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What we can learn from large-scale disasters about responding effectively to homelessness

The previous Croakey post looked at how the response to homelessness varies between Sydney, Brisbane and Darwin and according to whether it is framed as a health or a law and order issue.

The article below, by Heather Holst from HomeGround Services, looks at what can be learnt from the unprecedented public and government response to the survivors and the communities affected by the 2009 Victorian Bushfires.

It originally appeared in the December 2011 edition of Insight, published by the Victorian Council of Social Service (VCOSS), which can be downloaded in full here.

***

What does an effective response to homelessness require?

Heather Holst writes:

Many thousands of people were made homeless by the 2009 Victorian Bushfires. Several homelessness services, including HomeGround Services, found themselves responding, alongside a wide range of professionals and volunteers.

In contrast to this one-off disaster situation, homelessness services are part of a cluster of services that respond to personal emergencies whenever they happen.

This article considers how our ‘day-to-day’ crisis response to homelessness differs from the response to the bushfire disaster.

There were several linked components of the response to the 2009 Victorian Bushfires that were integral to its success:

1. UNDERSTANDING NEED

The teams that were quickly assembled and coordinated soon knew who had to be assisted in terms of numbers and locations. It took longer to fully understand needs, but there were concerted efforts to do so. This may seem a simple point, but it differs from day-to-day homelessness services where it is a case of waiting to see who comes on a one-by-one basis through the door seeking assistance.

2. PUBLIC SUPPORT

There was an immense outpouring of sympathy to the victims of this terrifying natural disaster. In contrast to many of the attitudes to ordinary homelessness, there was very little harsh judgment and blame from the general (and voting) public, although there was some criticism about living in fire-prone areas, not insuring property and possible imposture. Not only were politicians also part of this emotional response, but they were put on notice that they were expected to sort out this problem.

3. RESOURCES AND REMOVAL OF BARRIERS TO ASSISTANCE

Strongly related to this public sympathy, significant resources were made available through government funding and private donations. Similarly, barriers to the resolution of individual difficulties were removed. As just one example, paperwork requirements to prove eligibility for grants and payments were relaxed. This is very occasionally offered for other homelessness situations, but generally there is a huge amount of work involved in assembling papers and proof of eligibility with people experiencing homelessness who are in no position to have this all neatly filed away at home.

4. COORDINATION

There were very frequent whole-of-government meetings at a high officer level to coordinate efforts across departments. The case management response was organised around the person at their location of preference, rather than expecting them to approach a wide range of disconnected services (housing, health, material aid, legal etc) whenever they needed some assistance.

5. ACCOUNTABILITY

Underpinning all this effort was the appointment of a high profile officer to take responsibility for the effort and it was known quite early that a Royal Commission would examine every aspect of the causes of and responses to this disaster. This level of accountability is very far from our treatment of homelessness in general.

Very occasionally homelessness responses contain these ingredients, such as the recent re-housing effort when The Hub, one of the last big inner city rooming houses, closed in early 2011.

As the local homelessness service, HomeGround worked with local government and the owners to understand the nature and extent of the issue; the media took a keen interest in the story and very little adverse public comment occurred; government quickly made brokerage and worker funding available in response to a request from the homelessness agency; the relevant agencies and local government formed a local area response group to coordinate the effort; and senior departmental officers and the Minister’s office kept abreast of the re-housing progress.

It is notable that the Government would not expedite social housing access, so some people have had to wait a long time in temporary situations for permanent re-housing, but other agencies responded very favourably.

The homelessness sector has been moving towards greater understanding of need, coordination and accountability with the Opening Doors reforms, launched in 2006, which re-orient the system around clients rather than expecting people to find their own way or to accept limited assistance from single services.

There are now 17 catchments within which all funded homelessness organisations cooperate as Local Area Service Networks (LASNs) and a statewide 1800 number that operates 24 hours a day for direct access and to accommodate people after-hours.

To back this up, funded agencies advertise their available support, housing and brokerage resources to local agencies on an electronic register. Entry point agencies maintain a list of the households requiring assistance, which have been prioritised, based on the time spent waiting for assistance and their fit with the available resource (size, location, demographic).

