Specialist Homelessness Services annual report 2018–19

People leaving care arrangements, including people transitioning from health care settings (hospitals, psychiatric hospitals, rehabilitation and aged care facilities) and young people transitioning from out-of-home care (foster care and residential care facilities), can find themselves particularly vulnerable to homelessness. This can be due to inadequate transition planning, undertaking discharge assessments in time- or resource-pressured environments and limited options for exit into suitable and secure housing (Brackertz et al. 2018).

People exiting institutions and care into homelessness are a national priority homelessness cohort identified in the National Housing and Homelessness Agreement which came into effect on 1 July 2018 (See Policy section for more information).

Nationally, over 3,000 young people between the ages of 15 and 17 exit out-of-home care each year (AIHW 2019), corresponding with the end of formal support in the child protection system. The transition from adolescence to young adulthood is a time of significant change as young people prepare themselves for independent living and starting a new life on their own. Young people leaving out-of-home care often face barriers to accessing the same housing, educational and employment opportunities that are readily available to their non-care peers who tend to stay in their parental home (3 in 5 young people aged 18–29 were living at home in 2017) (Wilkins et al. 2019). Findings from a survey on young people transitioning from out-of-home care showed that 35% were homeless in the first year of leaving care (McDowall 2009).

People transitioning from health care settings are also at risk of being discharged into homelessness. In a study of people who have experienced homelessness, 17% had been admitted to hospital for a mental health diagnosis in the previous 2 years (Wood et al. 2016). Discharge from psychiatric hospital in particular has been identified as a key pathway into homelessness among people with mental health issues (Nielssen et al. 2018).

Client characteristics

In 2018–19 (Table LCARE.1):

• SHS agencies assisted over 6,800 clients leaving care.
• Clients transitioning from care accounted for 2% of all SHS clients.
• The rate of clients leaving care was 2.7 per 10,000 population, decreasing from 2.8 in 2017–18.

Table LCARE.1: Clients leaving care: at a glance—2014–15 to 2018–19 

	2014-15	2015–16	2016–17	2017–18	2018-19
Number of clients	6,084	6,869	7,104	6,917	6,834
Proportion of all clients	2	2	2	2	2
Rate (per 10,000 population)	2.6	2.9	2.9	2.8	2.7
Housing situation at the beginning of the first support period (proportion (per cent) of all clients)
Homeless	32	30	26	26	26
At risk of homelessness	68	70	74	74	74
Length of support (median number of days)	58	60	62	63	67
Average number of support periods per client	1.8	1.9	1.9	1.9	2.0
Proportion receiving accommodation	52	48	46	45	45
Median number of nights accommodated	44	42	49	48	48
Proportion of a client group with a case management plan	71	70	69	71	72
Achievement of all case management goals (per cent)	19	17	18	21	20

Notes

1. Rates are crude rates based on the Australian estimated resident population (ERP) at 30 June of the reference year. Minor adjustments in rates may occur between publications reflecting revision of the estimated resident population by the Australian Bureau of Statistics.
2. The denominator for the proportion receiving accommodation is all SHS clients who have left care. Denominator values for proportions are provided in the relevant supplementary table.
3. The denominator for the proportion achieving all case management goals is the number of client groups with a case management plan. Denominator values for proportions are provided in the relevant supplementary table.
4. Data for 2014–15 to 2016–17 have been adjusted for non-response. Due to improvements in the rates of agency participation and SLK validity, data from 2017–18 are not weighted. The removal of weighting does not constitute a break in time series and weighted data from 2014–15 to 2016–17 are comparable with unweighted data for 2017–18 onwards. For further information, please refer to the Technical Notes.

Source: Specialist Homelessness Services Collection 2014–15 to 2018–19.

Age and sex

In 2018–19, of clients leaving care (Supplementary table LCARE.1):

• The majority were male (54% or around 3,700 clients).
• The largest age groups were those aged 35–44 (19% or over 1,300 clients) and those aged 25–34 (19% or almost 1,300 clients).
• More than 1 in 5 clients were under 18 (21% or more than 1,400 clients); 11% (or almost 800 clients) were aged 15–17 and 10% were under 15 (or almost 700 clients).

Indigenous status

One in 4 clients leaving care identified as Aboriginal or Torres Strait Islander (25% or almost 1,600 clients; Supplementary table LCARE.8).

State and territory and remoteness

In 2018–19 (Supplementary table LCARE.2):

• The largest number of clients leaving care accessed services in Victoria (34% or over 2,300 clients), followed by New South Wales (28% or around 1,900 clients).
• The highest rate of clients leaving care was in the Northern Territory (11 clients per 10,000 population), followed by Tasmania (5 per 10,000).
• The majority of clients leaving care accessed services in Major cities (65% or over 4,400 clients), followed by Inner regional areas (22% or around 1,500 clients).

