Overview of specialist homelessness services client groups
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts, including women and children affected by family and domestic violence (FDV).
Why are they important
Women who experience family and domestic violence are considered an important sub-group of clients experiencing homelessness; national policies are aimed at preventing or ameliorating homelessness in this sub-group (CFFR 2018). In Australia, 1 in 6 women (17% or 1.6 million) have experienced physical or sexual violence from a current or former intimate partner since the age of 15 (ABS 2017). For women who are housing secure – self-reported housing situation – an episode of violence increases the probability that they will subsequently be at-risk of homelessness or homeless (Scutella et. al 2012; Diette and Ribar 2015). In 2020-21, approximately 68,100 females over 18 years affected by family and domestic violence received SHS support, which is 54% of all adult female SHS clients (AIHW 2021).
According to Scutella and others (Journeys Home 2012), the second most common reason a person became homeless was ‘domestic and family violence or abuse’, after ‘Relationship/family breakdown’. In 2021, the main reason females sought assistance from SHS agencies was ‘family and domestic violence’, higher than the number of clients who chose accommodation services as the main reason for seeking assistance (AIHW 2021).
Women leaving violence travel a diverse range of housing pathways, including moving between housing tenures and markets, depending on their resources, choices and needs; FDV often leads to homelessness, but victim-survivors sometimes decide to remain in or return to a violent relationship because of a lack of available and appropriate housing (Flanagan et. al 2019).
Pathways out of homelessness
The options generally available for victim-survivors of FDV are social housing and subsidised private rental housing (Flanagan et. al 2019). Social housing access is limited as it is targeted for those with the most complex needs (Flanagan et. al 2019). Payments of Commonwealth Rent Assistance (CRA) are one of the ways private rental housing is subsidised (Flanagan et. al 2019). However, once the subsidy ends, housing is again unaffordable. The increase in rent is another challenge for victim-survivors accessing private rental housing (Flanagan et. al 2019).
References
ABS (Australian Bureau of Statistics) (2017) Personal Safety, Australia, 2016. ABS cat. no. 4906.0, Australian Bureau of Statistics: Canberra.
AIHW (2021) Specialist homelessness services annual report, AIHW Cat. no. HOU 327. AIHW: Canberra.
CFFR (Council on Federal Financial Relations) (2018) National Housing and Homelessness Agreement. Viewed 18 July 2021.
Diette, C. and Ribar, D. (2015) A longitudinal Analysis of Violence and Housing Insecurity (Melbourne Institute Working Paper Series Working Paper No. 20/15), Melbourne Institute of Applied Economic and Social Research, Melbourne
Flanagan, K., Blunden, H., valentine, k. and Henriette, J (2019) Housing outcomes after domestic and family violence, AHURI Final Report 311, Australian Housing and Urban Research Institute Limited, Melbourne.
Scutella, R. Johnson, G., Moschion, J., Tseng, Y. & Wooden, M (2012) Journeys Home: Wave 1 Findings (Journeys Home Research Report No. 1, Prepared for the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs), Melbourne, Melbourne Institute of Applied Economic and Social Research.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts. While not specifically listed as a priority cohort, clients with a mental health issue (MH clients) are vulnerable to experiencing homelessness (Brackertz et al. 2020).
Why are they important
Housing and mental health are intertwined. For example, research has found the odds of experiencing homelessness among people with a mental health issue was nearly double that of people without a mental health issue (Nilsson et al. 2019). Similarly, an increased prevalence of mental health conditions among people experiencing homelessness, especially, ‘severe’ mental conditions such as schizophrenia and bipolar disorder (Ayano et al. 2019; Gutwinski et al. 2021). The most recent National Survey of Mental Health and Wellbeing found that 1 in 2 (54%) people with a history of homelessness reported an experience of a mental health condition, compared with almost 1 in 20 (19%) people without a history of homelessness (ABS 2008). In this way, mental health issues may equally be a contributor and/or outcome of housing instability/homelessness – rather than, simply a cause (Johnson and Chamberlain 2011).
The relationship between homelessness and mental health is complex and bidirectional (Brackertz et al. 2020). An interaction between various structural and individual factors contribute to the likelihood of experiencing homelessness, and the likelihood of mental health issues, particularly, for low-income households (Bentley et al. 2011). Mental health issues reduce a person’s capacity to maintain stable housing circumstances (Flatau et al. 2022). For example, an Australian study found that among people who experienced severe psychological distress, the likelihood of experiencing financial hardship – in the next year – increased by 89% (Brackertz et al. 2020). Equally, however, experiencing homelessness can amplify mental ill-health, such that mental health issues may be triggered and/or exacerbated (Kaleveld et al. 2018). For instance, past research into Australia’s homeless population found that the proportion (about 15%) of people who reported a history of mental health issues before entering homelessness was similar to the proportion of people who reported developing a mental health issue after entering homelessness (Johnson and Chamberlain 2011).
Pathways out of homelessness
Providing people with mental health issues with safe, secure, and appropriate housing and support services is critical for mental health recovery and sustaining stable housing (Brackertz et al. 2020; Flatau et al. 2022). Yet, given the diversity of mental health issues and varied pathways out of homelessness, addressing the needs, challenges, and circumstances of this cohort is complex and multifaceted (AIHW 2021). This is because the types of mental health support and homelessness services required will vary by person and local context (State of Victoria 2021). As a result, establishing an integrated and collaborative support system, based on a person-centred approach to service delivery and support, is crucial for facilitating exits out of homelessness (Productivity Commission 2020; NMHC 2020; Spinney et al. 2020), especially for people with complex needs, such as those who experience severe symptoms and/or other issues associated with homelessness and disadvantage including disabilities, problematic gambling, and problematic drug and/or alcohol use (Whittaker et al. 2017; Moore et al. 2011; Nower et al. 2015).
Through fulfilling the basic need for housing, people with mental health issues are afforded an opportunity to not only focus on their recovery, but also access the appropriate support services for treatment and rehabilitation (Honey et al. 2017; Holland 2018; Maslow 2013; NMHC 2017). Critically, it also enhances a person’s capacity to successfully engage in activities that help maintain stable housing circumstances, such as employment, studying, and the reestablishment of social networks (Flatau et al. 2022; Johnstone et al. 2016; van der Laan et al. 2020).
References
ABS (Australian Bureau of Statistics) (2016) National Mental Health and Wellbeing: Summary of Results, Australian Bureau of Statistics: Canberra.
AIHW (2021) Specialist homelessness services annual report, AIHW Cat. no. HOU 322. Australian Institute of Health and Welfare: Canberra.
Ayano G, Tesfaw G and Shumet S (2019) ‘The prevalence of schizophrenia and other psychotic disorders among homeless people: a systematic review and meta-analysis’, BMC Psychiatry, 19(370):1-14.
Bentley R, Baker E, Mason K, Subramanian SV and Kavanagh AM (2011) ‘Association between housing affordability and mental health: a longitudinal analysis of a nationally representative household survey in Australia’, American Journal of Epidemiology, 1(174):753-60.
Brackertz N, Borrowman K and Roggenbuck C (2020) Trajectories: the interplay between housing and mental health pathways, Australian Housing and Urban Research Institute Limited and Mind Australia (AHURI), Melbourne.
Flatau P, Lester L, Seivwright A, Teal R, Dobrovic J, Vallesi S, Hartley C and Callis Z (2022) Ending Homelessness in Australia: an evidence and policy deep dive, Centre for Social Impact, Crawley.
Gutwinski S, Schreiter S, Deutscher J and Fazel S (2021) ‘The prevalence of mental disorders among homeless people in high-income countries: An updated systematic review and meta-regression analysis’, PLoS medicine, 18(8):e1003750.
