Mentally ill public housing tenants in Sydney’s west risk developing post-traumatic stress disorder (PTSD) from living in dangerous environments, according to a former health worker at Mount Druitt Community Health Centre.

“Public housing in places like Mount Druitt and Blacktown are not a good environment for people who suffer from mental health issues such as depression or anxiety disorders,” says Ben, who can’t reveal his name due to a clause with his NSW Health contract.

“It’s also very hard for them to leave public housing, so they stay in these unsafe living environments. Their symptoms get worse, which only reinforces their negative beliefs of not having any control over their life.”

The rate of drug and alcohol abuse among the mentally ill also complicates attempts at treatment, says Dr Ian Webster, Emeritus Professor of public health and community medicine at the University of New South Wales.

“There seems to be a population group in the community who have impairments that are often associated with alcohol and drug use, as well as intellectual disabilities,” says Dr Webster, who is also director of the Alcohol Education and Rehabilitation Foundation, as well as a former director of population health in south-west Sydney Area Health Service.

“These groups are increasingly being represented in public housing, and a sizeable part of them intersect with the prison and homeless scene.”

Dr Webster says overcrowded public housing estates exacerbate mental health problems.

Mental health workers interviewed by the ACIJ agree. They say the conditions endured by mentally ill people in public housing are now a major public health problem.

But it’s a problem which multiple state government bureaucracies don’t want to know about. Meanwhile, vulnerable people are trapped in housing which is making them ill or preventing them from getting well.

Former Mt Druitt mental health worker Ben says people who try to transfer to other housing must wait months before their applications are assessed, and there is no guarantee they will be able to move.

Kerry Gordon knows exactly what Ben is talking about.

Downhill Spiral

Kerry lives in what appears to be a typical four-bedroom house in the western Sydney suburb of Seven Hills. Her street is quiet and lined with old gumtrees and large but modest single-storey fibro houses with wide backyards.

Kerry greets us with a warm smile.

“You’ll have to excuse the mess,” she says, just as we all do when there are a couple of dirty dishes in the sink or some clothes scattered around.

Inside, however, we are confronted with the stark reality.

The kitchen in Kerry’s public housing

The front door leads in to a dank living room, with little direct sunlight. Overturned sofas and unused furniture are piled high, occupying half of the room. Various items are scattered across the floor, from CDs and cigarette lighters to empty cans and food packaging.

Positioned between an upside-down couch and an old chair, is a small coffee table in the middle of the room, on top of which a stack of unwashed dishes and bowls balance delicately — a symbolic centre-piece in a house which has become unlivable for the 54 year-old mother of four.

Kerry suffers from post-traumatic stress disorder (PSTD), which manifests as clinical depression. She was diagnosed approximately ten years ago after a series of breakdowns and has been on a disability pension for the past eight years.

In recent years, she has suffered from a chronic back ailment and rheumatoid arthritis. Mobility has since become a critical issue for her, especially after moving
into her current home.

“I didn’t realise how physically downhill I had gone, because I came from a house that was relatively flat where I had easy access to the laundry,” she said. “I need to be somewhere with no steps and not on the side of a hill because I have a spinal disease and technically I should be in a wheelchair.”

Coupled with the somewhat scarce public transport in the area, Kerry’s health problems have taken an immense toll on her quality of life.

“There are no bus services around here,” she says. “To get to a bus stop you have to either go up or down the hill, then cross the main highway. The other one is almost a 2 km long walk. There is no direct service to the Seven Hills shopping centre.”

On paper Kerry Gordon is the archetypical candidate for a priority housing transfer. But the reality is much more complex – and frustrating.

Into the Black Hole

Requesting a housing transfer is a highly involved procedure requiring large amounts of paperwork and documentation. A priority transfer request can often be even more complicated.

Tenants with mental health issues like Kerry are forced to jump through the bureaucratic hoops placed in front of them by the housing authorities with little or no help. Trying to work out who’s actually accountable for making things happen is a near impossible task.  The system lacks transparency and appears to be a black hole for records.

Many tenants, as a result of their conditions, are often unable to produce documentation that details their dealings with authorities. Meanwhile, Housing NSW staunchly refuses to discuss individual cases.

Kerry Gordon’s house is one of 144,000 public housing properties under Housing NSW supervision, which in total accommodate around 200,000 tenants.

Gordon moved to her current house from Doonside, where she had been harassed by her neighbours. She had been targeted by their drug-addicted son, who she claims was “put up to it”.

“I had been trying to get out of Doonside for nine years at that stage,” said Gordon, who at that time was dealing with the death of her children’s father, from whom she had been separated for almost 20 years.

She applied for a direct housing swap, which is a legal option facilitated by Housing NSW under the Mutual Exchange Program.

Eventually, Gordon was able to swap the house in Doonside for her current home in Seven Hills. However, due to her mobility problems, she tried to arrange another swap four years ago, this time with her daughter Bethany.

