Specialist homelessness services annual report 2021–22

Key findings: Clients exiting care, 2021–22

People leaving care arrangements, including people transitioning from health care settings (hospitals, psychiatric hospitals, rehabilitation and aged care facilities) and young people transitioning from out-of-home care (foster care and residential care facilities), can find themselves particularly vulnerable to homelessness. This can be due to inadequate transition planning, undertaking discharge assessments in time or resource-pressured environments and limited options for exit into suitable and secure housing (Brackertz et al. 2018). One study of care leavers in Victoria found that more than half of the participants accessed specialised homelessness services in the 4 years following their transition from care (Martin et al. 2021).

In 2020–21, around 3,900 young people aged 15–17 were discharged from out-of-home care in Australia (AIHW 2022), corresponding with the end of formal support in the child protection system. Around 1 in 3 (30%) young people leaving out-of-home care experience homelessness at some stage within their first year after leaving care (37% of these for 6 months or more) (McDowall 2020).

Young people transitioning from out-of-home care face barriers to accessing the same opportunities as their non-care peers who increasingly rely on parental resources in young adulthood (Wilkins et al. 2019). During this accelerated transition to independence, young people leaving care need adequate support to access safe and stable housing, education, employment, financial security, supportive relationships and networks, and life skills (FaHCSIA 2011).

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

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

In 2021–22 (Supplementary table LCARE.1 and Historical data table HIST.LCARE):

• SHS agencies assisted around 6,000 clients leaving care, equating to 2.2% of all SHS clients in 2021–22.
• There were around 315 fewer SHS clients leaving care compared with 2020–21; the number of SHS clients leaving care has steadily decreased since the peak of around 7,100 clients in 2016–17.
• The rate of SHS clients leaving care was 2.3 per 10,000 population, a decrease from 2.9 in 2016–17

Client characteristics

Figure LCARE.1: Key Demographics, SHS Clients leaving care, 2021–22

Dwelling type at beginning of support

In 2021–22, of the 6,000 SHS clients who were leaving care and stated their dwelling type at the beginning of support (Supplementary table LCARE.7):

• Around 1,700 clients (28%) were living in independent housing (house/townhouse/flat).
• More than 1,000 (18%) were staying in a psychiatric hospital or unit.
• Almost 1,000 (17%) were staying in a hospital (excluding psychiatric).

New or returning clients

In 2021–22, of the 6,000 SHS clients leaving care (Supplementary table CLIENTS.40):

• Around 33% (2,000 clients) were new to SHS services and 68% (more than 4,000 clients) were returning clients, having previously been assisted by a SHS agency at some point since the SHSC began in July 2011.
• More than half (54% or nearly 650 clients) of the clients under 18 were returning clients while nearly 69% (around 820 clients) of clients who were aged 18–24 were returning clients. These age groups include young people who may have left foster care or other out-of-home care arrangements.
• The proportion of clients who had previously been assisted by SHS agencies was similar for males and females (67% of males, compared with 68% of females).

Selected vulnerabilities

Clients leaving care may face challenges that make them more vulnerable to experiencing homelessness, more specifically, family and domestic violence, a current mental health issue and problematic drug and/or alcohol use.

Figure LCARE.2: Clients leaving care, by selected vulnerability characteristics, 2021–22

Service use patterns

The median length of support clients leaving care received in 2021–22 was 75 days, an increase from 63 days in 2017–18. The average number of support periods was 2.0 per client. The proportion of clients receiving accommodation was 46% for a median of 54 nights of accommodation (Supplementary table CLIENTS.46).

Main reasons for seeking assistance

In 2021–22, the main reasons for seeking assistance among clients leaving care were (Supplementary table LCARE.5):

• housing crisis (16% or about 950 clients)
• transition from other care arrangements (13% or nearly 780 clients)
• inadequate or inappropriate dwelling conditions (10% or around 600 clients).

Clients leaving care who were at risk of homelessness at first presentation were more likely to identify mental health issues (9.9% of those at risk, compared with 4.6% experiencing homelessness) and family and domestic violence (9.0%, compared with 5.9% experiencing homelessness) as the main reason for seeking assistance (Supplementary table LCARE.6).

Clients leaving care who were experiencing homelessness at first presentation were more likely to report transition from other care arrangements (20%, compared with 9.8% at risk) or transition from foster care and child safety residential placements (12%, compared with 5.0% at risk) as the main reason for seeking assistance.

Services needed and provided

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

Clients leaving care were more likely than all SHS clients to need services including (Supplementary tables LCARE.2, CLIENTS.24):

• living skills/personal development (31%, compared with 17%), with 93% receiving this service
• transport (24%, compared with 15%), with 90% receiving this service
• assistance with challenging social/behavioural problems (21%, compared with 11%), with 87% receiving this service
• mental health services (approximately 18%, compared with 8.5%), with 59% receiving this service and a further 16% referred
• health/medical services (18%, compared with 9.0%), with 66% receiving this service and a further 19% referred.

Figure LCARE.3: Clients leaving care, by services needed and provided, 2021–22

Housing situation and outcomes

Outcomes presented here highlight the changes in clients’ housing situation at the start and end of support. That is, the place they were residing before and after they were supported by a SHS agency. The information presented is limited only to clients who have stopped receiving support during the financial year, and who were no longer receiving ongoing support from a SHS agency. In particular, information on client housing situations at the start of their first period of support during 2021–22 is compared with the end of their last period of support in 2021–22. As such, this information does not cover any changes to their housing situation during their support period.

By the end of support, some clients had achieved or progressed towards a more positive housing solution, however, for some clients transitioning from institutional setting can be challenging. The most common housing situation for clients leaving care at both the beginning and end of SHS support was institutional settings; more than 2,400 clients (62%) at the beginning and around 850 clients (24%) at the end of support. Institutional settings include hospitals, psychiatric hospital/units, rehabilitation and aged care facilities and may be a reflection of support provided while clients were in these settings, or may reflect clients returned to these settings (Supplementary table LCARE.3).

Outside of institutional settings, the number and/or proportion of clients housed in public or community housing (renter or rent-free) or private or other housing (renter or rent-free) increased compared with the start of support. For clients leaving care arrangements in 2021–22, around 980 clients (25%) were experiencing homelessness at the start of support; around 580 (15%) were in short-term temporary accommodation (Supplementary table LCARE.3).

By the end of support, of clients with a known housing situation at the start and end of support (Supplementary table LCARE.4):

• More than one-third (36%) of clients were housed in either public, community, private or other housing.
• One-quarter (25%) of clients either remained in or transitioned into short-term temporary accommodation.

Figure LCARE.4: Housing situation for clients leaving care with closed support, 2021–22