Living arrangements

In 2018–19, among clients leaving care (Supplementary table LCARE.9):

• The most commonly reported living arrangement was lone persons (60% or 4,000 clients), followed by groups (18% or almost 1,200 clients).
• Male clients were more likely to be living alone (65%, compared with 53% females) or with a group (20%, compared with 16% females) while female clients were more likely to be living as a single parent with one or more children (16%, compared with 7% males).

Dwelling type at beginning of support

In 2018–19, among clients leaving care (Supplementary table LCARE.11):

• The most commonly reported dwelling type at the beginning of support was independent housing (house/townhouse/flat) (28% or almost 1,900 clients).
• 1 in 5 clients reported their dwelling type as ‘rehabilitation’ (18% or over 1,200 clients).
• An additional 1 in 5 clients were transitioning from care in a psychiatric hospital or unit (18% or around 1,200 clients).

Selected vulnerabilities

SHS clients can face additional vulnerabilities that make them more susceptible to becoming homeless, in particular family and domestic violence, a current mental health issue and problematic drug and/or alcohol use.

In 2018–19, of the 6,400 clients leaving care who were aged 10 and over, 4 in 5 (83%) reported experiencing one or more of these vulnerabilities (Table LCARE.2):

• 2 in 3 clients leaving care (67% or 4,300 clients) reported a current mental health issue.
• 44% (or over 2,800 clients) reported problematic drug and/or alcohol use.
• Almost 1 in 4 clients leaving care (23% or almost 1,500 clients) reported both mental health issues and problematic drug and/or alcohol use.
• One-quarter (25% or around 1,600 clients) reported experiencing family and domestic violence.
• 10% (or more than 600 clients) reported experiencing all 3 vulnerabilities.

Table LCARE.2: Clients leaving care, by selected vulnerability characteristics, 2018–19

Family and domestic violence	Mental health issue	Problematic drug and/or alcohol use	Clients	Per cent
Yes	Yes	Yes	630	9.8
Yes	Yes	No	547	8.5
Yes	No	Yes	132	2.1
No	Yes	Yes	1,488	23.2
Yes	No	No	302	4.7
No	Yes	No	1,652	25.8
No	No	Yes	577	9.0
No	No	No	1,078	16.8
			6,406	100.0

Notes

1. Clients are assigned to one category only based on their vulnerability profile.
2. Clients are aged 10 and over.
3. Totals may not sum due to rounding.

Source: Specialist Homelessness Services Collection 2018–19.

Service use patterns

• In 2018–19, clients leaving care had an average of 2.0 support periods per client and a median of 67 days of support, increasing from 63 days in 2017–18.
• Almost half (45%) of all clients leaving care were provided with accommodation, with a median of 48 nights of accommodation.

New or returning clients

• Many clients leaving care (64% or more than 4,300 clients) were returning clients, having previously been assisted by a SHS agency at some point since the collection began in 2011–12 (Supplementary table LCARE.7).
• 2 in 3 clients leaving care (69% or more than 800 clients) who were aged 18–24 were returning clients. This age group includes young people who may have aged out of foster care or other out-of-home care arrangements.

Main reasons for seeking assistance

In 2018–19, the main reasons for seeking assistance among clients leaving care were (Supplementary table LCARE.5):

• housing crisis (18% or over 1,200 clients)
• transition from other care arrangements (12% or more than 800 clients)
• inadequate or inappropriate dwelling conditions (9% or almost 600 clients)
• mental health issues (8% or nearly 600 clients)
• transition from foster care and child safety residential placements (8% or more than 500 clients).

Housing crisis was the most commonly reported main reason for seeking assistance for clients leaving care who were homeless (19% or over 300 clients) and those who were at risk of homelessness (18% or nearly 900 clients).

Clients leaving care who were homeless at first presentation were more likely to report transition from other care arrangements (16%, compared with 10% at risk) or transition from foster care and child safety residential placements (13%, compared with 6% at risk) as their main reason for seeking assistance (Supplementary table LCARE.6).

Compared with those who were homeless, clients leaving care who were at risk of homelessness were more likely to report mental health issues (10%, compared with 5% homeless) or family and domestic violence (8%, compared with 6%) as the main reason for seeking assistance.

Services needed and provided

Similar to the overall SHS population, clients leaving care needed general services that were provided by SHS agencies including advice/information, advocacy/liaison on behalf of client and other basic assistance.

Apart from general services, the most common services needed by clients transitioning from care were:

• short-term or emergency accommodation (51% or around 3,500 clients), with 62% receiving this service
• long-term housing (47% or over 3,200 clients), with 6% receiving this service
• medium-term/transitional housing (44% or over 3,000 clients), with 33% receiving this service.

Clients leaving care were more likely than the overall SHS population to need services including:

• living skills/personal development (36%, compared with 19%), with 91% receiving this service
• transport (35%, compared with 20%), with 94% receiving this service
• assistance with challenging social/behavioural problems (27%, compared with 13%), with 87% receiving this service
• health/medical services (20%, compared with 9%), with 62% receiving this service
• mental health services (19%, compared with 8%), with 54% receiving this service.

