Specialist homelessness services client pathways: Indigenous clients in 2015–16

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Study cohort – Indigenous clients in 2015–16

Introduction

Adult Indigenous clients are considered an important sub-group of clients experiencing homelessness (see Indigenous Australians).

Using the Specialist Homelessness Services (SHS) longitudinal data set, analysis of a cohort of adult Indigenous clients in 2015–16 was undertaken to examine SHS support patterns for a cohort of service users.

See Introduction to the SHS longitudinal data for details on the longitudinal analyses undertaken.

The Indigenous 2015–16 cohort was defined as clients who received a service in 2015–16 and identified as Aboriginal, Torres Strait Islander, or both, in any support period in their SHS service history. That is, for the purpose of the longitudinal analyses, a person was considered Indigenous if they were recorded as identifying as Indigenous during any of their support periods, regardless of timing, and regardless of whether they were recorded as non-Indigenous in any or all other support periods.

The longitudinal analyses were limited to adult clients (aged 18 and over). This is because the longitudinal analyses focus on pathways for individual clients, whereas children accessing services may need support because of issues that are unrelated to them directly.

A comparison cohort (non-Indigenous cohort) was also created, comprising clients aged 18 and over who used services in 2015–16 but who were recorded as being non-Indigenous or not stated in all their support periods in the SHSC longitudinal data set.

The longitudinal SHS data for the period 2011–12 to 2020–21 were used to examine characteristics and service use of Indigenous clients, including a comparison with a non-Indigenous cohort (Figure Indigenous.1).

The retrospective study period for this cohort is the 48 months before the start of the defining study period (that is, the 12 months from the start of their first support period in 2015–16). The prospective study period is the 48 months after the end of each client’s 12 month defining study period.

Figure Indigenous.1: Indigenous cohort 2015–16, longitudinal analysis overview

Key characteristics of the Indigenous cohort

There were 38,600 clients in the adult Indigenous 2015–16 cohort; these clients had the following key characteristics (Figure Indigenous.2, Table Indigenous1516.1, Table Indigenous1516.2):

• Less than 20% were aged 45 or over.
• Nearly half (19,000 clients) had only one support period during the defining study period and 28% (10,800) had 3 or more support periods.
• Half (19,400 clients) were experiencing housing crisis (a reason for seeking assistance) and 44% (17,200) were experiencing financial difficulties.
• Over half (56%) had received SHS support previously; that is, 21,600 clients received SHS support in the 48-month retrospective period that preceded the defining study period.
• Over 23,000 clients (60%) continued to receive support into the future; that is, they received support in the 48 months after the 12-month defining study period.
• One in five (20% or 7,700) Indigenous cohort clients received short-term accommodation in the defining period and needed short-term accommodation again in the prospective period.

Figure Indigenous.2: Indigenous and non-Indigenous cohorts 2015–16, client key characteristics, by study period

Service engagement profiles

Indigenous clients are more likely than non-Indigenous clients to experience persistent homelessness (Scutella et al. 2012).

SHS support patterns of the Indigenous cohort over the entire longitudinal period (2011–21) were examined to explore long term service provision. Over a third (15,500 or 40%) of the Indigenous cohort were long-term clients (they received support in the retrospective and prospective periods as well as the defining period) (Figure Indigenous.3, Table Indigenous1516.1). A further 7,500 clients (19.5%) were ongoing clients.

Figure Indigenous.3: Indigenous cohort 2015–16, service engagement profiles

Vulnerability pathways

Using data for the entire longitudinal period, client profiles were examined for the presence of vulnerabilities including mental health issues, drug and/or alcohol problems, and experience of family and domestic violence (FDV) within each of the 3 study periods – the retrospective, defining and prospective periods (Figure Indigenous.4, Table Indigenous 1516.1, Table Indigenous 1516.3). For more information on the derivation of these vulnerabilities, see Methodology.

Over one-third (36%) of Indigenous clients (14,000) had family and domestic violence issues in the defining period. Of these, 4,100 (29% of clients with family and domestic violence issues in the defining period) had family and domestic violence issues in both the retrospective and prospective periods. Whereas 6% (870 clients) only had family and domestic violence issues in the past (retrospective period) in addition to the defining study period. Nearly 9% (1,200 clients) had ongoing family and domestic violence issues only (in both the defining and prospective periods).

Figure Indigenous.4 shows vulnerability pathways for Indigenous clients experiencing FDV, clients with a mental health issue and those with problems with drugs or alcohol.

Figure Indigenous.4: Indigenous cohort 2015–16, vulnerability pathways

SHS services needed by Indigenous cohort clients

The need for, and provision/referral of, SHS services was examined for the Indigenous cohort clients in the retrospective, defining and prospective study periods; aggregation is based on services needed or provided/referred in support periods that commenced within each study period only.

Patterns of service need were generally similar for Indigenous clients across the 3 study periods. For example, the proportion of clients with a need for accommodation assistance (all forms) was similar and pervasive, ranging from 80% in the 12-month defining period to around 85-87% in the retrospective and prospective periods (Figure Indigenous.5, Table Indigenous1516.1, Table Indigenous1516.4).

