Australian Institute of Health and Welfare (2020) Specialist homelessness services annual report., AIHW, Australian Government, accessed 30 November 2021
Australian Institute of Health and Welfare. (2020). Specialist homelessness services annual report. Retrieved from https://www.aihw.gov.au/reports/homelessness-services/specialist-homelessness-services-annual-report
Specialist homelessness services annual report. Australian Institute of Health and Welfare, 11 December 2020, https://www.aihw.gov.au/reports/homelessness-services/specialist-homelessness-services-annual-report
Australian Institute of Health and Welfare. Specialist homelessness services annual report [Internet]. Canberra: Australian Institute of Health and Welfare, 2020 [cited 2021 Nov. 30]. Available from: https://www.aihw.gov.au/reports/homelessness-services/specialist-homelessness-services-annual-report
Australian Institute of Health and Welfare (AIHW) 2020, Specialist homelessness services annual report, viewed 30 November 2021, https://www.aihw.gov.au/reports/homelessness-services/specialist-homelessness-services-annual-report
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Mental health is fundamental to the wellbeing of individuals, their families and the population as a whole (ABS 2018). According to the most recent national Survey of Mental Health and Wellbeing, in 2007, 1 in 5 (20%) Australians (aged 16–85) had a current mental health issue, while 45% of Australians reported having had a mental disorder at some point in their life (ABS 2008). More recent research has indicated that around 1 in 8 (13%) Australians experienced high or very high levels of psychological distress (ABS 2018). The intertwined nature of mental health issues and homelessness is well established (Kalevald et al. 2018). People with mental health issues are a group who are particularly vulnerable to homelessness. Research has shown that experiences of homelessness can trigger, exacerbate and magnify mental health issues (see for example, Kalevald et al. 2018, Brackertz et al 2018, CHP 2018 and Johnson & Chamberlain 2011). People living with a mental illness can be isolated, have disrupted family and social networks and sometimes suffer poor physical health, all of which impact their capacity to find and maintain adequate housing. Further, symptoms such as hallucinations, compulsive behaviours and anxiety can make it difficult to seek and maintain employment, which has financial impacts (Robinson 2003).
People experiencing homelessness with mental health issues need the support of various services including services dedicated to finding housing solutions, but navigating through these services can be particularly challenging. Several studies suggest that when people with mental health issues are supported by homelessness agencies, they are more likely to remain housed rather than become homeless (MHCA 2009, Du et al. 2013, Wood et al. 2016, ABS 2014).
Reporting clients with a mental health issue in the Specialist Homelessness Services Collection (SHSC)
Specialist Homelessness Services (SHS) clients are identified as having a current mental health issue if they are aged 10 years or older and have provided any of the following information:
The coronavirus (COVID-19) pandemic is posing significant health, lifestyle and economic challenges for Australians and evidence shows there is likely to be a significant negative mental health impact as a result (NMHC 2020). Common consequences of disease outbreaks include anxiety and panic, depression, anger, confusion and uncertainty, and financial stress (Black Dog Institute 2020).
COVID-19 has led to an increase in many of the risk factors for poor mental health including uncertainty, the risk of ill health, job loss and social isolation (Edwards et al. 2020). People with pre-existing anxiety or other mental health disorders are particularly vulnerable and at risk of experiencing higher anxiety levels during the COVID-19 outbreak, they may require more support or access to mental health treatment during this period (Black Dog Institute 2020). This report presents data for the financial year up to 30 June 2020, which overlaps with the beginning few months of the Australian spread of COVID-19. Therefore, any changes to the proportion of clients receiving SHS support with mental health issues may not be evident in the following data.
