vibrant communities with social housing, but notes that increasing pressures on health, access, and quality have changed the concept of general needs housing, reminding us that “general needs does not mean no needs.” 

The health needs of social housing tenants are shifting dramatically, with recent data highlighting the health inequalities played out in tenure. According to the English Housing Survey, 61% of social rented households contained someone with a disability or longterm illness in 2024–25, up from 49% in 2015–16 (compared to 37% and 31% for all households). 

Rising mental health challenges 

Mental ill health in particular is rising sharply: households reporting mental health issues in the English Housing Survey increased from 17% in 2013–14 to 38% in 2023–24. The latest Adult Psychiatric Morbidity Survey (APMS), which screens for a range of mental health conditions, shows how the prevalence of mental illness is increasing over time, as well as clear inequalities: adults in the most deprived areas are significantly more likely to have a common mental health condition (26% vs 16%). People with problem debt, not in employment, or with limiting long-term conditions also face far higher risk. 

Multiple factors are driving this rising need. MIND with the Centre for Mental Health point to greater awareness of mental health, the effects of the pandemic, poverty and the cost of living, cuts to public services and the digital environment. Within housing, poor conditions such as cold, damp or overcrowding can heighten anxiety and depression, particularly for young people.

A changing context for housing

Housing providers see these effects daily. In a small-scale survey on tenant mental health and housing services, Altair found that mental health needs of tenants are now a regular part of social housing staff workload, with most believing such needs have increased over the past 2–3 years. Common tenancy challenges linked to tenant mental health included:

• Rent arrears and financial difficulty (82% of respondents said this was a challenge linked to tenant mental health).
• Repeated complaints or calls for help (71%).
• Poor property conditions (59%).
• Issues with access to property (59%).
• Hoarding (53%).
• Antisocial behaviour or neighbour conflict (47%). 

Yet only 38% said their organisation has a formal policy for recording tenant mental health information, and employees’ confidence in supporting tenants with mental health was mixed. 

Staff wellbeing is also under pressure. In our 2023 survey of over 250 allocations and lettings staff in Scotland, 68% reported feeling burnout or close to burnout in the last year, with local authority staff more likely to face distressing interactions, including one in five speaking weekly or daily to someone expressing suicidal thoughts linked to their housing situation. 

Looking ahead: the vital role housing providers can play

Looking ahead, the pressures are set to grow. Demand for mental health support is rising faster than the workforce, and health inequalities are projected to widen. By 2040, major illness among workingage adults in the most deprived regions is expected to be more than double that in the least deprived, with anxiety and depression driving part of this rise.

Despite this, our survey showed promising approaches. Relationship based practice, clear safeguarding and crisis pathways, and dedicated specialists and teams help ensure timely support and appropriate referrals. As one respondent noted: “We are clear around our roles and responsibilities...The team support staff when they come across someone in crisis in making the appropriate referrals.”

Social housing providers can help support residents by:

• Recognising the central role of mental health in tenancy sustainment.
• Prioritising relationship-based practice with tenants and communities.
• Investing in staff support, training and wellbeing.
• Building stronger partnerships for housing to be viewed as a “professional body who knows their customers” by community mental health teams. 
• Developing clear policies and procedures with regular refresher training. 

Evidence suggests that the housing system, including social housing, can help lessen the effects of income poverty. The sector remains uniquely placed to provide protective factors that support wellbeing through providing safe, quality, affordable homes and responsive services, as well as meaningful careers for staff.