Honey A, Nugent A, Hancock N and Scanlan J (2017) ‘It’s hard work, believe me!”: active efforts to optimise housing by people who live with mental illness and access housing assistance’, Australian Journal of Social Issues, 52(4):347-366.
Holland JM (2018) ‘Challenges and Considerations for Housing in the Future’, Family and Consumer Sciences Research Journal, 47(2):124-129.
Johnson G and Chamberlain C (2011) ‘Are the Homeless Mentally Ill?’, Australian Journal of Social Sciences, 46(1):29-48.
Johnstone M, Parsell C, Jetten J, Dingle G and Walter Z (2016) ‘Breaking the cycle of homelessness: Housing stability and social support as predictors of long-term well-being’, Housing Studies, 31(4):410-426.
Kaleveld L, Seivwright A, Box E, Callis Z & Flatau P (2018) Homelessness in Western Australia: A review of the research and statistical evidence, Government of Western Australia, Department of Communities, Perth.
Maslow AH (2013) A Theory of Human Motivation, Wilder Publications, Radford.
Moore G, Manias E and Gerdtz MF (2011) ‘Complex health service needs for people who are homeless’, Australian Health Review, 35(4):480-485.
Nilsson SF, Nordentoft M, Hjorthøj C (2019) ‘Individual level predictors for becoming homeless and exiting homelessness: A systematic review and meta-analysis’, Journal of Urban Health, 96(5):741-50.
NMHC (National Mental Health Commission) (2017) Housing, Homelessness and Mental Health: Outcomes from the National Mental Health Commission’s consultation in 2017. Canberra: National Mental Health Commission, Canberra.
NMHC (2020) ‘Vision 2030: Blueprint for Mental Health and Suicide Prevention’, National Mental Health Commission, Canberra.
Nower L, Eyrich-Garg KM, Pollio DE. and North CS (2015) ‘Problem gambling and homelessness: Results from an epidemiologic study’, Journal of Gambling Studies, 31(2): 533-545.
Productivity Commission (2020) Mental Health, Report no. 95, Productivity Commission, Canberra.
Scutella R, Chigavazira A, Killackey E, Herault N, Johnson G, Moschion J and Wooden (2014) Journeys Home Research Report No. 4, Melbourne Institute, Melbourne.
State of Victoria (2021) Royal Commission into Victoria’s Mental Health System, Final Report, Parl Paper No. 202, Session 2018–21, Government of Victoria, Melbourne, accessed 11 February 2022.
Whittaker E, Dobbins T, Swift W, Flatau P and Burns L (2017) ‘First examination of varying health outcomes of the chronically homeless according to Housing First configuration’, Australian and New Zealand journal of public health, 41(3): 306-308.
Van der Laan J, Boersma SN, al Shamma S, Akkermans R, van Straaten B, Rodenburg G, van de Mheen D and Wolf JRLM (2020) ‘Differences in housing transitions and changes in health and self-determination between formerly homeless individuals’, European Journal of Public Health, 30(5): 900–905.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts. While not specifically listed as a priority cohort, problematic drug or substance use (SUB clients) can exacerbate housing instability (Lalor 2020) and potentially lead to homelessness.
Why are they important
Substance abuse is a typical pathway into homelessness and a factor which makes it difficult to exit, leading to longer periods of homelessness (Chamberlain and Johnson 2011). The Journeys Home research project utilised longitudinal survey data to identify 'clear associations between homelessness and risky drinking, cannabis use and illegal/street drug use' (Scutella et al. 2014). The Journeys Home data also provided insights into the direction of the relationship, suggesting that some forms of substance use can lead to homelessness (particularly risky alcohol use) (McVicar et al. 2015).
A study conducted by the AIHW between 2011 and 2014 found that a significant proportion (77%) of SHS clients who also used alcohol and other drug treatment services (AODTS) were also experiencing other vulnerabilities (such as having a current mental health issue, experiencing domestic and family violence, being young or aged 50 and over) (AIHW 2016). Half (51%) of the matched SHS and AODTS population reported experiencing a current mental health issue.
Pathways out of homeless
Homelessness is often a barrier to accessing alcohol and other drug treatment services; treatment at many rehabilitation and detoxification services is contingent on the individual providing a discharge address (Vallesi et al. 2021). In addition, traditional housing services frequently allocate supported accommodation contingent on drug and alcohol rehabilitation and other restrictions such as abstinence during the period of accommodation (Lalor 2020). Consequently, clients who cannot achieve or sustain abstinence find it difficult to obtain appropriate treatment or housing. Access to housing that is safe, affordable and stable supports an individual’s mental health and facilitates recovery (Duff et al. 2021).
References
AIHW (2016) Exploring drug treatment and homelessness in Australia: 1 July 2011 to 30 June 2014. AIHW Cat. no. CSI 23. Australian Institute of Health and Welfare: Canberra.
AIHW (2021) Specialist homelessness services annual report. AIHW Cat. no. HOU 322. Australian Institute of Health and Welfare: Canberra.
Chamberlain C & Johnson G (2011) Pathways into adult homelessness. Journal of Sociology, vol. 49 issue 1, pp. 3-21.
Duff C, Hill N, Blunden H, Valentine K, Randall S, Scutella R and Johnson G (2021) Leaving rehab: enhancing transitions into stable housing, AHURI Final Report No. 359, Australian Housing and Urban Research Institute Limited, Melbourne.
Johnson C & Chamberlain G (2008) ‘Homelessness and substance abuse: which comes first?’ Australian Social Work, 61(4).
Lalor E (2020) Inquiry into Homelessness in Victoria: Submission to Legal and Social Issues Committee Legislative Council Parliament of Victoria. North Melbourne, Vic: Alcohol and Drug Foundation.
McVicar D, Moschion J & van Ours J. C (2015) ‘From substance use to homelessness or vice versa?’. Social Science & Medicine, 136, pp.89-98.
Nilsson SF, Nordentoft M, Hjorthøj C (2019) ‘Individual level predictors for becoming homeless and exiting homelessness: A systematic review and meta-analysis’. Journal of Urban Health. vol. 96 issue 5, pp. 741-50.
POA (Parliament of Australia) (2004) ‘A hand up not a hand out: Renewing the fight against poverty’. Report on Poverty and Financial Hardship. Canberra: Senate Community Affairs Reference Committee.
Scutella R, Chigavazira A, Killackey E, Herault N, Johnson G, Moshcion J & Wooden M (2014) Journeys Home Research Report No. 4 Findings from Waves 1 to 4: Special Topics. University of Melbourne.
Vallesi S, Tuson M, Davies A, Wood L (2021) ‘Multimorbidity among People Experiencing Homelessness–Insights from Primary Care Data’ International Journal of Environmental Research and Public Health, vol. 18, issue 12, p. 6498.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts, one of which is children and young people.
Why are they important
Youth homelessness remains a persistent social problem in Australia. On any given night, almost 4 in 10 (38% of the homeless population or 44,200) people who experience homelessness are estimated to be under the age of 25 (ABS 2018). Similarly, longitudinal research into the Australian experience of homelessness and housing insecurity found that almost 3 in 4 participants first experienced homelessness before the age of 25 (Scutella et al. 2012). Some risk factors involved in young people’s entries into homelessness include family conflict (including domestic violence or abuse), problems at school (including academic failure and suspension), a history of problem behaviours and problematic substance and/or alcohol use (Grattan et al., 2021; Heerde et al. 2020, 2021). Conversely, the structural factors involved in the underlying conditions of youth homelessness include limited affordable housing, financial insecurity, and accessibility issues with welfare services (Johnson et al. 2015; Mackenzie et al. 2020; Pearl et al. 2021).