Of the 290,500 SHS clients accessing services in 2019–20, 88,300 (30%) clients reported a current mental health issue. The number and proportion of clients with a current mental health issue has been increasing since the beginning of the SHSC in 2011–12. Various factors, including increased identification, community awareness and reduced stigma, may have had an impact on the increase in self-identification and reporting of mental illness among SHS clients. In 2019–20 (Table MH.1):
Number of clients
Proportion of all clients
Rate (per 10,000 population)
Source: Specialist Homelessness Services Collection 2015–16 to 2019–20.
In 2019–20, of those clients presenting with a current mental health issue (Supplementary table MH.1):
In 2019–20, around 85,400 SHS clients with a current mental health issue reported their Aboriginal and Torres Strait Islander status (Supplementary table MH.8). Key findings for this group include:
There were differences across the states and territories in the rates of SHS clients with a current mental health issue. In 2019–20:
In 2019–20 at the beginning of support, clients with a current mental health issue (aged over 10) were more likely be living alone (39,800 clients or 46%) or as a lone parent with child(ren) (19,700 clients or 23%) rather than in a group (6,900 clients or 8%) or as a couple without child(ren) (4,600 or 5%) (Supplementary table MH.10).
SHS clients with a current mental health issue were also more likely to present to a SHS agency alone (80% or 70,500 clients) compared with all SHS clients (61% or 178,500) (Supplementary table MH.9 and CLIENTS.9).
In 2019–20, of the 88,300 SHS clients who had a current mental health issue, over half (55% or 48,200 clients) were experiencing additional selected vulnerabilities (Table MH.2):
These figures provide an insight into the multiple disadvantages clients experiencing mental health issues face and highlight the value of an integrated service response to homelessness for these clients (Flatau et al. 2013).
Family and domestic violence
Mental health issue
Problematic drug and
or alcohol use
Clients are assigned to one category only based on their vulnerability profile.
Clients are aged 10 and over.
Totals may not sum due to rounding.
Source: Specialist Homelessness Services Collection 2019–20.
At the beginning of their first support period in 2019–20, 1 in 2 (50%) SHS clients who had a current mental health issue were experiencing homelessness when they first presented to a SHS agency while 50% were at risk of homelessness (Supplementary table CLIENTS.12).
Service use patterns for clients with a current mental health issue have changed between 2015–16 and 2019–20 (Table MH.3).
Length of support (median number of days)
Average number of support periods per client
Proportion receiving accommodation
Median number of nights accommodated
In 2019–20, of those SHS clients with a current mental health issue (Supplementary table MH.7):
In 2019–20, the most common main reasons for seeking SHS assistance for clients with a current mental health issue were (Supplementary tables MH.5 and MH.6):
There were differences in the main reasons for those clients with a current mental health issue presenting at risk of, or experiencing homelessness:
Figure MH.1 illustrates the top 6 most-needed services (excluding advice/information, other basic assistance or advocacy/liaison) for clients with a current mental health issue in 2019–20. Four of these were related to accommodation:
Over 1 in 4 (28% or 25,000) clients with a current mental health issue identified a need for mental health-based services (Supplementary tables MH.3). Specifically:
Source: Specialist Homelessness Services Collection 2019–20, Supplementary table MH.3.
The proportion of SHS clients with a current mental health issue with a case management plan has remained comparatively high over time (72% in 2019–20, up from 70% in 2015–16); however those achieving all case management goals has remained low (16% in 2019–20, down from 19% in 2018–19) (Supplementary table CLIENTS.35).
Outcomes presented here describe the change in client’s housing situation between the start and end of support. Data is limited to clients who ceased receiving support during the financial year—meaning that their support periods had closed and they did not have ongoing support at the end of the year.
Many clients had long periods of support or even multiple support periods during 2019–20. They may have had a number of changes in their housing situation over the course of their support. These changes within the year are not reflected in the data presented here, rather the client situation at the start of their first support period in 2019–20 is compared with the end of their last support period in 2019–20. A proportion of these clients may have sought assistance prior to 2019–20, and may again in the future.
