Mental health and health programs

Housing Mental Health Pathways Program

Poor mental health and homelessness are closely connected. An analysis of more than 5,000 homeless agency client records, including HomeGround’s, showed that about a third of homeless people had mental health problems. There is also a high proportion of those with mental health issues who are homeless.

This research, released last year in the report Homelessness in Melbourne*, showed that half of those with mental health problems had these issues before becoming homeless and half developed mental health problems after becoming homeless.

HomeGround’s Mental Health Pathways Program aims to prevent the damaging experience of homelessness for people with mental health issues. The program works with patients, carers and staff in the acute psychiatric wards of The Alfred Hospital and St Vincent’s Hospital to ensure that patients are discharged into appropriate housing and have the support they need to stay housed.

The program brings a critical housing focus to patient recovery plans.

Mental Health Pathways Program workers build a trusting relationship with clients in order to assess housing and support needs and source the best accommodation to support recovery post-discharge.

As with all HomeGround’s programs, the goal is long-term and affordable housing in an appropriate location, usually near a person’s existing social support networks.

In the past year the program has been strengthened by greater planning and communication between workers in different hospitals; development of a shared service manual leading to greater consistency of practice; and in the north, participation in the Strengths Model of case management as part of the Yarra Alliance of Mental Health Services.

The Mental Health Pathways Program is also well integrated into HomeGround Outreach, ensuring that those in the program receive ongoing outreach support.

In the coming year, HomeGround’s consolidation of its databases will simplify the process of capturing and analysing data about service users. This data will inform next year’s research on outcomes of the Mental Health Pathways Program, which will further improve our services and ability to advocate for solutions.

ConnectED

HomeGround’s involvement in the ConnectED program is a welcome recognition of the strong relationship between safe and secure housing and health and wellbeing.

This service reduces preventable presentations to The Alfred Hospital’s Emergency Department. People are referred to this service due to regular, multiple and preventable presentations to the Alfred’s Emergency Department and inpatient services. Clients have physical and mental health needs and complex psychosocial needs. In most cases they have a primary issue of homelessness.

HomeGround brings housing expertise to the multi-disciplinary team that also includes The Alfred Hospital Emergency Department, Royal District Nursing Service Homeless Persons Program, Port Phillip Community Group, Bentleigh Bayside Community Health Service, Inner South Community Health Service and Prahran Mission. Together, partner organisations provide support, treatment and referral to clients that is specific to their complex needs. The project is auspiced by Bayside Health.

* Homelessness in Melbourne: Confronting the Challenge – Chamberlain, Chris; Johnson, Guy; and Theobald, Jacqui; RMIT University

Housing Mental Health Pathways Program case study

Wayne* is a 44 year old man with a diagnosis of major depression and a long history of suicidal ideation, transience and sleeping rough. Wayne had previously stayed at a men’s crisis accommodation service where he was stabbed by another resident. As a result, Wayne refused to return to this accommodation. In spite of his homelessness, Wayne had engaged with Turning Point Alcohol and Drug Centre for clinical support as well as alcohol and other drug treatment. He wished to be housed in the City of Yarra area in order to maintain this support.

HomeGround’s Housing Mental Health Pathways Program referred Wayne to Yarra Community Housing and he was placed on their housing waiting list. As Wayne was unable to stay in hospital as an inpatient while waiting for housing, he was discharged to a friend’s house.

Due to his support needs, Wayne was referred to HomeGround’s Support Allocation Meeting where all of HomeGround’s inner north services meet to collaborate on providing help to people with complex needs. At this meeting it was decided that Wayne’s case would be taken up by HomeGround’s Outreach Service (Psychiatric Disability and Rehabilitation Support).

As HomeGround Outreach was unable to start working with Wayne immediately, the Mental Health Pathways Program worker provided ongoing support in addition to material aid such as a sleeping bag, food and transport tickets.

Wayne’s accommodation with friends quickly broke down and Wayne was assisted into short-term accommodation by the HomeGround Housing Service. After a few weeks the Mental Health Pathways Program worker liaised with HomeGround Outreach to engage with Wayne.

Wayne was successfully housed in a Yarra Community Housing property and HomeGround Outreach continued to offer him support with the Mental Health Pathways Program worker facilitating this process.

ConnectED Program case study

Vanessa* was in her mid-thirties with a ten year history of homelessness when she was referred to the ConnectED Program. Apart from some isolated experiences of living in share houses, Vanessa’s accommodation had been unstable since her early 20s.

When Vanessa was referred by The Alfred Hospital, the ambulance service was considering charging her for frequent and vexatious calls.

Vanessa had a history of depression, chronic self-harm and abuse of benzodiazepines and alcohol. During binge phases she would call the ambulance service up to ten times a night and was presenting to The Alfred’s emergency department several times a week.

Vanessa was living in a private boarding house at the time of her referral. As ConnectED’s partner organisation responsible for housing, HomeGround first moved Vanessa to a community run boarding house which was a cheaper and more secure option, although still not ideal.

As soon as one of HomeGround’s transitional housing properties became available, Vanessa was assisted to move there and supported in applying for public housing.

Through the ConnectED program, Vanessa was assigned a family therapist for general counselling, focusing on the issues underlying her self-harm.

Despite having only been in transitional housing for four months, Vanessa’s situation is already improving. She is close to finishing a short course in event management and her contact with the ambulance service has significantly decreased. Previously, she would have presented at least 50 times during this period, but this has been reduced to only a few.

Vanessa has also reduced her alcohol and benzodiazepine use. She is beginning to repair fractured relationships with her family. Vanessa will be able to stay at the transitional housing property until the Office of Housing allocates a permanent home.

The positive impact of this for Vanessa is obvious. Her story is also a reminder of the financial and social costs of not acting to end homelessness.

By providing Vanessa with safe and stable housing and support, Victoria’s health system has already saved in the order of $100,000 in four months (based on the costs of ambulances and emergency admissions). It is also worth noting that the comparative costs of supportive housing over a four month period would have been around $5,000.

* Names have been changed