Experiences of homelessness can have serious ramifications for young people’s social, physical and emotional development and health and wellbeing (Flatau et al. 2016; Grattan et al. 2021). The disruption to daily life and stresses associated with experiencing homelessness has negative implications for their education, transition to employment and, the development of healthy and stable social networks and skills (Heerde and Patton 2020; Robards et al. 2019). Once homeless, young people may be exposed to situations that reinforce their situation, such as violence, mental health issues and interactions with the justice system (Gaetz et al. 2018).
Compared to the general population, young people experiencing homelessness experience greater levels of psychological distress, problematic substance and/or alcohol use and social isolation (Medlow et al. 2014). Further, young people experiencing homelessness are at increased of risk of developing and/or exacerbating health issues and mental health conditions (Flatau et al. 2016; Hodgson et al. 2013;). Critically, longitudinal data from the Journey Home research project demonstrated that the likelihood of experiencing persistent homelessness was highest when people first experienced homelessness at a young age compared to a later age (Scutella et al. 2012). In this way, young people experiencing homelessness are a group especially vulnerable to experiencing long-term homelessness (Brackenhoff et al. 2015).
Pathways out of homeless
Although housing is necessary for any pathway out of homelessness, housing alone does not ensure exits out of homelessness for most young people (Alves and Roggenbuck 2021; Scutella et al. 2012). Young people experiencing homelessness require tailored support for their transition into stable housing based on their unique pathways, circumstances and distinct range of needs in various domains and sectors (Wang et al. 2019). The provision of support that not only addresses their needs, but also helps them in developing their capacity to live independently and maintain housing stability is an important consideration for service delivery. Although the type of support required varies by young person, common supports include help with navigating different services and systems, reconnecting with family, and education and employment (Mackenzie et al. 2020; Gaetz et al. 2018; Wang et al. 2019).
An integrated and collaborative system, undergirded by a person-centred approach is critical to facilitating successful pathways out of homelessness (Flatau et al. 2022). Indeed, evidence from the Australian experience of youth homelessness highlights that care that addresses young people’s unique social, psychological and emotional needs, as well as their unique circumstances and priorities is critical towards facilitating the maintenance of stable housing for young people (Flatau et al. 2015; Turnbull et al. 2021). Young people who are not afforded such care may be left unprepared and ill-equipped for independent living. In turn, rendering them at an increased risk for further harm and/or re-entry into homelessness (Alves and Roggenbuck 2021; Mendes and Purtell 2020; Turnbull et al. 2021).
References
ABS (Australian Bureau of Statistics) (2018) Census of Population and Housing: Estimating Homelessness, accessed 20 January 2021. Australian Bureau of Statistics: Canberra
Alves T and Roggenbuck C. (2021) Final Report: Towards a Youth Homelessness Strategy for Victoria, Australian Housing and Urban Research Institute Limited (AHURI), Melbourne.
Brakenhoff B, Jang B, Slesnick N and Snyder A (2015) ‘Longitudinal predictors of homelessness: Findings from the National Longitudinal Survey of Youth-97’. Journal of Youth Studies, 18(8): 1015-1034.
Flatau P, Lester L, Seivwright A, Teal R, Dobrovic J, Vallesi S, Hartley C and Callis Z (2022) Ending Homelessness in Australia: An evidence and policy deep dive, Centre for Social Impact, Crawley.
Flatau P, Thielking M, MacKenzie D, Steen A, Bauskis A and Nolan K (2016) The Cost of Youth Homelessness in Australia, Centre for Social Impact: Crawley.
Flatau P, Thielking M, MacKenzie D and Steen A (2015) ‘The Australian youth homeless experience: Evidence from a longitudinal survey of homeless youth’, Parity, 28(3):4–6.
Gaetz S, Schwan K, Redman M, French D and Dej E (2018) ‘Report 5: Housing Stabilization for Youth’ in A. Buchnea (eds) The Roadmap for the Prevention of Youth Homelessness, Canadian Observatory on Homelessness Press, Toronto.
Grattan R, Tryon V, Lara N, Gabrielian S, Melnikow J, Niendam T (2021) Risk and Resilience Factors for Youth Homelessness in Western Countries: A Systematic Review, American Psychiatric Association, Psychiatric Services In Advance, Published Online: 29 July 2021.
Heerde JA, Bailey JA, Kelly AB, McMorris BJ, Patton GC and Toumbourou JW (2021) ‘Life-course predictors of homelessness from adolescence into adulthood: A population-based cohort study’, Journal of adolescence, 91:15–24.
Heerde JA, Bailey JA, Toumbourou JW, Rowland B and Catalano RF (2020) ‘Longitudinal Associations Between Early-Mid Adolescent Risk and Protective Factors and Young Adult Homelessness in Australia and the United States’, Prevention Science, 21:557–567.
Heerde JA and Patton GC (2020) ‘The vulnerability of young homeless people’, Lancet vol. 5 issue 6, E302–3.
Hodgson KJ, Shelton K.H, van den Bree MB and Los FJ (2013) ‘Psychopathology in young people experiencing homelessness: a systematic review’, American journal of public health, vol. 103 issue 6: e24-e37.
Johnson G, Scutella R, Tseng, Y and Wood G. (2015) Entries and exits from homelessness: a dynamic analysis of the relationship between structural conditions and individual characteristics, AHURI Final Report No.248, AHURI, Melbourne.
MacKenzie D, Hand T, Zufferey C, McNells S, Spinney A and Tedmanson D (2020) Redesign of a homelessness service system for young people, AHURI Final Report 327, AHURI: Melbourne.
Medlow S., Klineberg E and Steinbeck K (2014) ‘The health diagnoses of homeless adolescents: a systematic review of the literature’, Journal of Adolescence, 37(5): 531-542.
Mendes P and Purtell J 2020 ‘Relationship-based Models for Supporting Young People Transitioning from Out-of-home Care: Two Case Studies from Victoria, Australia’, Institutionalised Children Explorations and Beyond, 8(1):120-132.
Pearl B, Harvey C., and Brophy L (2021) ‘Understanding How Young People Exit Homelessness in Australia: A Critical Realist Approach’, Housing, Theory and Society: 1-18.
Robards F, Kang M, Steinbeck K, Hawke C, Jan S, Sanci L, Liew YY, Kong M and Usherwood T (2019) ‘Health care equity and access for marginalised young people: a longitudinal qualitative study exploring health system navigation in Australia’, International journal for equity in health, vol. 18 iss. 1:1-4.
Scutella R, Johnson G, Moschion J, Tseng YP, & Wooden M (2012) ‘Journeys Home Research Report No 1: Wave 1 Findings’, Melbourne Institute, Melbourne.
Wang JZ, Mott S, Magwood O, Mathew C, Mclellan A, Kpade V, Gaba P, Kozloff N, Pottie K and Andermann A (2019) The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review. BMC Public Health 19, 1528.
Turnbull L, Chavulak J, Mendes P (2021) What Does Australian Research Tell Us About Best Practice Housing Pathways for Young People Transitioning from Out-of-Home Care?, Monash University Department of Social Work, Melbourne.
In June quarter 2022, there were 40,600 persons in custody in Australia and 15,400 who were released from prison (ABS 2022).
Homelessness and custodial experiences are often intertwined; homelessness often precedes, and is strongly associated with, entering custodial arrangements, and both youth and adults exiting custodial arrangements have greatly increased chances of experiencing homelessness (AIHW 2021). The 5th National Prisoner Health Data Collection, conducted in 2018, found that one-third of prisoners had experienced homelessness in the 4 weeks before entering prison, and over half (54%) expected to be homeless after release (AIHW 2019). In addition to this, there is considerable churn within the prison population; 46% of prisoners released in 2017–18 had returned to corrective services (either prison or community corrections) within 2 years (SCRGSP 2021).
Recent longitudinal research using Australian data (Moschino and Johnson 2019) suggests, however, that homelessness itself does not increase the risk of incarceration (that is, controlling for various personal and circumstantial factors largely mitigates the effect of homelessness on incarceration), though addressing housing needs around 6 months after release does reduce rates of reincarceration.
