The International Journal of Psychosocial Rehabilitation

Make yourself at home: People living with psychiatric disability in public housing

Rebecca Jones, BA(Hons), MA
Research Fellow, School of Rural Health, Monash University

Janice Chesters, BA(Hons), PhD
Lecturer, School of Rural Health, Monash University

Meredith Fletcher, BA(Hons), MA, PhD
Senior Lecturer, Centre for Gippsland Studies, Monash University
 
 

 Citation:
Jones R., Chesters, J.& Fletcher, M.(2003)  Make yourself at home: People living with psychiatric
disability in public housing. International Journal of Psychosocial Rehabilitation. 7, 67-79.



 


Correspondence:
Rebecca Jones, School of Rural Health, Monash University, PO Box 424, Traralgon, Victoria, 3844, Australia.

Disclosures:
The project was funded by the Monash University Small Grants Scheme.
Janice Chesters is chair of the Committee of Management of SNAP Gippsland INC.
Rebecca Jones and Meredith Fletcher have no disclosures.


Abstract
To be successful, community integrated supported public housing for people with psychiatric disability, must not only provide shelter but must also allow people to make the house a home. This study explores the ways people with psychiatric disability in an Australian supported public housing program experience their houses. The supported public housing program evaluated is SNAP Gippsland Inc. located in regional Victoria, Australia. This study employs in-depth, semi-structured interviews to explore individual, personal experiences. The interviews reveal that, to differing degrees, all of the participants experienced their houses as home and the major criteria which participants identified as contributing to the creation of the home were stability, privacy, identity, physical comfort, domesticity and support. However, lack of personal, domestic relationships and renting rather than owning the property limits the ability of some participants to identify their houses as home. The narratives of home presented by the participants also suggest that creating a home can assist with managing psychiatric disability.

Introduction
I live in a two bedroom fully furnished unit. I feel safe. It is my home. I had the sort of lifestyle where I’ve been flitting from one place to another never spending any more than a year at the same place. Whereas now, thanks to Human Services and SNAP I’ve got a home for the first time. It’s my home, they can’t take it away from me unless I do something drastic which I have no intention of doing. It’s my home and they’ve made it feel like my home. You can put your plants and your pictures and have your friends around (Sheila).

Sheila lives in a regional town in East Gippsland in Victoria, Australia. She is a client of SNAP Gippsland Inc (subsequently referred to as ‘SNAP’), a psychiatric disability support agency that assists people with a psychiatric disability to live ‘independently’ in the community.

In this study we look at how people living with a psychiatric disability in supported public housing create ‘a home’. We explore the ways they experience their houses and the meanings they place on their homes. Insights and information have been gathered through in-depth, semi-structured interviews with clients of SNAP. This evaluation of the SNAP Housing and Support program is based on our reading of the opinions and experiences of the clients themselves.

In 1995 Belinda Robson completed a comprehensive evaluation of the Victorian Housing and Support program (Robson, 1995). Robson’s evaluation was based on semi-structured interviews and focus groups with tenants and support workers from a range of agencies within the program. Robson concluded that the program was highly successful in providing high quality housing and appropriate support and that clients’ quality of life significantly improved while on the program.

In contrast to the broad parameters of Robson’s evaluation, this study focuses exclusively on the experiences of the participants themselves and concentrates on one disability support agency - SNAP. The aim of this study was to assess the success of the SNAP housing and support program from the point of view of the clients. Unlike Robson’s study, which focused on the physical housing environment, management and support, the intention of our study was to gauge the emotional responses and opinions about the non-material aspects of a home as well as the physical environment.

One of the essential criteria of successful supported housing, we believe, is that the accommodation is experienced as home (Ridgeway & Zipple, 1990:116). Therefore, an essential part of evaluating a housing and support program is to consult clients about their opinions and experiences of their housing. This study explores whether SNAP clients experience their houses as home and, if so, what ‘home’ means to them. It looks beyond shelter and physical comfort to the emotional, non-material aspects of a home. In doing so, it tries to give voice to people recovering from psychiatric disorders. From this we gain some understanding of the success of a supported housing program.

