‘Rough sleepers’ most vulnerable people on Australian streets: Report

He is most probably a man, aged between 15 and 34, who has a drug, alcohol or mental health issue.
 
He is one of Australia’s ‘rough sleepers’.
 
According to the Australian Bureau of Statistics, on census night in 2016 around 8200 Australians were ‘sleeping rough’ – living on the streets, sleeping in parks, squatting, staying in cars or living in improvised dwellings.
 
Now a new Australian Institute of Health and Welfare report has used four years of specialist homeless services [SHS] data to map what a typical rough sleeper looks like, the challenges they face and the services they use.
 
SHS agencies provide emergency accommodation, meals, employment services, and services or referrals for health and legal needs.
 
Sleeping rough: A profile of specialist homelessness services clients shows that compared to other clients of SHS, rough sleepers are generally older males, often with drug, alcohol or mental health issues.
 
AIHW spokesperson Matthew James said while only 36% of all SHS clients are male, the numbers are much higher for rough sleepers, at 66%.
 
‘Male rough sleepers tend to be older than females,’ Mr James said. ‘Around 55% of female rough sleepers were aged 15–34 compared with 41% of males.’
 
According to the latest census, rough sleepers account for only around one in 14 homeless people in Australia, with the remainder having other accommodation, such as at shelters or refuges, couch surfing or emergency accommodation. While rough sleepers make up a relatively small proportion of Australia’s homeless population, the number of people in Australia who are sleeping rough has grown by 20% since 2011.
 
The AIHW report shows that 47% of rough sleepers reported having mental health issues, compared with 34% of other SHS clients. Similarly, while 17% of other SHS clients reported a drug and/or alcohol issue, these issues were twice as likely in rough sleepers.
 
These factors are among three vulnerabilities identified in the report – mental health issues, problematic drug and/or alcohol use, or domestic or family violence – and are associated with different patterns of SHS use among rough sleepers, which greatly increase the level of services accessed through SHS agencies.
 
‘Persistent services users – that is, rough sleepers who accessed services every financial year over the four years from 2011–12 to 2014–15 – had the most complex needs but accounted for only 13% of all rough sleepers,’ Mr James said.
 
‘Eight in 10 persistent rough sleepers reported a mental health issue, while two-thirds reported at least two of the three vulnerabilities – that is, out of the three factors of mental health issues, problematic drug and/or alcohol use, or domestic or family violence, they experienced at least two.’
 
The report also showed that many rough sleepers experience multiple periods of homelessness, highlighting the journey that people often face exiting homelessness. At the end of the four-year study period, SHS agencies had assisted more than one-quarter of rough sleepers into housing; others were in ongoing SHS support, and the housing situation was unknown for about a quarter of rough sleepers.
 
Dr Edmund Poliness, a GP at the Living Room, a Melbourne-based primary health service for homeless people, says homelessness is not due to a single issue, but rather the ‘Swiss cheese’ model of crisis with multiple things going wrong at the same time.
 
He previously told the RACGP that GPs who wish to provide assistance to homeless patients need to ensure their practices are accessible to this population, and are able to take a flexible approach to the complexity of their needs.
 
‘They need good healthcare that’s not only preventive but considers them in a bio-psycho-social-spiritual way, that individualises to their needs,’ he said.

Australian Institute of Health and Welfare rough sleepers Specialist Homeless Services