Pathways out of homelessness
The relationship between housing insecurity and imprisonment and re-imprisonment is relatively well established (Martin et al. 2021). Post-release housing assistance can be an effective measure in addressing the imprisonment–homelessness cycle. Critically, rates of re-imprisonment have shown to be less for ex-prisoners with complex needs who receive public housing compared with those who receive private rent assistance only (Martin et al. 2021). Conversely, ex-prisoners who rely on social networks or short-term housing solutions have an increased likelihood of re-imprisonment 6 months after release (Moschion and Johnson 2019). Despite this, only 14% of prison discharges in 2018–19 received Specialist Homelessness Services (SHS) support (AHURI 2021). Not only do people exiting custody face challenges securing stable housing they also need support maintaining the tenancy, including assistance paying rent and bills on time and managing relationships with neighbours (POA 2020).
References
ABS (2020) Prisoners in Australia, 2020. Australian Bureau of Statistics, Canberra.
ABS (2022) (Jun-quarter-2022), Corrective Services, Australia, Australian Bureau of Statistics Website, accessed 24 October 2022.
AHURI (2021) Exiting prison with complex support needs: the role of housing assistance. Final Report No. 361. Australian Housing and Urban Research Institute (AHURI), Melbourne. 105 pages.
AIHW (2019) The health of Australia’s prisoners 2018. Cat. no. PHE 246, AIHW, Canberra.
AIHW (2021) Specialist homelessness services annual report 2020–21, AIHW, Canberra.
Martin C, Reeve R, McCausland R, Baldry E, Burton P, White R, Thomas S (2021) Exiting prison with complex support needs: the role of housing assistance, AHURI Final Report No. 361, Australian Housing and Urban Research Institute Limited, Melbourne.
Moschion J & Johnson G (2019) Homelessness and incarceration: A reciprocal relationship? Journal of Quantitative Criminology, 35(4), 855–887.
POA (Parliament of Australia) (2020) Parliament of Australia: Inquiry into Homelessness. Inquiry into homelessness in Australia, Submission 77. Submission by the Australian Community Support Organisation. Canberra: House of Representatives Committee.
SCRGSP (Steering Committee for the Review of Government Service Provision) (2021). Report on Government Services 2021, Part C Table CA.4. Canberra: Productivity Commission.
Aboriginal and Torres Strait Islander people are the Indigenous peoples of Australia. They are not one group, but comprise hundreds of groups that have their own distinct set of languages, histories and cultural traditions (AIHW 2022).
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts, including Indigenous Australians (CFFR 2018).
The 2020 National Agreement on Closing the Gap is a partnership between governments and Aboriginal and Torres Strait Islander people that aims to overcome the inequality experienced by Aboriginal and Torres Strait Islander people (Commonwealth of Australia 2020). This agreement outlines a number of socio-economic outcomes and targets, one of which relates to the availability of secure appropriate and affordable housing for Aboriginal and Torres Strait Islander people that is aligned with their priorities and need.
Aboriginal and Torres Strait Islander people remain disproportionately affected by experiences of homelessness and housing instability (ABS 2018; AIHW 2018; Memmott and Nash 2016). Despite making up 4% of the total national population (as at 30 June 2021) (ABS 2022), 1 in 5 people who were homeless on Census night are Indigenous Australians (or 23,400 people): a rate of homelessness almost 10 times the rate among non-Indigenous Australians (ABS 2018). Moreover, past longitudinal research in Australia suggests that Indigenous Australians are significantly more likely to experience persistent homelessness than non-Indigenous Australians (Scutella et al. 2012). Indigenous Australians are not only overrepresented among the national homeless population, but also are a group especially vulnerable to both entries into and/or experiencing ongoing episodes of homelessness (ABS 2018; AIHW 2018, 2021).
The pathways and experiences of homelessness of Indigenous Australians are distinct from non-Indigenous Australians (Spinney et al. 2016; Memmott and Nash 2016). The high-rate of homelessness stems from various complex factors associated with the impact of colonisation, housing shortages in both Indigenous communities and Australia and cultural identity (Memmott et al. 2012). Some of the structural factors involved in Indigenous homelessness include low income, educational attainment, and poverty (Birdsall-Jones and Shaw 2008; Keys Young 1998; Habibis 2013). While individual risk factors associated with Indigenous homelessness include family violence, substance disorders and unemployment (AIHW 2018), these factors can either be a contributor and/or outcome of, insecure housing circumstances or alternatively, other social problems, such as poverty (Flatau et al. 2005). In this way, effectively addressing Indigenous homelessness requires recognition of an Indigenous person’s needs, values and preferences, as well as their culture.
Safe and secure housing is basic human right integral to health and wellbeing. Strong evidence exists for the role of homelessness in the deterioration people’s physical and mental health. Therefore, addressing Indigenous homelessness is a critical step towards improving the health and wellbeing of Indigenous Australians and remains a national priority.
Pathways out of homelessness
Safe, secure and culturally appropriate housing and support is critical for Indigenous Australians to exit homelessness and sustain stable housing. Because of the complexities involved in Indigenous homelessness, special support and care is required when addressing the needs of Indigenous Australians. Indigenous Australians with complex needs related to their homelessness, such as experiences of family violence, mental health issues and legal issues are especially in need of support (Flatau et al. 2022). Further, Indigenous Australians who experience homelessness require tailored support based on not only their specific needs, but also based on considerations of the challenges unique to their pathway into homelessness, for instance an Indigenous person’s local context and their cultural understandings, values and norms (Memmott et al. 2011; 2012). Accordingly, an integrated and collaborative support system that emphasises culturally appropriate service delivery that addresses the needs and circumstances of Indigenous Australians is crucial in facilitating a pathway out of homelessness (Flatau et al. 2022).
Culturally safe and appropriate service delivery and intervention has been identified as key factor in successfully promoting Indigenous pathways out of homelessness (Flatau et al. 2022). Indeed, the provision of long-term housing in combination with context-specific, tailored support based on an Indigenous person’s culture, circumstances and needs have shown some success in facilitating housing stability (Moran et al. 2016). This support may include ongoing support for drug and alcohol issues, family issues and/or physical and mental health issues (Chamberlain and Johnson 2013).
References
Australian Institute of Health and Welfare (AIHW) (2018) Aboriginal and Torres Strait Islander people: a focus report on housing and homelessness, AIHW, Canberra.
AIHW (2021) Specialist homelessness services annual report 2020–21, AIHW, Canberra.
AIHW (2022) Indigenous Australians, Australian Institute of Health and Welfare website, accessed 12 September 2022.
Australian Bureau of Statistics (ABS) (2022) Estimates of Aboriginal and Torres Strait Islander Australians, ABS website, accessed 12 October 2022.
ABS (2018) Census of Population and Housing: Estimating homelessness, 2016, ABS cat. no. 2049.0., ABS, Canberra.
Birdsall-Jones C & Shaw W (2008) Indigenous homelessness: place, house and home, AHURI Positioning Paper No. 107. Melbourne: Australian Housing and Urban Research Institute
CFFR (Council on Federal Financial Relations) (2018). National Housing and Homelessness Agreement. Viewed 3 August 2022.
Chamberlain C and Johnson G (2013) Pathways into adult homelessness, Journal of Sociology, 49(1):60-77.
Flatau P, Cooper L, McGrath N, Edwards D, Hart A, Morris M, Lacroix, C, Adam M, Marinova D, Beer A, Tually S. and Traee C (2005) Indigenous access to mainstream public and community housing, AHURI Final Report No. 85, Australian Housing and Urban Research Institute Limited (AHURI), Melbourne.