Snap housing and support program
Australian, United States’, Canadian and Scandinavian studies report that people with mental illness want to live in individual dwellings in the community, alone or with a companion of choice (Lambert et al., 2000; Owen et al., 1996; Tanzman, 1992; Tanzman, 1993; Middleboe et. al., 1998; Keck, 1990). They also desire some level of support with everyday living that would be available when needed. In the last ten to fifteen years a ‘supported housing’ approach has emerged in North America, Western Europe and Australia which attempts to meet these fundamental needs of people with serious mental illness and ongoing disability. Carling suggests that supported housing is based on three interrelated principles of consumer choice, integrated community housing and flexible services (Carling, 1993:439). It aims to provide stable and affordable housing which emphasizes the principles of independence, integration through community living, enhanced quality of life, consumer choice and support as required and which is integrated into the general community (Hogan & Carling, 1992; Ogilvie, 1997).

In Victoria, Australia in the early 1990s the Mental Health Branch and the Office of Housing (sections of the Victorian State Government Department of Human Services) worked with psychiatric disability support organizations to establish a supported housing program for people with psychiatric disabilities in rural and metropolitan Victoria. This program is known as the Housing and Support Program.

SNAP became involved in the Victorian Housing and Support program in 1993/4 and now has 22 two-bedroom properties. Clients for the program are selected on a needs basis. They occupy their house alone, with children or a housemate of their own choice. Residents are tenants of the Office of Housing and receive disability support services from SNAP. The type of support provided is shaped by the clients’ needs and desires but may include assistance with budgeting, shopping and other domestic activities. All clients require support when they join the program but, for some clients, the need for support may decline over time. They may stay in their houses as long as they wish, even if they no longer require support from SNAP.

The Office of Housing purchased fifteen units for the SNAP Housing and Support program in the regional towns of Bairnsdale, three units in Sale and four units in Lakes Entrance in East Gippsland. East Gippsland is a rural, predominantly agricultural area with dairy, wool and timber industries. It is sandwiched between the Victorian Alps and the Southern Ocean and has large tracts of relatively remote forest and mountain areas. The service center for East Gippsland is Bairnsdale, with a population of 11 000, located 277km east of Melbourne, the State capital. About 65 km west of Bairnsdale is Sale which, with a population of 13 400 is the largest town in the region and the administrative centre for offshore oil and gas industries and a RAAF military base. Both Sale and Bairnsdale have SNAP offices, where staff are based and recreational activities for clients are organized. Lakes Entrance is a small coastal tourist and fishing industry town east of Bairnsdale, with a population of 5250.

SNAP houses were spot purchased by Office of Housing and are located individually in residential areas about one kilometer from the shopping and service areas of the towns. Due to the unavailability of one-bedroom units, Office of Housing purchased two bedroom units in which clients have been housed individually. All the units are brick or brick veneer, built within the last 20 years. In addition to the bedrooms they have a kitchen, lounge/dining area, bathroom and laundry, small rear garden, and many have a garage. They are decorated in neutral colours and carpeted throughout the bedrooms and living areas. If needed, SNAP uses State government funding to supply a refrigerator, washing machine, television, dining table and chairs, cutlery, crockery and soft vinyl covered lounge suite.

Methods
The project was funded by the Monash University Small Grants Scheme and ethics clearance was granted for this project by the Monash University Standing Committee on Ethics in Research Involving Humans.

At the time of the interviews twenty-one clients were involved in the SNAP Housing and Support program. (Two SNAP clients lived in the same house and two other houses were vacant while renovations were being completed). All of the clients were approached and four declined to be interviewed, two were hospitalized and one could not be contacted. In addition, one former SNAP resident, who left the program two years previously, was also interviewed. Therefore, fifteen people (eleven women and four men) volunteered to participate in this study.

The participants whose stories are told in this study are: Deanne, Helen, Jackie, Bill, Mick, Cathy, Jacko, Paul, Anne, Sheila, Barb, Heather, Maureen, Deborah and Joanne. They have been assigned pseudonyms to match the character, gender, age and ethnic origin of their real names. The participants all experience chronic psychiatric disability associated with schizophrenia, bipolar disorder and depression. Their ages range from late thirties to early fifties, except one participant who is in her mid twenties. With the exception of one Aboriginal person, all participants are of Anglo-European decent. Two participants recently began sharing a house but the others all live alone or with one child. While all of the participants’ narratives inform this paper, we have focused on the stories of Deanne, Helen, Barb, Sheila, Cathy and Jackie whose stories exemplify the experience of the clients of this housing and support program.

