Australian Institute of Health and Welfare (2019) Specialist Homelessness Services annual report 2018–19, AIHW, Australian Government, accessed 25 May 2022.
Australian Institute of Health and Welfare. (2019). Specialist Homelessness Services annual report 2018–19. Retrieved from https://www.aihw.gov.au/reports/homelessness-services/shs-annual-report-18-19
Specialist Homelessness Services annual report 2018–19. Australian Institute of Health and Welfare, 18 December 2019, https://www.aihw.gov.au/reports/homelessness-services/shs-annual-report-18-19
Australian Institute of Health and Welfare. Specialist Homelessness Services annual report 2018–19 [Internet]. Canberra: Australian Institute of Health and Welfare, 2019 [cited 2022 May. 25]. Available from: https://www.aihw.gov.au/reports/homelessness-services/shs-annual-report-18-19
Australian Institute of Health and Welfare (AIHW) 2019, Specialist Homelessness Services annual report 2018–19, viewed 25 May 2022, https://www.aihw.gov.au/reports/homelessness-services/shs-annual-report-18-19
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According to the most recent national Survey of Mental Health and Wellbeing, in 2007, 1 in 5 (20%) Australians (aged 16–85) had a current mental health issue, while 45% of Australians reported having had a mental disorder at some point in their life (ABS 2008). The intertwined nature of mental health issues and homelessness is well established (Kalevald et al. 2018). People with mental health issues are a group who are particularly vulnerable to homelessness. Research has shown that experiences of homelessness can trigger, exacerbate and magnify mental health issues (see for example, Kalevald et al. 2018, Brackertz et al 2018, CHP 2018 and Johnson & Chamberlain 2011). People living with a mental illness can be isolated, have disrupted family and social networks and sometimes suffer poor physical health, all of which impact their capacity to find and maintain adequate housing. Further, symptoms such as hallucinations, compulsive behaviours and anxiety can make it difficult to seek and maintain employment (Robinson 2003).
People experiencing homelessness with mental health issues need the support of various services including housing, but navigating through these services can be particularly challenging. Several studies suggest that when people with mental health issues are supported by homelessness agencies, they are more likely to remain housed rather than become homeless (MHCA 2009, Du et al. 2013, Wood et al. 2016, ABS 2014).
Specialist Homelessness Services (SHS) clients are identified as having a current mental health issue if they are aged 10 years or older and have provided any of the following information:
Of the 290,300 SHS clients accessing services in 2018–19, 86,500 (30%) clients reported a current mental health issue. The number and proportion of clients presenting with a current mental health issue has been increasing since the beginning of the SHSC in 2011–12. Various factors, including increased identification, community awareness and reduced stigma, may have had an impact on the increase in self-identification and reporting of mental illness among SHS clients. In 2018–19 (Table MH.1):
Number of clients
Proportion of all clients
Rate (per 10,000 population)
Housing situation at the beginning of the first support period (proportion (per cent) of all clients)
At risk of homelessness
Length of support (median number of days)
Average number of support periods per client
Proportion receiving accommodation
Median number of nights accommodated
Proportion of a client group with a case management plan
Achievement of all case management goals (per cent)
Source: Specialist Homelessness Services Collection 2014–15 to 2018–19.
In 2018–19, of those clients presenting with a current mental health issue (Supplementary table MH.1):
In 2018–19, around 83,200 SHS clients with a current mental health issue reported their Aboriginal and Torres Strait Islander status (Supplementary table MH.8). Key findings for this group include:
There were differences across the states and territories in the rates of clients presenting to SHS agencies with a current mental health issue. In 2018–19:
In 2018–19, of the 86,500 SHS clients who had a current mental health issue, over half (54% or 46,600 clients) were experiencing additional selected vulnerabilities (Table MH.2):
These figures provide an insight into the multiple disadvantages clients experiencing mental health issues face and highlight the value of an integrated service response to homelessness for these clients (Flatau et al. 2013).
Family and domestic violence
Mental health issue
and/or alcohol use
Source: Specialist Homelessness Services Collection 2018–19.
