Permanent Housing is Number One Priority

Moving into permanent housing is the number one priority for people experiencing homelessness, according to a new report which also revealed veterans and Indigenous Australians were at significant risk of sleeping rough in Australia’s cities.

The State of Homelessness in Australia’s Cities Report was released on Thursday by the Centre for Social Impact at The University of Western Australia (CSI UWA) in partnership with the Australian Alliance to End Homelessness (AAEH).

It looked at Registry Week data from across Australia and is the first study of its kind, drawing on the lived experience of 8,370 individuals experiencing homeless in Australia’s major cities over a seven year period.

Study lead and director of CSI UWA, Professor Paul Flatau, told Pro Bono News it was an amazing collection of data that pointed to a number of things.

“The sheer size of the numbers means that a lot of the things that we’ve picked up from research studies in the past, particularly around health issues, are confirmed over a very large data set. So it’s always good to have that confirmation about the prevalence of very serious medical conditions, issues around mental health etc, and use of acute health care services,” Flatau said.

“But I think there are other things here that are really important too that go beyond that. They are about justice and the high prevalence of lifetime interaction with the justice system and that brings up the question of the revolving door between incarceration and homelessness, not experienced by all [but that is still a question].

“There’s also the question of straight out legal issues that impact on people’s lives.”

The report showed that the majority of homeless people in Australia’s cities had low educational attainment, elevated rates of serious medical conditions and high levels of interaction with the justice system.

The data also revealed that high numbers of veterans were rough sleeping, with many suffering from serious brain injury or head trauma.

Of 457 individuals in the Registry Week data that reported they had served in the Australian Defence Force, 43 per cent reported a serious brain injury or head trauma in their lives.

“We have close to 50 per cent of veterans reporting serious brain injury and a number talking about permanent physical disability but they were rough sleeping and alone on the street. That’s a huge issue,” Flatau said.

He said Census data needed to change to provide a clearer picture.

“Unlike in the USA, where the issue of veterans’ homelessness receives widespread attention, there has been limited research into the issue in Australia,” he said.

“Neither Census nor administrative data sources have included veterans’ status. However, more than 5 per cent of homeless people interviewed indicated they were Australian veterans.”

The research also showed a much larger proportion of veterans identified as Indigenous (16 per cent), when compared to the proportion of Indigenous Australians in the Australian Defence Force (1.6 per cent).

“Once again, Indigenous Australians were significantly overrepresented overall, with nearly 20 per cent of homeless respondents’ identifying as Indigenous, despite Indigenous people making up only 2.8 per cent of the population. It’s completely unacceptable,” Flatau said.

“In addition, we saw a higher proportion of this group sleeping rough, experiencing imprisonment and youth detention than their non-Indigenous counterparts.”

Of all the cohorts of homeless people, those sleeping rough fared significantly worse.

This group also reported the longest cumulative time spent homeless with an average of six years, and reported high rates of acute healthcare system use.

Flatau said it pointed to a number of serious determinants of homelessness.

“There is still a very basic financial determinant that you don’t have enough money to be able to rent a home and that’s still a really critical factor, we have to remember that,” he said.

“Going back to the causal factors, one can look at issues around a quarter having been in detention and incarceration, many having an experience of out-of-home care as a child, these kind of factors impact. Serious medical conditions impact. So many of them are alone and are talking about things like forming relationships, there is a causal link there as well.

“If we’re going to address homelessness we have to look at the preventative factors and that includes violence in the family home. A lot of women talk about the priority being getting into housing not just because they want housing but they want security and safety.”

The data revealed those experiencing homelessness considered moving into permanent housing as the number one priority, followed by addressing health and substance use issues, safety and legal issues, forming close relationships and moving into work.

Flatau said the data supported the case for a housing first approach.

“There’s no question about that. The interesting part about it is that the people who were interviewed actually talk in a housing first way, in other words ‘I need to get into housing so that I can address my health needs’ or ‘I need to get into housing and then I’ll be able to get a job’, ‘I’ll get into housing and then I’ll be able to sort out my legal issues’ etc,” he said.

“But the other side to this is that sometimes the way that housing first operates, because of the fact that we do often have issues of mental health, often it becomes housing first and then health, which of course is critical. But what I would argue is it is housing plus.”

He said the approach needed to consider more than health support.

“In my reading of what they are saying, it’s housing plus health and that’s supported by what they’re saying but it is also housing plus legal. And we’re not necessarily doing enough on the legal side. It’s housing plus social connection, and social connections means being part of a community, forming friendships and forming relationships. How are we going to do that?,” Flatau said.

“Sometimes in a housing first approach you get the person into the house but they’re stuck in the middle of nowhere and they become even more lonely. So we have to address that.

“The other thing that we have to really work on in the service delivery is linkage to employment. So many of the respondents refer directly to the desire to get a job. And that’s critical in their thinking.”

Flatau said the costs to Australia’s healthcare system could not be ignored.

“For rough sleepers, when we looked at A&E, ambulance, and inpatient admissions, we estimated that the health care costs alone come in at nearly $25,000 per person every six months for rough sleepers who access these services,” he said.

“Yet we know that with a housing first approach, integrated with ongoing social and health support and jobs, could result in significant healthcare costs savings over the longer term.”

Karyn Walsh AM, CEO of Micah Projects and chair of the AAEH, said capturing the State of Homelessness was important for giving a more comprehensive picture of the people “living the toughest lives in our society”, and providing the evidence base for campaigns to end homelessness.

“Australia is a prosperous country and we should maintain a vision for no one to live on our streets,” Walsh said.