Outcomes at the end of support

Outcomes presented here describe the change in clients’ housing situation between the start and end of support. Data is limited to clients who ceased receiving support during the financial year—meaning that their support periods had closed and they did not have ongoing support at the end of the year.

Many clients had long periods of support or even multiple support periods during 2018–19. They may have had a number of changes in their housing situation over the course of their support. These changes within the year are not reflected in the data presented here, rather the client situation at the start of their first support period in 2018–19 is compared with the end of their last support period in 2018–19. A proportion of these clients may have sought assistance prior to 2018–19, and may again in the future.

In 2018–19, for clients leaving care (Table LCARE.3).

• The proportion of clients leaving care who were known to be homeless increased from 24% at the beginning of support to 35% at the end of support; 300 more clients were known to be homeless when support ended.
• The largest change was in the proportion of clients who were living in institutional settings, which dropped from 62% to 26% at the end of support (a decrease of 1,800 clients).
• Aside from institutional settings, more clients were known to be housed at the end of support; the proportion of clients living in private or other housing increased from 9% to 23% (over 500 clients), while the proportion living in public or community housing increased from 5% to 17% (nearly 500 clients). However, these increases did not account for all those leaving institutional settings, with over 600 clients in short term temporary accommodation or in a housing situation without tenure.

These trends demonstrate that housing outcomes following support can be challenging for clients transitioning from institutional settings. While some of these clients progressed towards more positive housing solutions, many remain in institutional settings or return to institutional settings by the end of support. Some clients might only require short-term accommodation immediately after leaving, others might need support to access or maintain housing in the long-term.

Table LCARE.3: Clients leaving care (closed support), by housing situation at the beginning and end of support, 2018–19

Housing situation	Beginning of support (number)	End of support (number)	Beginning of support (per cent)	End of support (per cent)
No shelter or improvised/inadequate dwelling	266	223	5.7	5.3
Short term temporary accommodation	556	860	12.0	20.5
House, townhouse or flat - couch surfer or with no tenure	310	370	6.7	8.8
Total homeless	1,132	1,453	24.4	34.7
Public or community housing - renter or rent free	213	700	4.6	16.7
Private or other housing - renter, rent free or owner	431	963	9.3	23.0
Institutional settings	2,864	1,071	61.7	25.6
Total at risk	3,508	2,734	75.6	65.3
Total clients with known housing situation	4,640	4,187	100.0	100.0
Not stated/other	244	697
Total clients	4,884	4,884

Notes

1. Percentages have been calculated using total number of clients as the denominator (less not stated/other).
2. It is important to note that individual clients beginning support in one housing type need not necessarily be the same individuals ending support in that housing type.
3. Not stated/other includes those clients whose housing situation at either the beginning or end of support was unknown.

Source: Specialist Homelessness Services Collection 2018–19. Supplementary table LCARE.4.

Housing outcomes for homeless versus at risk clients

For clients with a known housing status who were at risk of homelessness at the start of support (almost 3,100 clients), by the end of support (Interactive Tableau visualisation):

• Almost one-third (around 1,000 clients or 32%) remained in an Institutional setting
• Around 700 clients (24%) were in private housing
• Less than 1 in 5 (511 clients or 17%) were in public or community housing.

A smaller number were experiencing homelessness at the end of support (around 800 clients or 27% of those who started support at risk).

For clients who were known to be homeless at the start of support (just over 1,000 clients), agencies were able to assist:

• 300 clients (32%) into short term accommodation
• 200 (21%) into private housing.

A further 200 clients (17%) were in public or community housing at the end of support. 

References

AIHW (Australian Institute of Health and Welfare) 2019. Child protection Australia 2017–18. Cat. no. CWS 65. Canberra: AIHW.

Brackertz N, Wilkinson A & Davison J 2018. Housing, homelessness and mental health: towards systems change. Melbourne: Australian Housing and Urban Research Institute.

McDowall JJ 2009. CREATE report card 2009 – Transitioning from care: tracking progress. Sydney: CREATE Foundation. Viewed 3 October 2019.

Nielssen OB, Stone W, Jones NM, Challis S, Nielssen A, Elliott G, Burns N, Rogoz A, Cooper LE & Large MM 2018. Characteristics of people attending psychiatric clinics in inner Sydney homeless hostels, The Medical Journal of Australia 208(4): 169-173.

Wilkins R, Laß I, Butterworth P & Vera-Toscano E 2019. The Household, Income and Labour Dynamics in Australia Survey: selected findings from waves 1 to 17. Melbourne: Melbourne Institute.

Wood L, Flatau P, Zaretzky K, Foster S, Vallesi S & Miscenko, D 2016. What are the health, social and economic benefits of providing public housing and support to formerly homeless people? AHURI Final Report No. 265. Melbourne: Australian Housing and Urban Research Institute Limited.