Case studies in deinstitutionalisation: implementing supported housing programs in two Australian states

This paper is one of a pair examining implementation in two states of programs that provide housing and support to people discharged from psychiatric hospitals. The first paper describes the implementation in Victoria of a program established in 1995 by a non-government agency called Neami. This second paper takes the Neami Community Housing Program as a point of reference against which to examine the implementation since 2005 in South Australia of a program called Returning Home. The paper begins by outlining some of the debates that have informed the delivery of mental health services in Australia, and considers ways in which mental health reform objectives articulate with changes in public and private provision of housing. It describes some of the programs developed in Australia to provide housing and support to people with psychiatric disabilities, and identifies similarities and differences in the models adopted in different states. After introducing the current study, the paper outlines findings in relation to two programs implemented in Victoria and South Australia. It concludes with a discussion of critical differences in context, program design and approach to implementation that influence the capacity of these programs to meet their objectives. Compared with the situation in Victoria a decade previously, planning for redevelopment of mental health services in South Australia has been advanced in an environment that is suspicious of deinstitutionalisation and in which public discussion of mental health policy has been politically sensitive in the extreme. In addition, attempts to find housing for people with high and complex needs were hampered by problems with supply of housing that had not existed when the National Mental Health Strategy was established