In 2019–20, for clients with a current mental health issue (Table MH.4):
These trends demonstrate that by the end of SHS support, fewer clients with a current mental health issue were known to be experiencing homelessness, and most (63%) were living in stable accommodation, be it public or community, private or other housing or an institutional setting.
Beginning of support
Beginning of support
No shelter or improvised/inadequate dwelling
Short term temporary accommodation
House, townhouse or flat - couch surfer or with no tenure
Public or community housing - renter or rent free
Private or other housing - renter, rent free or owner
Total at risk
Total clients with known housing situation
Source: Specialist Homelessness Services Collection. Supplementary table MH.4.
In 2019–20, 51,800 clients had a known housing status at both the start and end of support. Of these clients, almost 27,000 were at risk of homelessness at the start of support, by the end of support (Figure MH.2):
A smaller number were experiencing homelessness at the end of support (around 3,900 clients or 15% of those who started support at risk).
Source: Specialist Homelessness Services Collection, 2019–20.
In 2019–20, there were 24,800 SHS clients with a mental health issue who were known to be homeless at the start of support. By the end of support (Figure MH.3):
A further 5,200 clients (21%) were couch surfing at the end of support.
ABS (Australian Bureau of Statistics) 2008. National Survey of Mental Health and Wellbeing: Summary of Results, 2007. ABS cat. no. 4326.0 Canberra: ABS.
ABS 2014. Mental Health and Experiences of Homelessness, Australia, 2014. ABS cat. no. 4329.0.00.005. Canberra: ABS.
ABS 2018. National Health Survey: First Results 2017–18. ABS cat. no. 4364.0.55.001. Canberra: ABS
Biddle N, Edwards B, Gray M & Sollis K 2020. Hardship, distress, and resilience: The initial impacts of COVID-19 in Australia, COVID-19 Briefing Paper. ANU Centre for Social Research and Methods, Australian National University, Canberra.
Brackertz N, Wilkinson A & Davison J 2018. Housing, homelessness and mental health: towards systems change. AHURI Research Paper, Australian Housing and Urban Research Institute Limited, Melbourne.
Black Dog Institute 2020. Mental Health Ramifications of COVID-19: The Australian context. Viewed 3/08/2020.
CHP (Council to Homeless Persons) 2018. Housing Security, Disability and Mental Health.
Duff C, Jacobs K, Loo S & Murray S 2013. The role of informal community resources in supporting stable housing for young people recovering from mental illness: key issues for housing policy-makers and practitioners. AHURI Final Report No. 199. Australian Housing and Urban Research Institute Limited, Melbourne.
Flatau P, Conroy E, Thielking M, Clear A, Hall S, Bauskis A, Farrugia M & Burns L 2013. How integrated are homelessness, mental health and drug and alcohol services in Australia?. AHURI Final Report No.206. Australian Housing and Urban Research Institute Limited, Melbourne.
Johnson G & Chamberlain C 2011. Are the Homeless Mentally Ill? Australian Journal of Social Issues, vol. 46, no. 1: 29–48.
Kaleveld L, Seivwright A, Box E, Callis Z & Flatau P 2018. Homelessness in Western Australia: A review of the research and statistical evidence. Perth: Government of Western Australia, Department of Communities.
MHCA (Mental Health Council of Australia) 2009. Home Truths: Mental Health, Housing and Homelessness in Australia.
NMHC (National Mental Health Commission) 2020. National Mental Health and Wellbeing Pandemic Response Plan. Sydney: NMHC. Viewed 3/08/2020.
Robinson C 2003. Understanding interactive homelessness: the case of people with mental disorders. AHURI report. Australian Housing and Urban Research Institute Limited, Melbourne.
Wood L, Flatau P, Zaretzky K, Foster S, Vallesi S & Miscenko, D 2016. What are the health, social and economic benefits of providing public housing and support to formerly homeless people? AHURI Final Report No. 265. Melbourne: Australian Housing and Urban Research Institute Limited.
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