Mental health navigators

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The context

Large-scale research in Scotland gave clear evidence of the relationship between homelessness and poor health. It showed interactions with health - especially mental health - services increased in the lead up to homelessness, and concluded mental health issues are likely to be homelessness risk factors. Since 2007, ‘mental health reasons’ have been cited as a reason for failing to maintain housing for a growing number, and proportion, of Scottish homeless applicants. In 2020-21, 27% of households identified mental health as a support need at assessment.

The research also found people who are homeless are more likely to present from deprived areas, which often have higher proportions of social housing. All this suggests closer preventative working between mental health services and landlords of those at higher risk of housing failure makes sense. This is something that social housing provider, WDH, and its local NHS Mental Health Trust have been doing since 2015.

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The intervention

Stock transfer social housing provider WDH, which owns over 32,000 homes in Yorkshire, carried out research on health inequalities with its (then) Primary Care Trust. It found around a quarter of tenants experienced mild to moderate mental health issues, for which there was little local support provision. WDH assessed that these issues often, when unsupported, impacted on tenants’ abilities to manage various aspects of their homes, including neighbour relations, maintenance and rent.

As a response, South West Yorkshire Partnership NHS Foundation Trust and WDH jointly funded a 12-month pilot of ‘mental health navigator’ roles. This saw mental health clinicians seconded to WDH to support tenants with low to moderate issues. Their early interventions proved fundamental to tenancy sustainment - so much so that the pilot was subsequently mainstreamed, with three navigators becoming a permanent part of WDH’s wellbeing service offer. The team, which is conceptualised as ‘estate management in different guise’, also contains five wellbeing caseworkers.

The service is open to all WDH tenants and receives over 1,000 referrals a year. Each one is triaged by the team. Some tenants benefit from a wellbeing worker, who takes a holistic, person-centred approach to helping them address barriers and achieve goals (for example, diet, lifestyle, social anxieties). Others require input from the mental health navigators: someone who is able to make clinical judgements, offer coping mechanisms and strategies, and/or facilitate access to specialist recovery services.  

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The outcome

WDH’s mental health navigators and wider wellbeing service have been busy, with referrals rising by around 30% each year. 95% of tenants referred for support engage with it. By intervening early, with expertise, to assess what support is needed and making sure that this is put in place, WDH calculated approximately 50% of tenants identifying an antisocial behaviour issue at the point of referral no longer had the issue when the case was discharged following supportive interventions. As such, the housing provider believes the service more than pays for itself.

WDH determines the presence of navigators as part of the housing service also reduces demands tenants may place on other health services including Accident & Emergency (A&E), GP surgeries and crisis mental health services.

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Key insights

•  navigators have a different feel/look to other staff working for the landlord, and this works well
• mutual understanding of the challenges of both housing and health systems allows for closer integration and deeper collaboration
• early evaluation capable of showing outcomes and cost effectiveness really helps a business case

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Find out more…

David Thorpe, Care and Health Manager, WDH
dthorpe@wdh.co.uk