The application was denied.

“I am the only person I have ever met who has had the mutual exchange rejected. Exchanges are going on all the time. It happens because it is cheaper for the department to allow the exchanges. With this, they don’t have to do any major renovations,” she said.

Gordon says no explanation was ever provided by Housing NSW.

After being denied the swap with her daughter, Gordon began looking for other avenues to get out of the Seven Hills house and move to a more suitable location. She has been on the waiting list for an urgent disability transfer for 18 months.

“It’s all weighed on the evidence that is placed in front of us,” says Housing NSW spokesperson David Maher. “That would include documentation from medical experts who would say ‘yes, this house is injurious to her health and that as soon as she gets into an alternative house the better her health will be.”

Furthermore the waiting time for a transfer also depends on the availability of the houses in a particular area.

According to Housing NSW, the Mt Druitt area has one of the heaviest concentrations of public housing in Sydney, if not NSW.

“We do have a lot of houses in Mt Druitt and yes, there is a steady turnover of houses in those areas. So [Gordon’s] transfer is a matter of many variables which would determine whether she should be housed before anyone else,” Maher explained.

In NSW the waiting time for public housing can reach up to 12 years, with 248,419 applicants waiting for social housing across Australia in 2010. Meanwhile, local mental health services struggle with the strain of supporting more cases than they are equipped to handle.

Western Sydney – A Mental Health Blackspot

“It [mental health services in public housing] is atrocious,” says Paul Taylor, the Greens candidate for Blacktown in the 2011 NSW State election.

Taylor’s criticisms are based on his own personal experiences with Blacktown’s mental health services.

“I live in public housing and when I went through depression, I was in the mental health unit, Bungarribee House, at Blacktown Hospital for a few days,” recalls Taylor.

“But they only have 30 or so beds, so after four days I left because they basically needed a bed, and when I got out there was no follow-up whatsoever.”

Taylor says suburbs with a high number of public housing dwellings aren’t given enough funding to deal with the issues associated with disadvantaged social groups.

“Some people out there with mental health issues don’t realise they have a problem until it’s too late,” Taylor says. “When they try and get help, their problem isn’t ‘bad’ enough to actually end up in one of those services. So they get worse.”

According to Australian Bureau of Statistics (ABS) figures, as of June 30, 2008, there were 197,200 people living in public housing in NSW, with a total of 119,000 households.

Blacktown had the highest number of persons living in public housing with 17,100 people or 9600 households, followed by Campbelltown with 6400 households or 12,500 people.

Mental health worker Ben says poverty prevents public housing tenants with mental illnesses from getting the help they need.

“Many of our clients cannot afford the train fare needed to travel to their appointments with doctors and counsellors,” he says, adding it’s even harder for mentally ill public housing tenants who come from different cultures.

“People who suffer from a mental health issue in public housing are extremely isolated. They withdraw from the community, they don’t talk about their problems, or they don’t realise they have a problem … if they don’t speak English, or it’s not in their culture to speak about their problems, they are even less likely to realise they are unwell or they need help.”

NSW government policy over the last decade has been to break up estates in favour of mixed communities. New developments now aim for a 70 to 30 per cent private to public ratio, opposed to the old model where over 85 per cent was public housing.

But research into the break up of public housing estates has found mixed estates can break rather than make communities.

When University of Western Sydney academics Dr Gabrielle Gwyther and Lauren Kenworthy conducted case studies with over 30 public housing residents, they found relocating people to mixed estates could in fact lead to them becoming more social isolated.

When estates are broken up, says Gwyther, the community services dealing with housing, health and family support are also broken up. People are relocated but not the services that cater to them. In other words – for mentally ill people in public housing, it’s back to square one.

The development of primary health care networks is one way Dr Ian Webster believes public health can tailor its mental health services to dispersed and concentrated communities.

“When it comes to mental health, the spotlight is usually focused on the funding debate between State and Federal Governments. One area that does not receive a lot of attention is primary health care.”

“The establishment of primary health care networks would be a better way to engage with wider community services. Primary health care networks where general practitioners and multi-disciplinary teams — so psychologists, social workers and psychiatrists — are built up as local hubs would enable mental health patients be managed or assisted in a community setting.”

Jacqueline Le, Michael Davis, Veronika Pitrová and Simona Suciu are reporters with the Australian Centre for Independent Journalism. Jacqueline Le and Michael Davis are enrolled in the Journalism program at UTS. Veronika Pitrová and Simona Suciu spent a semester at UTS on the Erasmus Mundus exchange program.

This special investigation is published in collaboration with Reportage Online, the Magazine of the Australian Centre for Independent Journalism.

This is the third installment in a five-part series on a major public health issue — out of sight and out of mind in Western Sydney. Read the coverage so far here. Tomorrow: Refugees hit hard by housing crisis.