Rebecca Jones conducted in-depth, open-ended interviews with thirteen of the participants and John Monahan, a SNAP volunteer, conducted two interviews. Participants were interviewed individually and the interviews were tape-recorded then transcribed verbatim. Prior to the interview the project and its outcomes were explained to each participant, both verbally and in written form. Participants were then asked to sign a consent form agreeing to be interviewed and having excerpts from their interviews published anonymously. In the interview, a series of open-ended thematic questions encouraged participants to speak in their own words with few interruptions. Participants were asked: 1) to describe their house (both physically and emotionally); 2) what they liked and did not like about their house; 3) if the house felt like home and why or why not; 4) how their experiences of their houses have changed over time; 5) to describe their ideal house; 6) their opinions of the support services they received from SNAP. These thematic questions were followed by a series of prompt and clarification questions about the house, visitors, the neighbourhood, domestic activities, SNAP services and support, and demographic details of the participants.

The in-depth interview does not set out to obtain ‘objective’ information; its intention is wholeheartedly subjective and is designed to generate an individual’s narrative and give interviewees scope to explain, in detail, their feelings, thoughts and experiences (Crabtree & Miller, 1991:146).

Interviewees elected where they wished to be interviewed, an approach designed to ensure the participants felt as comfortable as possible. Thirteen of the participants chose to be interviewed at home and these interviews were supplemented by observations of the house made by the interviewers. Two participants, Paul and Helen, chose not to be interviewed in their houses and were interviewed in SNAP offices.
 

What makes a house a home?
Houses are places prickling with meanings. When a house becomes a home it ceases to be simply a shelter and becomes a space that contributes to emotional, non-material needs and well-being. Shelter and physical comfort are basic requirements of a house but do not, by themselves, constitute ‘a home’. A home is constructed by attaching meaning to the physical environment.

Our theoretical understanding of the idea of ‘home’ has been shaped by the work of Somerville (1992), Csikszentmihalyi & Rochberg-Halton (1981), Rapoport (1981), Allan & Crow (1989) and Saunders (1989). Peter Somerville, in his analysis of home and homelessness, argues that home is both a socially constructed set of imagined ideals and an experienced reality. He identifies seven key signifiers of home: shelter, hearth, heart, privacy, roots, abode and paradise. ‘Shelter’ and ‘hearth’ relate to the basic physical aspects of a house such as the built structure, physical environments of warmth and, hopefully, coolness in the hot Victorian summer, while ‘heart’ represents emotional comfort and a sense of well-being. ‘Abode’ describes the home as a base for domestic activities and everyday living and ‘paradise’ describes the house as a place where ideals and aspirations are realised. Home as a private place is discussed by Somerville (1992) as well as by Allan & Crow (1989) and Saunders (1989). They discuss the importance of a sense of privacy, control and maintaining boundaries in developing a home. Macgregor Wise (2000) expands on this concept of privacy and control in exploring the ways people define personal territories in and around their houses. Somerville’s concept of ‘roots’ describes the home as a source of identity, a place in the world as well as a retreat from the world. This idea is taken up by ethnographers, Csikszentmihalyi & Rochberg-Halton (1981) and Rapoport (1981), who focus on the role of the home in affirming and creating identity and explore the relationship between identity and physical environment. Csikszentmihalyi & Rochberg-Halton examine the importance of objects in personalizing space for urban residents of the United States of America, while Rapoport provides a cross-cultural examination of the representation of personal and group identity in domestic buildings.

These theoretical discussions of home help us to understand the complex ways houses are experienced by their occupants and provided the context for interpreting SNAP clients experiences of home. Somerville’s definitions were also particularly useful in helping us to shape the thematic questions used in the in-depth interviews with participants. As this project focuses on the housing experiences of the clients themselves, we did not allow the theories of home proposed by these theorists to dictate the structure of our findings. Rather, we concentrated on themes that emerged strongly in the client interviews and used the theories of home to broaden our understanding of SNAP clients’ experiences. In the section below, we organize our findings using themes that emerged strongly in the interviews.

What the SNAP participants told us
In common with the subjects of the studies mentioned above, the most important attributes of home, which emerge in these interviews with SNAP clients, are stability, identity, privacy, ownership, physical comfort, domesticity and love. In the following sections the participants of this project identify those things that make a house a home and discuss their significance to their lives.

Identity
I guess it felt a bit sterile because it was quite modern and neutral and it didn’t have a definite style or feel, a bit like a blank canvas. It also had vertical blinds. To me it just felt a little bit clinical, especially since I had previously lived in a mud brick cottage with lead light windows and a loft and wood fire cooking that was filled with character. So to make it less clinical I picked up some prints. It was great because we were allowed to hang things on the walls and I burnt candles and essential oils. In an op shop I picked up a lovely Chinese satin robe and pinned it up on the wall. It was gorgeous. I added my own touches, which made a difference. I bought bright colourful throw rugs… I started to feel like it was my home and my son’s home and took even more pride in it by planting a garden out the front. We planted lots of lavenders and daisies and a couple of really nice special things, a weeping cherry tree and a tree for a friend of mine who suicided. I wanted to plant something for him (Deanne).