The practice of sending people from one agency to the next to seek assistance was stopped, and replaced by engaging and working with each person until all their housing and support needs are met. Entry points were given the authority to match the most suitable applicant to each resource, rather than referring many people to a single resource and letting the other agency choose the successful applicant at a remove from the people involved.

There were several powerful reasons for this reform. The service system had grown and specialised to become a bit of a maze, especially in metropolitan Melbourne, and people reported significant confusion in trying to find the assistance they needed.

People were obliged to put together their own package of assistance because the cooperation between agencies was very limited, and few agencies were large and varied enough to offer a complete package of assistance ‘in house’. Clearly it was the most persistent and lucky who were receiving help rather than all those in need. Indeed, the more disadvantaged people were the least likely to be able to persist and tell their story in an appealing manner.

However Opening Doors has completely lacked two of the ingredients of success that distinguished the 2009 Victorian Bushfires response: resources and public support. The accountability ingredient has also been at a lower level than necessary, no doubt because of the absence of alert public interest.

In short, it has worked well in some respects and fallen short in others. Not all agencies have come along with the changes by making all their resources available and wholeheartedly participating in the local area service networks. Funding for this reform has been very limited compared to its scale. There has been no extra housing and no extra support funded, so the supply of assistance is still much less than demand.

Endorsement of this reform has seemed weak at times and some senior government officers have not engaged strongly. Rather, the investment has been made by the non-government sector, regional officers and a small number of senior government officers who understood the importance of becoming more efficient and improving overall quality.

Despite all this, a person who needs homelessnesss assistance can now find help more readily at any hour of the day or night, and only has to approach one service and undertake one assessment in order to access homelessness resources.

There is significantly more cooperation between agencies and knowledge of the options, making the referrals easier for people needing assistance. Resources are used more intentionally, with those in greatest need prioritised for most services, as well as some capacity for diversion for first episodes of homelessness.

There are reports that people with high needs who were homeless for many years, transient and not engaged, have now received housing and support by being prioritised. We now have the best information we have ever had as a homelessness sector about the extent and nature of need. Consumers are reporting that they understand and support the reforms.

There is an evaluation of the reform currently underway, and agencies continue to work on improving responses within the current resourcing constraints, but perhaps a rethink of our day-to-day responses to align them with disaster responses is warranted by the Government.

After all, homelessness is a disaster for each individual concerned, regardless of the cause.

• Dr Heather Holst is General Manager Client Services of HomeGround Services, one of Melbourne’s largest homelessness, housing and support agencies. See www. homeground.org.au for more information.

 ***

For more related reading

• This recent Productivity Commission report Health; Community services; Housing and homelessness gives an overview of how different jurisdictions are responding to homelessness and housing pressures.

• This is a report of a Canadian study investigating resilience in young homeless people.

• This blog on how charities can tell stories about their work mentions an interesting initiative from the US, InvisiblePeople TV, which features the stories of homeless people.

[youtube]http://www.youtube.com/watch?v=G0_Uj42rYC4&feature=mfu_in_order&list=UL[/youtube]

 

 

 

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Croakey Conference News Service 2013 – 2019
2013 conferences
Australian Centre for Health Services Innovation Forum 2013
Australian Health Promotion Association Conference 2013
Closing the Credibility Gap 2013
CRANAplus Conference 2013
FASD Conference 2013
Health Workforce Australia 2013
International Health Literacy Network Conference 2013
NACCHO Summit 2013
National Rural Health Conference 2013
Oceania EcoHealth Symposium 2013
PHAA conference 2013
2014 conferences
#IPCHIV14
AIDA Conference 2014
Congress Lowitja 2014
CRANAplus conference 2014
Cultural Solutions - Healing Foundation forum 2014
Lowitja Institute Continuous Quality Improvement conference 2014
National Suicide Prevention Conference 2014
Racism and children/youth health symposium 2014
Rural & Remote Health Scientific Symposium 2014
2015 conferences
#CPHCEforum
#CRANAplus15
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#OTCC15
Population Health Congress 2015
2016 conferences
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#cphce2016
#CPHCEforum16
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#IAMRA2016
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2017 conferences
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#AIDAconf2017
#BTH20
#CATSINaM17
#ClimateHealthStrategy
#IAHAConf17
#IDS17
#LBQWHC17
#LivingOurWay
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Australian Palliative Care Conference