At the beginning of support, clients with a current mental health issue (aged over 10) were more likely to be living alone (38,700 clients or 46%) or as a lone parent with child(ren) (20,700 clients or 25%) rather than in a group (6,600 clients or 8%) or as a couple with child(ren) (6,300 or 7%) (Supplementary table MH.9).
Service use patterns for clients with a current mental health issue have changed between 2014–15 and 2018–19 (Table MH.1).
In 2018–19 of those clients presenting with a current mental health issue (Supplementary table MH.7):
In 2018–19, the most common main reasons for seeking SHS assistance for clients with a current mental health issue were (Supplementary tables MH.5 and MH.6):
There were differences in the main reasons for those clients with a current mental health issue presenting at risk of, or experiencing homelessness:
Figure MH.1 illustrates the top 6 most needed services for clients with a current mental health issue in 2018–19. Four of these were related to accommodation:
The other 2 most needed services by clients with a current mental health issue were related to financial security:
Over 1 in 4 (27% or 23,600) clients with a current mental health issue identified a need for mental health-based services. Specifically:
Source: Specialist Homelessness Services Collection 2018–19, Supplementary table MH.3.
Outcomes presented here describe the change in client’s 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 with a current mental health issue (Table MH.3):
These trends demonstrate that by the end of SHS support, fewer clients with a current mental health issue were known to be experiencing homelessness, and most (64%) were living in housing, be it public or community, private or other housing or an institutional setting.
Beginning of support
Beginning of support
House, townhouse or flat - couch surfer or with no tenure
Public or community housing - renter or rent free
Private or other housing - renter, rent free or owner
Total at risk
Source: Specialist Homelessness Services Collection. Supplementary table MH.4.
For clients with a known housing status who were at risk of homelessness at the start of support (almost 27,700 clients), by the end of support (Figure MH.2):
A smaller number were experiencing homelessness at the end of support (around 4,000 clients or 15% of those who started support at risk).
Source: Specialist Homelessness Services Collection, 2018–19
For clients who were known to be homeless at the start of support (just over 24,200 clients) (Figure MH.3):
A further 5,200 clients (21%) were couch surfing at the end of support.
Source: Specialist Homelessness Services Collection, 2018–19.
ABS (Australian Bureau of Statistics) 2008. National Survey of Mental Health and Wellbeing: Summary of Results, 2007. ABS cat. no. 4326.0 Canberra: ABS.
ABS 2014. Mental Health and Experiences of Homelessness, Australia, 2014. ABS cat. no. 4329.0.00.005. Canberra: ABS.
Brackertz N, Wilkinson A & Davison J 2018. Housing, homelessness and mental health: towards systems change. AHURI Research Paper, Australian Housing and Urban Research Institute Limited, Melbourne.
CHP (Council to Homeless Persons) 2018. Housing Security, Disability and Mental Health. Viewed at 15 Oct. 2019.
Du C, Jacobs K, Loo S & Murray S 2013. The role of informal community resources in supporting stable housing for young people recovering from mental illness: key issues for housing policy-makers and practitioners. AHURI Final Report No. 199. Australian Housing and Urban Research Institute Limited, Melbourne.
Flatau P, Conroy E, Thielking M, Clear A, Hall S, Bauskis A, Farrugia M & Burns L 2013. How integrated are homelessness, mental health and drug and alcohol services in Australia? AHURI Final Report No.206. Australian Housing and Urban Research Institute Limited, Melbourne.
Johnson G & Chamberlain C 2011. Are the Homeless Mentally Ill? Australian Journal of Social Issues, vol. 46, no. 1: 29–48.
Kaleveld L, Seivwright A, Box E, Callis Z & Flatau P 2018. Homelessness in Western Australia: A review of the research and statistical evidence. Perth: Government of Western Australia, Department of Communities. Viewed 27/06/2019
MHCA (Mental Health Council of Australia) 2009. Home Truths: Mental Health, Housing and Homelessness in Australia.
Robinson C 2003. Understanding interactive homelessness: the case of people with mental disorders. AHURI report. Australian Housing and Urban Research Institute Limited, Melbourne.
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.
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