10 years ago, as a brand new government, we wanted to take a fresh look at how we could better tackle our most difficult social problems such as a mental health crisis; low retention rates in too many schools and gang related youth crime. We were concerned traditional ways of dealing with these problems weren't working as well as they should. We were frustrated that government agencies tended to operate in silos and too often dealt with complex, inter-related social issues separately; treating the symptoms not the causes. Our first priority was to tackle homelessness. Homelessness is not just a problem about a lack of affordable housing. It is much more about alcoholism, drug dependency; mental illness; unemployment, a lack of skills and self esteem and sometimes criminal behaviour. So, Monsignor David Cappo (www.david-cappo.com), a renowned social justice advocate, was appointed to head our pioneering Social Inclusion Initiative.
I asked him to look around the world for ‘ideas that work' and some of his best came from the United States.
We wanted him to confront the hardest end of homelessness, those ‘sleeping rough' in city parks, under bridges or dependent upon shelters for support. We found that government agencies and charities, while working hard to support homeless people, were too often operating in isolation. I am not diminishing their valuable work in providing food, shelter and care. But we wanted to take the next step by helping homeless people find a home and also move into a productive and fulfilling life.
Cappo proposed a series of programs including our Street to Home initiative, based on the successful New York model. It actively seeks out homeless people and connects them with the range of services they need to achieve a sustainable housing outcome. While finding a home is the main goal, addressing issues such as physical and mental health, substance abuse and other barriers to housing are equally important.
Street to Home workers engage with homeless people wherever they are – such as in a park or on the streets. Once contact is made, the person is assessed across different areas of their life. A Street to Home ‘key worker' will then work with them on a one-to-one basis for the duration of their support. They will work assertively with the person and not let go of them until sustainable housing is achieved. A comprehensive plan based on the person's goals is developed – in their own words. Street to Home makes finding housing the foremost priority so that services and supports can be delivered to the person in the one place.
Street to Home advocates on behalf of the client and coordinates with other services and resources. This way, everyone is on the same page and the person doesn't have to keep repeating their story to different agencies. Priority is also given to developing the person's capacities, such as financial management and domestic skills, to help ensure their housing is given the greatest chance of being long-term. Once housed, Street to Home maintains regular contact to assist with matters as they arise.
Now adopted around Australia, Street to Home is playing a significant role in Social Inclusion's efforts to reduce homelessness by 50% in the Adelaide CBD.
New York was also the inspiration for Common Ground with inner city apartments especially designed for homeless people who now live in a small ‘community' with other low income people including artists. They are supported by a range of specialist services on site to assist them to re-integrate into society. Common Ground was an initiative that followed the work in New York, of social entrepreneur Rosanne Haggerty. Like Street to Home, Common Ground has proven so successful that it has ‘gone national' attracting support from business and governments. The concept is to bring together a mix of people on low incomes into high quality residential complexes comprising well furnished, self contained apartments, communal areas plus office space for a range of support services and workshops. Common Ground's embrace of life skills to foster greater independence; the arts to build confidence; further education and training as a pathway to employment, has contributed to its success.
Last year I met a young woman, a long term resident of Common Ground, whose life from the age of 13 had been damaged by alcohol, drugs, couch surfing, homelessness, years of domestic violence and serious drug addiction. She nearly died of an accidental overdose in 2003. She is now clean of drugs, has completed a behavioural science degree and a second degree in biochemistry with a 1st class place, winning the Dean's commendation and the University Medal for academic excellence. She now has a scholarship and is completing a PhD with plans to do a medical degree as well. She wants to help others.
"I'm just one success story at Common Ground – there are many others. We have gifted musicians, artists and writers; People studying and working in all types of areas; People rebuilding their families. People with chronic health problems who are now getting the help they need. Some came to Common Ground very broken and mentally unwell. They found a safe, stable place to rebuild themselves, to heal.
Common Ground is more than just a roof over our heads – it's about believing that each person has something unique to offer if they are given the chance to stop just surviving and start growing. It's a place where people are not judged by their past, but supported into their future. Common Ground allows people to realise their potential, then pass their story, their success…onto others – like I am here today."
Hospitals are also playing a role in tackling homelessness.
For years homeless people, when they became ill, were taken to emergency departments. They were treated and discharged, usually back into homelessness. They would then get sick or injured again, treated and then discharged once more back on to the streets. This approach perpetuated the problem at high cost to the individual and taxpayers alike. So in 2004, we set up the Community Liaison Team (CLT) aimed at ‘joining up' health services with housing, mental health, drug and alcohol services. This approach is now embedded in the operations of the emergency departments of two of Adelaide's biggest public hospitals.
The CLT's first task is to identify homeless people -or those at risk of homelessness-who are admitted to hospital. If the person is assessed as needing accommodation upon their discharge, CLT staff will work closely with them to develop a case plan. This involves finding accommodation but also addresses physical and mental issues, substance misuse, family support and the person's financial and legal situation.
In devising and executing the plan the CLT joins up with other services and advocates on behalf of the client to achieve a smoother transition into accommodation. The CLT also provides outreach services. This may include attending appointments with the client, assisting their search for accommodation and following up with the client once they are in their new home. The team helps develop coping skills, including budgeting, meal planning and preparation, and relocation from temporary accommodation such as a 'transition bed' in a boarding house, to their new home. CLT engagement with a client is usually short term (a maximum of three months) during which a lead agency responsible for ongoing case management is then identified.
Between 2004 and June 2010, 1,132 people entering emergency departments were assisted into accommodation. A further 724 people at risk were assisted to prevent them falling into homelessness. Many of the people helped would have otherwise been discharged back into rough sleeping where their health and well being would have further deteriorated. This means that not only has the CLT helped to significantly reduce homelessness but it has also reduced the amount of repeat emergency department admissions by individuals who use the service.
This Blog was published on the Center for National Policy website.
Mike Rann is Fellow for Democracy and Development with the Center for National Policy, Washington, D.C.