Personalizing her house with objects, décor, furniture and garden has made a characterless house feel like home for Deanne. One of the most important roles of a home is to reflect a sense of personal identity (Rapoport, 1981; Csikszentmihalyi & Rochberg-Halton, 1981, Somerville, 1992). SNAP clients do this by filling their houses with objects that they feel reflects their taste, life or personality. Deborah, whose unit is a repository for 200 Barbie dolls and 160 porcelain dolls that march in battalions across her lounge room walls, takes this need to extreme. Despite the fact that there is little room to move in her house she continues to acquire dolls and mentioned mildly: I’ve added a few touches of my own.

Furniture, while being functional, is also a means by which many people express individuality in a house. However, all but one of the participants use furniture provided by SNAP that conforms to a standard design with a choice of colours. SNAP clients were grateful that furniture was supplied and recognize its functionality but Deanne and Jackie both regret that they do not have ‘their own’ furniture that expresses themselves. As Jackie says: Eventually I’d like to save up enough money that I get my own lounge suite, my own vacuum cleaner, my own TV. I don’t like having things that are other people’s. I like having my own things.

Maintenance and decoration also creates a sense of ownership of a house through impressing individuality on its physical structure (Csikszentmihalyi & Rochberg-Halton, 1981). However, painting, carpets and structural repairs are too costly for most participants to contemplate and are the responsibility of the Office of Housing. Although this ensures an adequate physical living environment, it deprives residents of an opportunity to personalize their houses (Rapoport, 1981:21).

Only three participants made little attempt to impress personal identity on their houses. Mick, Anne and Jacko have almost no personal items, decorations or furniture other than that provided by SNAP. For Anne and Mick, home is elsewhere (with parents and with a fiancée, respectively, as discussed below). Jacko hasn’t made his unit into a home because he has a desire to move away from Gippsland and live elsewhere. For these reasons, all three participants put little energy into maintaining, modifying and personalizing their houses.

Privacy and autonomy
It’s my home. No one can take it off me. It’s safe. If I don’t want anyone there I can tell them where to go. Its mine… I like having my own home because I can do just what I want to. I can have who I want to there. I can eat when I want to and go to bed when I want to… I know its mine. No one can tell me what to do there. I’ve become very possessive of it because I’ve never had anything before (Helen).

In lives marked by psychiatric disability, hospitalization and, for some, abusive relationships, control over personal space is a reality, which, prior to moving into their SNAP units, has eluded most participants. Helen’s SNAP house is the first opportunity she has had to have some control over her immediate living environment. This control gives her a sense of ownership.

Similarly, Paul sees his house as a place to withdraw, where he can do as he pleases: I like to know I can go home and say, think and do more or less what you like in your own premises. A home allows residents to retreat to a private world away from the scrutiny of others. It is a place where they have a sense of autonomy because it is a space over which they have control (Macgregor Wise, 2000; Allan & Crow, 1989; Saunders, 1989).

Living with a very active two-year-old, Jackie is less certain that she has complete control over everything that happens in her house so she has created a small space within the house where she can withdraw from the demands of the world. Pointing at the armchair in the corner of the lounge room she said, you can sit in that seat and get away from whatever is going on in the house, even if it’s really busy you kind of feel like no-one can get you.

One of the ways personal space or territory is delineated is by including and excluding others (Allan, 1989). Bill described how important it is for him to control who enters his house and describes visitors as ‘invaders’. I can’t handle people invading my space. When people come to visit me I get very anxious, worried and generally feeling uneasy.

Despite feelings of satisfaction at the privacy and control that the SNAP houses afford, there are whispers of uncertainty from some participants about the degree of their control, as participants acknowledge the authority of the Office of Housing. When discussing changes they would like to make to the décor of their units participants used the term "If I am allowed" deferring to the external control of Office of Housing. Paul explained the importance of abiding by the rules of the housing authority: You have got to abide by rules and if you can abide by rules you can conform and that is half the battle won. Barb was more rebellious about submitting to external control. She was disgusted that her autonomy and sense of responsibility is undermined by being required to call SNAP to report maintenance problems rather than ringing Office of Housing directly: It makes me feel as though I’m a little kid. If you’re supposed to get better in your illness, why don’t they let you try and do it yourself? Why can’t they give you the responsibility?

