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Abstract
There has been an increasing emphasis on the provision of domestic-style, community-based accommodation for those with severe, long-term mental health problems. The British Government has formalised this trend to some degree by establishing Housing Associations which have as part of their responsibilities the provision of affordable housing to those who require care and support as well as a home. Housing Associations are obliged by their regulatory body to give the maximum security of tenure possible: this usually takes the form of an assured tenancy. However, for a small number of people with long-term mental health problems, the use of tenancies as a means of ensuring security of living arrangements raises serious ethical dilemmas which revolve around conflicts between a duty of care and a duty of confidentiality. These dilemmas are outlined in this paper, with the aim of promoting wider discussion of this area.