Flatau P, Lester L, Seivwright A, Teal R, Dobrovic J, Vallesi S, Hartley C and Callis Z (2022) Ending homelessness in Australia: an evidence and policy deep dive, Centre for Social Impact, Crawley.
Habibis D (2013), Australian housing policy, misrecognition and Indigenous population mobility, Housing Studies, 28(5):764-781.
Keys Young (1998) Homelessness in the Indigenous and Torres Strait Islander context and its possible implications for the Supported Accommodation Assistance Program (SAAP): final report, Department of Family and Community Services, Canberra.
Memmott P, Birdsall-Jones C, Go-Sam C, Greenop K & Corunna V (2011), Modelling crowding in Aboriginal Australia, AHURI Positioning Paper no.141, Australian Housing and Urban Research Institute (AHURI), Melbourne.
Memmott P, Birdsall-Jones C and Greenop K (2012), Why are special services needed to address Indigenous homelessness?, Institute for Social Science Research, Brisbane.
Memmott P and Nash D (2016) ‘Indigenous homelessness: Australian context’ in Peters EJ and Christensen E (eds) Indigenous Homelessness: Perspectives from Canada, Australia and New Zealand, University of Manitoba Press, Winnipeg.
Moran M, Memmott P, Nash D, Birdsall-Jones C, Fantin S, Phillips R and Habibis D (2016) Indigenous lifeworlds, conditionality and housing outcomes, AHURI Final Report No.260. Australian Housing and Urban Research Institute Limited, Melbourne.
Scutella R, Johnson G, Moschion J, Tseng, Y & Wooden M (2012) Journeys Home: Wave 1 Findings (Journeys Home Research Report No. 1, Prepared for the Australian Government Department of Families, Housing, Community Services and Indigenous Affairs, Melbourne Institute of Applied Economic and Social Research), Melbourne.
Spinney A, Habibis D and McNelis S (2016) Safe and sound? How funding mix affects homelessness support for Indigenous Australians, AHURI Final Report No. 272, Australian Housing and Urban Research Institute Limited, Melbourne.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts, one of which is older people (CFFR 2018).
Older people in Australia are a rapidly growing group among Australia’s homeless population. An increasing number of older people are impacted by poverty and financial insecurity, such that older clients have been one of the fastest growing SHS client groups since the collection began (Peterson and Parsell 2014; AIHW 2021). The risk of and/or the experience of homelessness can be exacerbated by issues associated with later life, including health issues, cognitive decline and limited social networks (Thredgold et al. 2019). When considering Australia’s ageing population in light of these trends, the risk of and/or experience of homelessness is projected to increase in the coming decades (ABS 2018; AHRC 2019).
Older people experiencing homelessness have unique health and welfare vulnerabilities and high rates of geriatric symptoms - such as frailty, cognitive impairment and mobility issues - and mortality compared to older people with housing (Canham et al. 2020; Crane and Joly 2014). Further, older people experiencing homelessness are significantly more likely to have functional disabilities, chronic diseases, and other complex physical and mental health needs than younger people experiencing homelessness (Crane and Warnes 2010; Humphries and Canham 2021). Older people experiencing homelessness often lack access to the appropriate treatment and support services required to manage their health conditions, as they unable to provide a fixed address or may be unfamiliar with navigating support systems. As a result, many older people are left with worsening or persistent health conditions that are exacerbated by their poor living conditions (Humphries and Canham 2021).
The structural factors involved in homelessness, such as unaffordable housing, may impact older people differently due to their unique housing needs and financial circumstances (Mission Australia 2017). There are a number of different pathways into homelessness for older people, some have had intermittent periods of homelessness and others have experienced chronic homelessness for many years (Thredgold et al. 2019). More common for older people, however, is first time homelessness in later life (Peterson and Parsell 2014). Cultural factors related to economic disadvantage in later life, such as historically low wages for women, have contributed to increases in first time homelessness among older people in recent times, especially, older women (AHRC 2019). For example, older women are more likely to have lower retirement savings than older men and thus, may be at greater risk of homelessness in unaffordable housing circumstances (AHRC 2019). However, it should be noted that older women are often statistically invisible due to the nature of women’s homelessness (Peterson and Parsell 2014). This is because older women experiencing homelessness typically stay with friends and family, live in their car, or live in a severely overcrowded dwelling, rather than seek assistance from Specialist Homelessness Services (SHS) (Mission Australia 2017).
Pathways out of homelessness
Many older people are not getting the support they need, and service providers often lack the capacity to support the needs of older people (Royal Commission 2021; Thredgold et al. 2019). Older people experiencing homelessness are more likely to require support for complex and/or multiple mental and/or physical health issues, which often require specialised care. Recent Australian research on older people homelessness identified that a lack of resources dedicated to supporting older people’s needs in the SHS system, and lack of access to income support and services as key barriers in older people’s pathway out of homelessness (Thredgold et al. 2019). In other words, some older people require support navigating (e.g., information) and/or accessing (e.g., travelling) service systems, whereas others require support with accessing income support (e.g., aged care pension) and health and aged-care services. On the other hand, the service system is currently ill-equipped to provide the appropriate support to help these older people (Humphries and Canham 2021).
Older people experiencing chronic homelessness – who are often men – more likely require support for the needs, challenges and circumstances contributing to their homelessness, such as problematic alcohol and substance use, limited social networks and multiple health issues (Humphries and Canham 2021). Conversely, older people experiencing homelessness for the first time – who are often women – more likely require support overcoming barriers to service, such as travelling to or accessing information about homelessness, healthcare and community services.
Irrespective of the contributing factors, access to secure, affordable, and age-appropriate housing and support services is required for older men and women to successfully exit homelessness (Flatau et al. 2022). Yet, given the complexity and diversity of the unique needs of older people, addressing the needs, challenges, and circumstances of this cohort is difficult and multifaceted (Peterson et al. 2014). Older people experiencing homelessness have distinct needs regarding housing and support services compared to younger people experiencing homelessness (Power et al. 2018). For example, many older people require support with aged care, employment, and service system navigation in combination with housing. As a result, establishing an integrated and collaborative support system that promotes an age-appropriate and person-centred approach towards service delivery is critical in helping older people exit homelessness successfully (Humphries and Canham 2021; Thredgold et al. 2019).
References
ABS (Australian Bureau of Statistics) (2018) Population Projections, Australia [Data Explorer],accessed 17 February 2022.
AHRC (Australian Human Rights Commission) (2019) Older womens’ risk of homelessness: Background paper 2019, AHRC, Sydney.
AIHW (Australian Institute of Health and Welfare) (2021) Specialist homelessness services annual report [dataset], accessed 17 February 2022.
Canham SL, Custodio K, Mauboules C, Good C and Bosma H (2020) ‘Health and psychosocial needs of older adults who are experiencing homelessness following hospital discharge’, The Gerontologist, 60(4): 715-724.
CFFR (Council on Federal Financial Relations) 2018. National Housing and Homelessness Agreement. Viewed 3 August 2022.
Crane M and Joly L (2014) Older homeless people: Increasing numbers and changing needs, Reviews in Clinical Gerontology, 24:255–268.
Crane M. and Warnes AM (2010) Homelessness among older people and service responses, Reviews in Clinical Gerontology, 20(4):354-363.
Flatau P, Lester L, Seivwright A, Teal R, Dobrovic J, Vallesi S, Hartley C and Callis Z (2022) Ending Homelessness in Australia: an evidence and policy deep dive, Centre for Social Impact, Crawley.
Humphries J and Canham SL (2021) Conceptualizing the shelter and housing needs and solutions of homeless older adults: Housing Studies, 36(2):157-179.
Mission Australia (2017) Ageing and Homelessness Report, accessed on 15 February 2022.
Peterson M and Parsell C (2014) Homelessness for the First time in Later Life: An Australian Study, Housing Studies, 30(3):368-391.