Stability
I’d moved out of a relationship and I’d been moving around different caravan parks and different places and I was on my fifth move in a couple of years when they came up with this house. They brought me round here and I went ‘I can’t believe I’ve got this place’. Yes, it is really good. Really good. I mean if it wasn’t for them I don’t know where I’d be now, probably still be in a caravan park or who knows where… This is the longest I’ve ever been in a place and I’ve been in here two years… . I’m sick of moving around. The old brain thinks ‘oh God I wonder how long I’m going to be here for before I’ve got to move again’. In relationships and as a child all I’ve done all my life is move from place to place and I tell you what, I’m sick of it. I’m really sick of it. You can never call any place your home (Barb).

Stability and security of tenure is a theme that emerges as a vital factor in participants’ experiencing their houses as homes. Most of the participants in this project, like many people with serious mental illness, have a history of disjointed housing and many have been homeless, living for extended periods in boarding houses, caravan parks and other temporary accommodation, or moving regularly between rented accommodation. For these participants, a SNAP house is the first opportunity many participants have had to enjoy stable, affordable accommodation.

Offices of Housing’s tenancy agreements inform SNAP clients that as long as they meet their obligations (such as paying the rent and keeping the house intact) the units are theirs for life, or as long as they wish even if they no longer require support from SNAP. Participants expressed their relief at the stability this allows. Helen says defiantly: It’s my home. No one can take it off me. [This is] SNAP’s house but its mine. SNAP don’t get it back until I move. I’m going to die when I’m 80 so they will have to wait another 30 years. I don’t have to give it up.

Jackie feels simultaneously blessed and bound by the stability offered by her SNAP unit. While she enjoys the feeling that the unit is ‘hers for life’, she also finds the security restrictive. Because she is a tenant and not owner of the house, she is not able to leave her SNAP house without forfeiting her right to return. She therefore feels that she can’t leave her house and her choices are restricted.

Physical comfort
It is all really good. They haven’t scabbed out. It wears well. It looks nice. They don’t just go ‘oh that will do’. It all looks very nice and they’ve tried to match it up. They don’t send you into a place that’s got holes in the wall, broken windows. You go into a nice place (Cathy).

The thing that I loved the most of all was the new carpet. It was a lovely feeling to walk in and find new carpet. Knowing that no one’s been on that carpet before makes a big difference (Maureen).

Physical comfort is an important criterion for a home. In these interviews, it emerged as a significant backdrop against which the emotional aspects of the home such as identity and privacy can be realized. Office of Housing selects units that represent a physically high standard. All the units were built within the last twenty years of brick or brick veneer and are well maintained. The furniture provided by SNAP is new (although subsequent tenants may ‘inherit’ the previous tenant’s furniture). All of the participants were satisfied with the physical quality of their units. The newness and quality of the building, fittings and furniture impress tenants and give them a sense of pride and self worth. As Sheila summed up: It makes you feel rich.

Domesticity
You keep the place clean and tidy, keep yourself clean and tidy, showers, vacuuming, just do your washing and clean up… make sure everything is clean and tidy. That you’ve dusted and vacuumed, garden is looking good and the front’s been swept up. Everything that you do at home. If you had your own little home you’d keep it nice and clean and tidy (Heather).

Heather chants these phrases like a mantra, as if she is reminding herself of the domestic tasks done by a ‘well’ person. She is playing the role of ‘housekeeper’ and her house is a home because she is doing the tasks ‘normally’ expected of a person living ‘at home’. Home is a place where people conduct their everyday life and is associated with particular daily activities such as cooking, cleaning, sleeping and washing. These tasks take on additional importance for SNAP clients because they represent ‘normality’. Domestic activities can be important in creating purpose, particularly when a person does not have paid employment or child-raising responsibilities. Housekeeping becomes, in itself a purpose and an activity instilling the certainty of a routine into everyday life (Higgins, 1989: 167). Some participants also believe that the routine and order of housekeeping can assist them to maintain a sense of mental order: "As you can see I keep the place pretty neat and tidy and organized. But that’s mainly my state of mind. If I don’t have things organized I become disorganized within myself. When I’m becoming unwell, if I know where everything is it doesn’t take as much mind power" (Jackie).

However, without the practical support of SNAP support workers most of these clients would be unable to maintain their homes.

