Beyond safety to wellbeing: how local authorities can mitigate the mental health risks of living houses in multiple occupation

The regulation of houses in multiple occupation (HMOs) by local authorities focuses on ensuring the physical safety of occupants through adequate standards of building quality, safety provision and management suitability. However, it has been suggested that HMOs may also pose a particular threat to the mental health of residents. In this paper we consider the suitability of current regulations to tackle the possible risks to the mental health of HMO residents and then outline how the current public health agenda may present an opportunity for environmental health professionals to tackle these issues in new ways. Using a framework which encompasses the psychosocial processes thought to link residents’ mental health with their housing conditions, we describe how local authorities can address some of the mental health risks posed by HMOs but that the current enforcement culture, in which prosecution is seen as a last resort makes decisive action against landlords very difficult. In recognising the many vulnerable households living in HMOs, we argue that local authorities dealing with housing standards and environmental management are strategically placed to be more ambitious and proactive in protecting the health of local residents particularly through the developing public health and wellbeing partnerships. We call for empirical research to look at how local authorities actually use current legislation as well as other strategies to manage HMOs and protect the mental health of tenants.