Peterson M, Parsell C, Phillips R and White G (2014) Preventing first time homelessness amongst older Australians, AHURI Final Report No.222, Australian Housing and Urban Research Institute (AHURI): Melbourne.
Power E, Mee K, Horrocks J (2018) Housing: An infrastructure of care for older Australians, Parity, 31(4):16-18.
Royal Commission into Aged Care Quality and Safety (2021) Final report: Care, dignity and respect. Royal Commission into Aged Care Quality and Safety, Canberra.
Thredgold C, Beer A, Zufefrey C, Peters A and Spinney A (2019) An effective homelessness services system for older Australians, AHURI: Melbourne.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments to address priority policy areas and priority cohorts, including children on care and protection orders (CPO), and their access to affordable, safe and sustainable housing. The agreement also details the provision of homelessness services and support for people at risk or experiencing homelessness (CFFR 2018).
Child abuse and neglect is often associated with disadvantage and issues such as poverty, homelessness, drug and alcohol addiction, domestic violence and mental health issues (DSS 2021).
In 2020–21, around 8,300 children with a care and protection order received support from specialist homelessness services (AIHW 2021). Most (68%) children on a CPO presented with a single parent or carer and almost a quarter (23%) presented alone (23% of children on a CPO presented alone in their first SHS support period in 2020–21) (AIHW 2021); they may have absconded from their home due to family violence, abuse, or neglect (Noble-Carr & Trew 2018).
Around 16% of CPO clients accessing SHS in 2020–21 cited housing crisis as a reason for seeking assistance, an umbrella term often describing the interplay of housing supply, affordability and availability among other factors impacting access to safe and secure housing (AIHW 2021). The journeys home research suggest that the state of the housing market is strongly associated with an individual’s risk of homelessness, citing higher rates of homelessness in areas of higher housing costs (Bevitt et al. 2015).
Children require safe, secure, and stable home environments to maintain mental and physical wellbeing for their development into adulthood, with short periods of being at risk of or experiencing homelessness associated with an increased likelihood of experiencing negative health outcomes in the long term (AIFS 2012; Bassuk et al. 2014; Clair 2019; Flatau et al, 2016). Children experiencing homelessness are also at increased risk of being homeless as adolescents and adults (Flatau et al. 2012).
Pathways out of homelessness
A critical element of a child’s wellbeing within out-of-home care within the child protection system is placement stability, and child protection agencies prioritise this where possible (AIFS 2021; Prentice 2018; Seselja 2017). Being placed on a child protection order means that a young person can be placed in a residential or foster care household (Noble-Carr & Trew 2018). For some young people, being placed on a child protection order does not always lead to a safe, stable, and secure housing situation. Reviews of outcomes and experiences for children in care have found that many (for example, nearly two-thirds of children in Victoria; CCYP 2020) experience placement instability (marked by multiple placements) during their time in care.
This instability can exacerbate the trauma that the children have experienced, and can lead to adverse outcomes for children transitioning from out-of-home care, including increased chances of experiencing homelessness, mental health issues, and interactions with the youth justice system (AIFS 2011; CCYP 2020).
Young people in out of home care legally exit the system at 18 years old, with the transition from care to independence challenging for many young people. For example, a study found that young people in care were concerned about losing caseworker and carer support and social networks when they left the care system as well as facing financial difficulties and homelessness (McDowall 2020). This survey of 325 respondents found that 17% transitioning from care were homeless immediately on leaving care and 35% were homeless in the first year after leaving care.
References
AIFS (2011) The link between child maltreatment and adolescent offending, Australian Institute of Family Studies, Melbourne.
AIFS (2012) Housing and children’s wellbeing and development, Evidence from a national longitudinal study, Family Matters 2012, Australian Institute of Family Studies. Issue No. 91. Melbourne.
AIFS (2021) The multiple meanings of permanency, Australian Institute of Family Studies, Melbourne.
AIHW (2021) Specialist homelessness services annual report 2020–21, AIHW, Canberra.
Bassuk M, Richard M, Tsertsvadze A (2014) The Prevalence of Mental Illness in Homeless Children: A Systematic Review and Meta-Analysis. Journal of American Academy of Child & Adolescent Psychiatry. Vol 54, Issue 2, P86-96. E2, Feb 1, 2015. https://doi.org/10.1016/j.jaac.2014.11.008
Bevitt A, Chigavazira A, Herault N, Johnson G, Moschion J, Scutella R, Tseng Y, Wooden M and Kalb G (2015) Journeys Home Research Report No. 6, The University of Melbourne.
CCYP (2020) Keep Caring: Systemic inquiry into services for young people transitioning from out-of-home care, Commission for Children and Young People, Melbourne.
CFFR (Council on Federal Financial Relations) (2018). National Housing and Homelessness Agreement. Viewed 3 August 2022.
Clair A (2019) Housing: an Under-Explored Influence on Children’s Well-Being and Becoming. Child Ind Res 12, 609–626. https://doi.org/10.1007/s12187-018-9550-7.
DSS (Department of Social Services) (2021) Safe and Supported: the National Framework for Protecting Australia’s Children 2021–2031. Canberra: DSS.
Flatau P, Conroy E, Eardley T, Spooner C & Forbes C (2012) Lifetime and intergenerational experiences of homelessness in Australia. Melbourne: Australian Housing and Urban Research Institute.
Flatau P, Thielking M, Mackenzie D, Steen A (2016) The Cost of Youth Homelessness. Swinburne Institute for Social Research, Salvation Army, Mission Australia & Anglicare Australia. https://doi.org/10.4225/50/5722A58AE5600
McDowall J (2020) Transitioning to Adulthood from Out-of-Home Care: Independence or Interdependence. CREATE Foundation.
Noble-Carr D and Trew S (2018) Nowhere to go: investigating homelessness experiences of 12–15 year olds in the Australian Capital Territory. Institute of Child Protection Studies, Australian Catholic University, Canberra.
Prentice, the Hon. J (2018) Community Services Ministers’ Meeting Communiqué: National Permanency Work Plan for children and young people [media release], Australian Government.
Seselja, the Hon. Z (2017) Community Services Ministers’ Meeting communique: Permanency reform for children and young people [media release], Australian Government.
The National Housing and Homelessness Agreement (NHHA) describes the roles and responsibilities of governments in delivering homelessness services across Australia. The agreement specifies that states and territories address priority policy areas and priority cohorts, including people experiencing repeat homelessness (CFFR 2018).
A larger share of the homeless population in most countries is homeless for only a short period before finding a more stable housing solution (OECD 2020). Events such as sudden unemployment or illness, or relationship breakdown may result in a short period of homelessness. However, there are a smaller, but more visible, share of the homeless population experiences longer or multiple episodes of homelessness. This report is focused on those people who experience repeat periods of homelessness.
There are a variety of terms used to describe multiple episodes of homelessness, such as, chronic homelessness, persistent homelessness or long-term homelessness. The exact definition on the length of homelessness and/or the number of episodes varies.
For the purpose of the NHHA performance indicators, clients of Specialist Homelessness Services (SHS) experiencing repeat homelessness are measured by two indicators:
Indicator Persistent homelessness: Describes the number of SHS clients who have been homeless for more than 7 months over a 24-months study period, that is, 30% of the study period. The homeless months do not need be consecutive. Clients must have at least one support period with a homeless housing status during the specific financial year, e.g. 2021–22. Data is based on the housing situation recorded on the last service provision date of each month during a client’s support period, therefore, may not reflect whether a client was continuously homeless over the entire period.
Indicator Return to homelessness: Describes the number of SHS clients who experienced an episode of homelessness during the financial year and a pattern of homeless–housed–homeless in the 24-months prior to the most recent record of homelessness. Data is based on the housing situation recorded on the last service provision date of each month during a client’s support period, therefore, may not reflect whether a client had continuous days experiencing homeless or more secure housing. (AIHW 2022a).