Support
I was able to get a support worker that would see me once a week and help with basic budgeting and food shopping. That was a big help because I’d been in a defacto relationship, been very unwell on and off during that time and so I hadn’t had to completely look after myself on my own for more than ten years. I didn’t know anyone in Bairnsdale and had no family. So I really need housing and support… I had to virtually learn to look after myself and my son all over again. How to budget, how to plan menus on a limited budget and shop appropriately. How to cope with the numerous disruptions because I was still unwell… We put in place a written plan. Its something you do together with your worker. It’s a positive thing. You can sometimes fall off the track if unexpected things crop up so it gives you as sense of direction and also a sense that we are both working together, not them taking over your life (Deanne).

For people whose lives have been fractured by illness or disability, everyday living can be a struggle. Without support services provided by SNAP, most clients, like Deanne would be unable to create and maintain a home and the linking of these services is clearly crucial to the success of the program. All SNAP clients require support when they first move into their houses but for some people their need for support declines over time. All of the people interviewed for this project received support except Maureen who now lives successfully without SNAP support.

Home ownership
I guess I’m really lucky that I was able to find a way of buying a place. The irony is that I could have stayed in the SNAP housing for the rest of my life it I wanted. It was affordable, better condition and twice the size of the place I’m living in now you know what? Buying my house is the most wonderful experience. It is mine (Deanne).

While most clients achieved a sense of ownership of their house by stamping their personality on the place with objects or through a sense of privacy and control, three clients felt their SNAP units could never be a true home because they did not legally and financially own it. Deanne left her SNAP house two years ago and now has a mortgage to purchase a house in a small town near Bairnsdale. For her, home ownership held an allure greater than modern housing and quality appliances. Similarly, when asked, do you feel that this is your home? Heather responded doubtfully it takes a lot more money than what I’ve got to buy this place…. Jackie considers her lack of home-ownership to be an indication of lack of success, which makes her unhappy. Seventy percent of Australians own their own homes, either with or without a mortgage (Australian Bureau of Statistics, 1999: 5). Home ownership is often referred to as the ‘Australian dream’, indicative of security, independence and success and some SNAP clients, like many people in the general population, aspire to this dream.

Love
I have no partner and no one to talk to at home. I never imagined I’d be a single mother. I get very, very lonely as a single mum ‘cause you don’t get much communication with your child. The most interaction I have is my thoughts when the TV is on, which is pretty pitiful from someone who was one of the most popular girls in high school… To just living a lonely existence, going out once a fortnight, doing a shop, getting what you need to survive. My only friends are my caseworkers (Jackie).

Jackie, like most of the participants in this project is haunted by loneliness and the absence of loving relationships has left a deep sense of loss. Home is a place conventionally associated with family, particularly the nuclear family, (Allan, 1989: 143) however family is notably absent from the lives of the SNAP clients and this absence prevents many from experiencing their houses as home.

When asked what would make his place feel like home, Paul, who lives alone, responded gloomily People that are in it. People that are in it. While Paul’s loneliness is generalized, other participants deeply regret that children, parents and partners – the chief ingredients of the nuclear family - are not living with them. Anne believes ‘home’ to be the house where her parents live. Similarly, Bill comments: My ideal house: I’d like my two children to live in the house with me (but I don’t care about my ex, she can live in the shed!). Only Cathy, who lives with her teenage daughter and is regularly visited by her fiancé Mick, does not appear to yearn for love.

In the absence of domestic relationships Barb, like many of the participants, symbolically brings children, grandchildren and parents into her house through photographs even though she is estranged from most of her family. Barb says the photographs make the house feel like home.

For some, like Helen, pets are a substitute for human affection: Do you know what really makes it a home? Helen asked the interviewer. My two cats, because they are special. Try and take ' em off me – I’d move first. Office of Housing tenancy regulations prevent most SNAP residents from having pets and until regulations changed in early 2002, the body corporates of many of the units also forbade pet ownership. Perhaps as compensation for not being able to own a dog, Barb has a one metre high stuffed English Sheepdog and a large ceramic German Shepherd in her lounge room.

Discussion
The interviews with SNAP clients, undertaken as part of this study, serve as a means of evaluating the success of the SNAP Housing and Support program. They reveal the outstanding success of the SNAP and Office of Housing in assisting clients to make their houses into homes. The participants’ stories also reveal the difference the program has made to the quality of their lives. Through the interviews, participants told us not only that they experience their houses as home but also what they believe their home to be.

