Treatments & Services
Appropriate Housing: Four Criteria
Regardless of the appropriate housing option, they must meet four criteria in order to be appropriate and effective.
Housing must be affordable to people with mental illnesses. Ideally, tenants should not have to pay more than 30 percent of their income for housing costs. Ideally, an individual receiving a monthly Supplemental Security Income (SSI) benefit of $674 should pay no more than $222 per month toward rent (30 percent of $674). When tenants are required to pay a greater percentage of their income for rent, they often have to forego other critical needs such as health care, food and clothing. Because many people living with mental illness have low-incomes, meeting housing costs may only be possible with additional financial assistance, usually government-funded rental assistance or rental subsidies.
In fact, the Priced Out in 2010 report found that people living with mental illness relying on SSI needed to pay (on average) 112 percent of their monthly income to rent a modest one-bedroom apartment at the HUD Fair market Rent (FMR) level. Further, in 218 housing markets, across 42 states, one-bedroom rents exceeded 100 percent of monthly SSI benefits, including 30 communities with rents over 150 percent.
Independence is less tangible than affordability, but equally important. One component of independence is that people choose their housing, including its location and model. Independent housing provides occupants with a clear sense of their rights, including rights of tenancy. Tenants should be provided leases or occupancy agreements that clearly outline fundamental tenant rights and responsibilities. Independent permanent housing should not be directly tied to services; it should enable the participant to keep the provision of services distinct from the housing. In independent housing, occupants enjoy privacy, choice of a roommate, the ability to determine who enters their home and when they have guests.
Housing must meet a range of accessibility needs. First, people living with mental illness who also have physical disabilities must live in units that are physically accessible and modified to meet their special needs. These modifications may include wheelchair accessible features such as ramps, wide doorways, lower cabinets and roll-in showers. For those with hearing or visual impairments, an accessible unit may include assistive technologies such as blinking lights, alarms or other appropriate features. In addition to physical accessibility, it is important to recognize the importance of access to needed services such as healthcare providers and community amenities such as supermarkets. Because many people living with mental illness do not drive cars, housing must be close to needed services or public transportation so that they do not have to rely on other people for transportation.
Housing Free From Discrimination
The federal Fair Housing Act bars discrimination in rental housing based on disability. This prohibition bars landlords and property owners from refusing to rent to people living with serious mental illness based on their disability. It also requires landlords to make “reasonable accommodation” to people living with mental illness based on their disability—including specific features in rental housing. This includes allowing tenants with disabilities to use rent subsidies such as Section 8. In addition, the U.S. Supreme Court has ruled that local communities cannot use restrictive zoning and land use policies to restrict placement of supportive housing in residential neighborhoods.
NAMI webinar on Best Practices in Supportive Housing
The Bazelon Center’s What Fair Housing Means for People With Disabilities
NAMI’s Housing Tool Kit
SAMHSA’s Projects for Assistance in Transition for Homelessness