These cohorts are not mutually exclusive, that is, SHS clients can experience both persistent and a return to homelessness in a period. In 2021–22, approximately 44,200 SHS clients experienced repeat homelessness (AIHW, unpublished). Of these clients, 35,200 clients experienced persistent homelessness and 16,100 clients returned to homelessness (AIHW 2022a).
Approximately 30% of all individuals experiencing homelessness had chronic patterns of homelessness (HUD 2022). They are a highly disadvantage group and are likely to have complex needs, for example, more than one of the following:
- developmental disability
- traumatic brain injury
- serious physical health problems
- history of abuse and/or trauma
- mental illness
- mental disorder
- psychiatric disability
- addictions (to alcohol and/or drugs)
- literacy problems.
Chronically homeless people may cycle through services and temporary accommodation (such as boarding houses), or living permanently or semi-permanently on the streets (Zaretzky et al. 2013).
Pathways out of homeless
Programs targeted at supporting people with long histories of homelessness and more complex needs typically require more intensive and longer periods of support. These programs are typically of higher cost, greater likelihood of improved client outcomes but often positive changes occur in small increments over a long period (Zaretzky et al. 2013).
The national and international evidence has established that the longer someone is homeless, the more difficult it is to assist them to stabilise their life (AHURI 2018). Thus, early intervention strategies, targeting at individuals who have recently become homeless and that aim to ensure that short periods of homelessness do not become chronic, are crucial.
Evidence shows that Housing First is an effective approach leading to improvements in housing stability for young people and adults (Morton 2020, Wang 2019, Munthe-Kaas 2018). Housing First prioritises rapid rehousing into stable accommodation, as opposed to stepped models which involve moving people from crisis accommodation into transitional and then long-term housing. After housing has been secured, other supports are put in place to address health and well-being issues to help people sustain housing and avoid repeat homelessness.
Interventions by service providers for people experiencing repeat or ongoing homelessness requires the establishment of trust and wrap-around support services including health, and drug and alcohol services (Mackie et al. 2017).
References
AHURI (Australian Housing and Urban Research Institute) (2018). Housing, homelessness and mental health: towards systems change.
AIHW (Australian Institute of Health and Welfare) (2022a). National Housing and Homelessness Agreement Indicators.
AIHW (Australian Institute of Health and Welfare) (2022b). Specialist homelessness services annual report [dataset].
CFFR (Council on Federal Financial Relations) (2018). National Housing and Homelessness Agreement.
HUD (The U.S. Department of Housing and Urban Development) (2022). Part 1: Point-in-time estimates of homelessness, The 2022 Annual Homelessness Assessment Report to Congress.
Mackie P, Johnson S & Wood J 2017. Ending rough sleeping: what works? An international evidence review. London: Crisis.
Morton, MH. et al. (2020). ‘Interventions for youth homelessness: a systematic review of effectiveness studies’, Children and Youth Services Review, vol. 116.
Munthe-Kaas, H. Berg, RC. and Blaasvaer, N. (2018). ‘Effectiveness of interventions to reduce homelessness: a systematic review and meta-analysis’, Campbell Systematic Reviews, vol. 14, no. 1, pp. 1-281.
OECD (Organisation for Economic Co-operation and Development) (2020). Better data and policies to fight homelessness in the OECD, Policy Brief on Affordable Housing, OECD, Paris.
Wang, JZ. et al. (2019). The impact of interventions for youth experiencing homelessness on housing, mental health, substance use, and family cohesion: a systematic review. BMC Public Health, vol. 19.
Zaretzky, K. and Flatau, P. (2013). The cost of homelessness and the net benefit of homelessness programs: a national study, AHURI Final Report No. 218. Melbourne: Australian Housing and Urban Research Institute.
On the night of the 2021 Census, around 6% (7,600 people) of people experiencing homelessness were considered to be rough sleeping, that is, living in improvised dwellings such as tents, or in parks or on the streets (ABS 2023).
People rough sleeping are a highly visible subset of people experiencing homelessness who face considerable challenges, particularly fear of violence and theft, sometimes from others experiencing homelessness (Parsell 2012). People rough sleeping can have complex needs including chronic health and mental health issues, drug or alcohol problems, and exposure to violence (FACSIAR 2023).
People experiencing homelessness are often excluded from education, training, employment, and can develop severe health problems (Box et al 2022). It has been estimated that each person rough sleeping costs $25,000 or more to the community each year (Steen 2018, Joffe et al 2012). A large part of these costs come from emergency hospital attendance for acute health issues (Flatau et al 2022), which remain unresolved as long as the person remains homeless and experiences severe health inequality (Wood et al 2019).
Disengagement with health and housing service providers can be a characteristic of some people rough sleeping (Parsell, Clarke and Vorsina 2020). The more prolonged the period of homelessness, the more disengaged from services people rough sleeping can become.
Specialist homelessness services (SHS) provide a range of services to people who are facing housing insecurity or experiencing homelessness, including people rough sleeping. For the latest data on how many people SHS agencies support, see the SHS annual report.
Pathways out of rough sleeping
A housing first model, which does not depend on behavioural changes for eligibility, has been shown to be effective in addressing homelessness when compared with conditions-based solutions (Parsell 2017).
Permanent reductions in the number of people rough sleeping became a policy priority following the Australian Government’s white paper, “The Road Home: A National Approach to Reducing Homelessness” (FaCHSIA 2008). Key to this approach was the notion of assertive outreach which involved seeking out people rough sleeping and providing integrated housing and wrap-around services (Parsell and Jones 2012). Since then, some state and territory governments have implemented programs with housing first principles at the core.
The NSW Homelessness Strategy (2018–2023) identified expanding the housing first approach, as well as assertive outreach and service integration, as methods to reduce rough sleeping in NSW. Additionally, prevention and early intervention services, especially for people leaving custody or those with complex health needs, have also been identified as ways to meet the NSW Premier’s Priority Target to halve rough sleeping by 2025 (FACSIAR 2023).
A similar focus on Housing First and assertive outreach – that is, “an active and persistent approach … to find and engage with rough sleepers” underpins Victoria’s Homeless and Rough Sleeping Action Plan (DFHH 2021). The Queensland Government’s Housing and Homelessness Action Plan 2021-2025 provides an integrated framework for delivering housing and support – an important step towards ending homelessness in Queensland”. The Homes for Queenslanders plan, including extending the availability of support and emergency accommodation for families, couples and single persons, an investment in more temporary supported accommodation in the regions, and enhanced outreach services for people who are homeless. As part of the plan, a Critical Response Team will be expanded across the state which actively engages with people experiencing homelessness, or who are at risk of homelessness.
The Western Australian Government’s 10-year Strategy on Homelessness 2020–2030 (All Paths Lead to Home) has a housing first approach as its first and primary goal, accompanied by “immediate targeting” of people rough sleeping (WA Department of Communities 2021). South Australia’s Housing Authority Strategic Plan has a goal to eliminate rough sleeping, with reforms to homelessness service delivery that place housing first as an “overarching ambition” (SA Housing Authority 2020). The ACT Government’s Strategic Investment Plan for Homelessness Sector also incorporates housing first into a model that focusses on culturally-appropriate early intervention and greater integration with the health system. The Northern Territory Homelessness Strategy 2018–23 also focusses on integrated, early intervention as well as increased access to affordable social housing.
Feature analysis: rough sleeping among SHS clients
Data collected monthly from more than 1,700 SHS agencies across Australia can be used to explore the scale of rough sleeping among clients of SHS agencies.