The narratives of home presented above demonstrate that these clients of supported housing experience their houses as home in five key areas: stability, identity, privacy, domesticity and physical comfort. Stability emerged in these narratives as a crucial factor in allowing these participants to experience their houses as home. The opportunity of a permanent home was particularly important to clients, although some, such as Deanne, chose not to exercise that choice. A sense of home was also achieved by providing a space that can reflect residents’ sense of identity and that they can personalize and stamp with a sense of themselves. A small number of participants chose not to personalize their space because they had reservations about their houses as home. SNAP units are also a space where clients have privacy and control; where they have autonomy to do as they wish and can create a personal territory by choosing who to include and exclude. The units are a place where, with the help of SNAP support services, residents can undertake domestic activities and maintain or reaffirm their sense of normality and ‘wellness’. Finally, SNAP units are comfortable and well maintained giving residents a sense of pride and self worth. These last aspects of home described by the participants (identity, privacy, domesticity and physical comfort) correspond with five of Somerville’s (1992) key signifiers of home: roots (a source of identity, a place in the world) privacy (territory and power to control one’s boundaries) abode (a site for everyday living and domestic activities) shelter (the physical structure & the material conditions which provide protection) and hearth (physical warmth and comfort). However, Somerville’s remaining two signifiers (‘heart’ and ‘paradise’) are largely absent from clients’ experiences of home, as described below.

The stories told by SNAP clients reveal three areas in which clients do not experience their houses as home. These are: 1) SNAP houses can’t ensure that clients experience meaningful relationships; 2) a sense of control and ability to personalize their houses is somewhat reduced by the external control of Office of Housing tenancy regulations; 3) a small number of clients felt that their house was not a home because of their lack of equity in the physical structure. Of these three issues, the most strongly articulated is residents’ lack of intimate, personal relationships. Participants felt that intimate personal relationships are an important aspect of a home, an idea supported by Somerville (1992), and yet they do not have them and their stories are infused with loneliness: either Paul’s diffuse, generalized loneliness or Bill’s, Anne’s and Jackie’s loneliness for specific people, such as children, parents and partners. For these participants, their current experience of home is associated with a sense of loss and is defined by something missing. However, in the absence of the particular relationships they desire, most SNAP clients chose to live alone, possibly recognizing the conflict between ‘privacy’ and ‘heart’ – autonomy and relationships – that is inherent in home life.

Psychiatric disability has affected personal relationships in the lives of these participants. Often the symptoms of their psychiatric illnesses such as depression, mania, and paranoia, combined with social stigma have contributed to the breakdown of domestic relationships. These symptoms also make it difficult for clients to share a house with friends. For clients of supported housing, the importance of relationships with friends, family and people other than staff has been documented as vital in maintaining a sense of well being, purpose and connection to the world (Robson, 1995; Goering et al., 1992). However, supported housing with its emphasis on living independently has, ironically, resulted in greater social isolation and loneliness than institutional living or group homes with their ‘inbuilt’ community (albeit an artificial one). SNAP’s Housing and Support program attempts to alleviate the isolation of living ‘alone’ in the community by providing and encouraging social interaction between clients. This is facilitated through recreational activities provided at the SNAP offices in central Bairnsdale and Sale where clients voluntarily participant in activities such as community garden building, craft, bowling and a weekly ‘drop-in’ morning tea. While SNAP can, and does, provide opportunities for social interaction, providing intimate relationships is simply beyond the capacity of a disability support organization.

The second issue which participants mentioned as reducing their experience of home (although much less strongly than absence of personal relationships) was their perception of external control by Office of Housing. Clients’ feelings of privacy and control and their ability to stamp their personal identity on their houses is modified by Office of Housing tenancy regulations which prevent participants from modifying the structure of their houses and limits tenants’ abilities to personalize their environment and to own a pet. In supplying public housing, it is necessary for Office of Housing to balance the need to maintain high physical standards against the individual needs of the tenant. Office of Housing must also work within an allocated budget and assure the quality of life of neighbours. However, within these parameters Office of Housing and SNAP could investigate the possibility of, where appropriate, relaxing tenancy regulations and introducing a greater level of personal choice, autonomy and choice being one of the fundamentals of supported housing (Carling, 1993; Hogan & Carling, 1992; Ogilvie, 1997). In this way individuality may be accommodated and assist in increasing the ‘homeliness’ of the houses. Areas to be investigated could include tenant participation in purchasing, maintaining and decorating units.

Animals need regular feeding and care therefore pet ownership is problematic for people who often experience periods of hospitalization. However, rather than forbidding all SNAP clients from owning pets, the individual circumstances of each tenant could be assessed, and pet ownership could be allowed in some circumstances, thereby again recognizing the individuality of people’s circumstances.