Figure Indigenous.5: Indigenous cohort 2015–16, select top 10 services and assistance needed and service provision status by study period

How Indigenous clients compare with non-Indigenous clients

In 2015–16, compared with non-Indigenous clients, Indigenous clients were (Figure Indigenous.2, Table Indigenous1516.1):

• more likely to be aged 18–24 years; 28% compared with 20% for the non-Indigenous cohort
• more likely to have presented with children at some time; 28% compared with 20%
• more likely to have needed multiple periods of support in the prospective period (34% had 3 or more support periods), compared with 20%
• more likely to have needed short-term or emergency accommodation (55% compared with 35%) and more likely to have received accommodation (41% compared with 24%)
• more likely to have experienced homelessness (59% compared with 48%), including having been a couch surfer (31% compared with 22%)
• equally likely to have experienced FDV (36% to 37%) and less likely to have had mental health issues (31% compared with 35%). They were more likely, however, to have had problematic drug or alcohol issues (18% compared with 12%)
• more likely to have received support in the past, 56% of Indigenous clients received support in the retrospective period, compared with 41% of non-Indigenous clients. Similarly, Indigenous clients were more likely to continue receiving support into the future (the prospective period; 60% compared with 40%)
• more likely to be long-term clients (40% compared with 23%) – that is, receive support both in the past (the 48-month retrospective period) and the future (the 48-month prospective period).

How did service needs differ?

Differences in the services needed between Indigenous and non-Indigenous clients were examined using relative risk, calculated by dividing the risk of an event occurring for one group (specifically, service need for each service type separately for Indigenous clients) by the risk of an event occurring for another group (service need for non-Indigenous clients).

Figure Indigenous.6 highlights the need and therefore importance of providing culturally appropriate services to Indigenous clients. Indigenous clients were over 4 times more likely to require culturally specific services (relative risk (RR) 4.12) and need assistance to connect culturally (RR 3.60) during the 2015–16 defining study period than non-Indigenous clients (Figure Indigenous.6; Table Indigenous1516.5).

Figure Indigenous.6: Relative risk of needing a SHS service type, Indigenous and non-Indigenous clients, by study period, 2015–16

Factors associated with SHS service use

Descriptive regression models were used to examine whether client characteristics or support experience in the defining period were associated with SHS support in the prospective study period (ongoing service use). Information on interpreting regression models can be found in the section Understanding factors associated with past and future support. Two models were created; a ‘client characteristic’ model (Model 1) that contained client characteristics and a ‘reasons’ model (Model 2) that supplemented these characteristics with flags for the 26 possible reasons why the client sought support during the defining study period.

Variations in state and territory specific policies and service delivery models mean that the likelihood of a client receiving services in the future varies among states and territories. Therefore, in addition to a national model, separate regression models were created for each state or territory where there was sufficient sample size (at least 3,500 clients; Figure Indigenous.7). The models are descriptive, that is, they are intended to describe the client variables that are associated with past or future service use without proposing or testing specific causal pathways.

The outcome variable (receipt of SHS support) was a binary measure (yes or no) and did not distinguish between clients that needed SHS services only once in the prospective study period and clients that required frequent support.

Risk ratios were created to measure the association between the use of SHS services and a set of client characteristics (see Glossary entry on Relative Risk for how to interpret the results)

Some bias is present in this outcome measure because some clients who required services in the future may not have been able to receive them (see the section on Bias within the SHSC longitudinal data).

The national results from the client characteristic model (Model 1) demonstrate that having experienced family and domestic violence (15% greater likelihood) and being female (15%) were associated with ongoing SHS support (Figure Indigenous.7). Transitioning from custody (14%) and having problematic drug/alcohol issues (14%) were also associated with ongoing SHS support.

The results from the reasons model (Model 2) align with the client characteristics model and demonstrates that Indigenous clients whose reason was transition from custodial arrangements were 17% more likely to receive SHS support into the future. Other factors associated with an increased likelihood of ongoing SHS support among Indigenous clients included having domestic and family violence as a reason for seeking assistance (16% greater likelihood in the national data).

Figure Indigenous.7: Relative risk for use of SHS services (Indigenous cohort 2015–16)

Summary

Over 38,600 clients aged 18 and over used services in 2015–16 and identified as being of Aboriginal or Torres Strait Islander origin.

These clients were more likely to have presented with children and need accommodation, particularly short-term or emergency accommodation than non-Indigenous clients. They were also more likely to have experienced homelessness and to be long-term clients.

They were more likely to use culturally specific services (including assistance to connect culturally) and family planning support.

Indigenous clients were more likely to use services into the future (60% compared with 40% of non-Indigenous clients). Over one-third of the Indigenous cohort (34%) needed multiple periods of support in the prospective period (3 or more support periods), compared with only 20% of non-Indigenous clients.

Client traits or experiences, as reported during the defining study period, associated with either a history of or future SHS support include having transitioned from custody, experiencing family and domestic violence or problematic drug/alcohol issues.

Data tables