Data are collected about the characteristics and circumstances of clients when they first present to an agency, in particular, whether a client is rough sleeping the week before or the day of commencement of support. Additional data on the assistance received by clients and their circumstances are collected at the end of the month in which the client receives services, and again when contact with the client has ceased receiving support.
Defining rough sleeping clients
Rough sleeping clients are defined as clients who, either the week before presenting, at the time of presenting to an SHS agency, or at the end of their support with an SHS agency in any month within the reference year, had no shelter or who were living in non-conventional accommodation, including:
- living on the streets
- sleeping in parks
- squatting
- staying in cars or railway carriages
- living in improvised dwellings
- living in the long grass.
Trends in SHS clients rough sleeping
The number and proportion of SHS clients rough sleeping increased over the five years to 2022–23; females increased more than males and over time an increasing proportion of clients rough sleeping were aged 55 and older. SHS clients rough sleeping in 2022–23 were less likely to receive short term accommodation than SHS clients rough sleeping in 2019–20.
Nearly 43,000 (or 16% of all SHS clients) SHS clients were sleeping rough at some point during their contact with SHS agencies in 2022–23 across Australia, an increase from 36,800 (13%) in 2017–18. The rate of SHS rough sleeping clients has changed from 15.0 clients per 10,000 population in 2017–18 to 16.4 clients in 2022–23. The rate of female rough sleeping clients has increased to 14.0 clients in 2022–23 from 11.9 clients.
The largest increase between 2017–18 and 2022–23 was in Queensland (increasing by 2,400 clients) and Victoria (2,000 clients) (Figure 1, Table RSO.1).
The number of female SHS clients rough sleeping increased over time from 14,700 clients in 2017–18 to 18,400 in 2022–23. Over the same time period, the proportion of rough sleeping clients who were female also increased (40% and 43% respectively).
Figure 1: SHS clients rough sleeping in any month, by sex and states/territories, 2017–18 to 2022–23
This interactive stacked bar chart shows annual counts (2017–18 to 2022–23) of rough sleeping clients, by sex and states/territories. A drop down filter allows selection for the individual state/territory and Australia. The number of female SHS clients rough sleeping increased over time from 14,700 clients in 2017–18 to 18,400 in 2022–23. Males also increased, from 22,100 clients in 2017–18 to 24,300 in 2022–23.
Source: Specialist Homelessness Services Collection 2011–23.
For both females and males, there was an increase in the proportion of clients aged 55 and over rough sleeping (Figure 2, Table RSO.2), from 8% (3,100 clients) of all rough sleeping clients in 2017–18 to 11% (4,900 clients) in 2022–23. Conversely, the proportion of youth (aged 15–24) rough sleeping decreased over the 6 year period from 18% of clients rough sleeping in 2017–18 to 15% in 2022–23.
Figure 2: SHS clients rough sleeping in any month, by sex and age group, 2017–18 to 2022–23
This interactive bar chart shows annual counts (2017–18 to 2022–23) of rough sleeping clients, by sex and age group. A radio button allows selection for client numbers or percentage of the rough sleeping total. A drop down filter allows selection of Females, Males or All clients. The majority (64%) of rough sleeping clients are adults aged 25 to 54 years. For both females and males, there was an increase in the proportion of clients aged 55 and over rough sleeping, from 8% (3,100 clients) of all rough sleeping clients in 2017–18 to 11% (4,900 clients) in 2022–23. Conversely, the proportion of youth (aged 15–24) rough sleeping decreased over the 6 year period from 18% of clients rough sleeping in 2017–18 to 15% in 2022–23.
Source: Specialist Homelessness Services Collection 2011–23.
Almost 60% (24,500 clients) of rough sleeping clients in 2022–23 presented to a SHS agency with no formal referral, that is, there was no contact from another person, group or organisation on behalf of the client (Table RSO.3). Around 1 in 3 rough sleeping clients (12,900 clients) were referred by another SHS agency or an outreach worker.
The proportion of SHS rough sleeping clients who received accommodation (short, medium, or long-term) decreased, from 46% (17,900 clients) of all rough sleeping clients in 2019–20 to 41% (17,400 clients) in 2022–23 (Table RSO.4). The provision of short-term accommodation was the main driver of this decrease, from 42% (16,300 clients) to 37% (15,700 clients) over the same time period.
Rough sleeping clients and selected vulnerabilities
SHS clients who were rough sleeping were more likely to have experienced a mental health issue than other SHS clients. The proportion of female rough sleeping clients with a mental health issue has increased.
Around 43% (17,000 clients) of rough sleeping SHS clients aged over 9 years experienced a mental health issue in 2022–23, compared with 37% of all SHS clients (aged over 9 years in 2022–23) (Figure 3, Table RSO.5, AIHW 2023). The proportion has been declining from a peak of 49% (17,900 clients) in 2019–20.
The age and sex composition of rough sleeping clients with a mental health issue has changed over time; in 2017–18, 40% were female, increasing to 45% in 2022–23 (Table RSO.6). The proportion of male clients aged 45 years and over also increased, from 31% to 36% over the same time period. Conversely, the proportion of males aged 25 to 44 years declined, from 52% in 2017–18 to 49% in 2022–23.
The proportion of all rough sleeping clients (clients aged over 9 years) where the formal referral source was 'Mental health service' has remained stable since 2017–18 at around 2% (Table RSO.7).
Figure 3: SHS rough sleeping clients (aged over 9 years) who experienced a mental health issue in any month, by sex and states/territories, 2017–18 to 2022–23
This interactive stacked bar chart shows annual counts (2017–18 to 2022–23) of rough sleeping clients (aged over 9 years) who experienced a mental health issue in any month within the year, by sex and states/territories. A drop down filter allows selection for the individual state/territory and Australia. Nationally, around 17,000 clients rough sleeping SHS clients aged over 9 years experienced a mental health issue in 2022–23. In 2021–22 this number was lower at 15,800, similar to 2017–18 (15,600 clients).
Notes: A client is identified as having a mental health issue if they are aged 10 years or older and have provided any of the following information in any month during the reporting period:
- They have reported 'Mental health issues' as a reason for seeking assistance, or main reason for seeking assistance
- At some stage during their support period, a need was identified for psychological services, psychiatric services, or mental health services (as determined by a need for such services being recorded for the client, a relevant service being provided to the client and/or the client being referred for such a service)
- Their formal referral source to the specialist homelessness agency was a mental health service
- They are currently receiving services or assistance for their mental health issues or have in the last 12 months
- They have been in a psychiatric hospital or unit in the last 12 months
- Their dwelling type either a week before presenting to an agency, or when presenting to an agency, was a psychiatric hospital or unit.
Source: Specialist Homelessness Services Collection 2011–23.
In 2022–23, 1 in 5 (8,800 clients) rough sleeping clients presented to a SHS agency with children, this proportion has remained similar since 2017–18 (Figure.4, Table RSO.8). Over the same period, the proportion of clients with drug and/or alcohol problems declined, from 20% in 2017–18 to 15% in 2022–23. The proportion of clients transitioning from custody to homelessness services and rough sleeping was consistently around 4%. The proportion of rough sleeping clients who had experienced family and domestic violence also remained consistent at around 23%.
Figure 4: SHS rough sleeping clients, by client groups, 2017–18 to 2022–23
This interactive bar chart shows annual counts of rough sleeping clients between 2017–18 and 2022–23 by select client groups. A radio button allows selection for client numbers or percentage of the rough sleeping total. The proportion of rough sleeping clients who had exited custodial arrangements remained stable between 4 to 5% over the period. Clients with a current mental health issue dropped slightly from 42% in 2017–18 to 40% in 2022–23. Clients with problematic drug or alcohol issues also declined, from 20% in 2017–18 to 15% in 2022–23.
Note: See table RSO.8 for the definitions for each of the client groups.
Source: Specialist Homelessness Services Collection 2011–23.
References
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