The third issue which participants identified as preventing a sense of home is home ownership, which, to some extent corresponds with Somerville’s (1992) ‘paradise’ as it embodies occupants’ ideals and aspirations. Home ownership was expressed as an ideal by three of the participants in this project and one participant (Deanne) has left the program and is buying her own house. The current arrangement of the SNAP Housing and Support program relies on accommodating clients in public housing, a system which cannot currently allow personal ownership of the unit although it can, as noted, provide stability through security of tenure. SNAP and Office of Housing could work towards a system that allowed residents to purchase their units. This would give clients options and for some lead to a greater sense of home. However, in order to continue to provide a much-needed supported housing resource it would be imperative that these units were then replaced by additional housing stock.

It is important to note that lack of control and ability to personalize their houses as well as lack of home ownership is caused as much by poverty as it is by Office of Housing regulations. All of the participants interviewed are on the very low income of a disability support pension and home maintenance and decoration, let alone home ownership, is not a financial possibility. These issues may also be experienced by other members of the community without psychiatric disability such as renters of both public and private houses and other people on low incomes. While it is important to acknowledge these contradictions in participants’ experiences of home, they do not detract from participants’ overall experience and understanding of their houses as places where, with support, clients can create a home.

Participants identified with some aspects of home more than others, indicating that home is a place experienced not only in different ways, but also to differing degrees. Four men (compared to ten women) were interviewed reflecting the differences in numbers of male and female SNAP housing and support clients (fourteen women compared to six men). Therefore we can only draw tentative conclusions about gender differences in the understandings and experiences of home among SNAP housing and support clients. However, two points should be noted. Firstly, female participants valued home as a place for domestic activity more than any of the male participants did, reflecting traditional roles of women as ‘housekeepers’. Secondly, there appeared to be no strong gender divide in the need to have significant domestic relationships. Given the lack of variation in age and cultural background among the participants and the lack of information on class background, few inferences can be drawn about these factors.

Houses are not just a physical structure but are an important way a resident can realize emotional and non-material aspirations. While important to many people, home is particularly significant for these participants because it allows them space to create many of the things that are lacking in their lives. The symptoms of psychiatric disability and associated social marginalisation that the participants experience has resulted in factors such as lack of control over their lives, poverty, instability, inability to perform tasks of everyday living and social isolation. The significance of creating a home is that it can give people with psychiatric disability a sense of self identity through personalizing their space; a sense of control through maintaining a private place where they can do as they like and can control who enters and exits; a sense of purpose through domestic activity; a sense of self worth through material quality; and, finally, it provides a sense of stability by maintaining a permanent dwelling. The support they receive from SNAP is crucial to their ability to achieve this sense of home, a finding which supports Robson’s (1995: 88) conclusion that for people requiring psychiatric disability support, housing and support are integral to each other and each will not truly succeed without the other.

The creation of a home, even with the ambivalences that this entails for people with psychiatric disability living in public housing, is one means by which people living with chronic psychiatric disability can create a space that belongs to them and to which they, in turn, belong. In addition, there is some correlation between the well being of individuals with psychiatric disability and their housing conditions with better physical housing conditions related to greater quality of life (Baker & Douglas, 1990; Nelson et al., 1998; Earls & Nelson, 1988; Robson, 1995). As noted above, comments made by participants in this study suggest that ‘making themselves at home’ may assist people to live with and manage psychiatric disability by providing order.

Conclusion
The narratives presented in this study have provided a means of evaluating the success of the SNAP Housing and Support program. By listening to and analyzing these stories we have been able to assess whether the clients of the program consider their houses to be home and how they define that home. To be successful, mental health services must reflect clients’ preferences and desires. Consulting clients about their opinions is an important part of any mental health service, particularly a supported housing program. This study, employing in-depth interviews, reveals individual stories and experiences and focuses on narratives of the participants themselves. The answer that resonates loud and clear is that SNAP and the Office of Housing are very successful in assisting clients to create homes in their houses and that this is integral to the success of this supported housing program. This study reveals that the SNAP housing and support program successfully provides valuable opportunities for clients to make public housing into homes by providing stability, a sense of identity, privacy and control and a space for domestic activity. However participants revealed that their sense of home was modified by the lack of loving relationships, some tenancy regulations and lack of home ownership. While SNAP already encourages friendships among clients, creating loving relationships is beyond the scope of a disability support agency or the Office of Housing. SNAP Housing and Support program is encouraged to seek ways to accommodate home ownership for those who desire it and a greater sense of control and individuality, while continuing to balance responsibilities to clients and the general community.

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