Capstone Project 2012

An Evaluation of the Cairns HHOT Service by External Organisations

Placement OrganisationQueensland Health

Homeless Health Outreach Team HHOTCairns

GHD Building Floor 3 85 Spence Street Cairns

Background to Project

In a country as prosperous as Australia no one should

be homeless.

Homelessness is not just the result of too few houses – its causes are

many and varied

•Domestic violence • Shortage of affordable housing •Unemployment •Mental illness •Family breakdown •Drug and alcohol abuse

All contribute to the level of homelessness in Australia. (Department of Families Housing Community Services and Indigenous Affairs 2008)

Homelessness can affect anyone.

In Australia around 105 000 people are homeless on any given night.

While the overall rate of homelessness has been relatively stable over the last 12 years increasing numbers of children families and older people are experiencing homelessness.

(Department of Families Housing Community Services and Indigenous Affairs 2008)

What is Homelessness?

• Homelessness includes people who are sleeping rough as well as people staying in temporary unstable or substandard accommodation.

Often people sleeping rough are referred to as the chronic homeless or people with complex needs who are difficult to respond to. They experience a range of problems such as mental illness and substance use and other health issues.(Phillips et al. 2011 p. 3-4)

A side of Cairns the tourist brochures don't mention

Cairns Homeless Rate Shame

Intervention not Perfect but its better than ...

Town camps leave Abbot speechless

Mount Isa Leichardt River

Primary Homelessness people without conventional accommodation

•living on the streets •sleeping in parks •squatting in derelict buildings •or using cars or railway carriages for temporary shelter.

•Secondary Homelessness

Includes people who move frequently from one form of temporary shelter to another.

people staying in emergency or transitional accommodation provided under the Supported Accommodation Assistance Program (SAAP).

people residing temporarily with other households because they have no accommodation of their own and

people staying in boarding houses on a short-term basis operationally defined as 12 weeks or less.

Tertiary Homelessness Refers to people who live in boarding houses on a medium to long-term basis operationally defined as 13 weeks or longer. They are homeless because their accommodation situation is below the minimum community standard of a small self-contained flat.

Policy 2008 the Australian Government released the White

Paper on Homelessness, The Road Home.

which called on all levels of government business , the not-for-profit sector and the community to join together to reduce homelessness

The Road Home The Road Home outlined the need for new investment in homelessness and reform of existing services.

People who experience homelessness should be supported to move quickly through the crisis system into long term housing and at the same time get help to reconnect with education employment and the community.

Mainstream services and homelessness services have to work together more effectively to reduce homelessness.

National Partnership Agreement on Homelessness

Australian Government has agreed to provide additional funding for homelessness to the states and territories who have agreed to match Australian Government Funding and deliver services and capital projects that will contribute to an overall reduction in homelessness.

Queensland's Homelessness Implementation Plan

includes specific measures for particular groups such as rough sleepers and young people. Under the Agreement Queensland is delivering a number of initiatives.

Initiatives • 143 homes for people experiencing homelessness will be purchased or built

across Queensland. Support for people moving into these homes will be provided through Referral for Active Intervention and Family Intervention Services.

• Supported Accommodation for Young People• Supported accommodation for young people who are experiencing or at risk of

homelessness to assist these young people to achieve educational and training outcomes and increase their capacity to live independently and reconnect with their families and local community.

• Post Care Support for Young People Exiting Care with a Disability• Continuum of care to young people with a disability who are turning 18 years

of age and who are exiting the care of the state to community-based living and independent adult life. The service will provide support arrangements appropriate to the person’s needs to ensure they do not become homeless.

Initiatives Street to Home•Assertive Outreach teams will bring people off the street into the housing they need to end their homelessness permanently. The teams will provide support until they are ready to move into permanent accommodation.

Common Ground Brisbane•Long-term housing and on-site support to people who are chronically homeless or at risk of homelessness to assist them to regain independence and stability.

•Home Stay SupportVulnerable families and singles will be assisted to maintain their tenancies through the provision of early intervention and post crisis support.

Assertive Outreach

New Street to Home service delivery models promoted under national homelessness policies have assertive outreach as a core component (Australian Government 2008).

Support for these new service approaches to addressing rough sleeping are heavily influenced by reported successes overseas.

Assertive Outreach The Queensland Health Homeless Initiative represents an attempt by Queensland Health to expand the delivery of mental health, drug and alcohol and other health services to people already homeless and to some at risk of homelessness, through the introduction of two innovative service models.

These refer to Health Homeless Outreach Teams operating in Brisbane Mount Isa Cairns Townsville and the Gold Coast and to Transitional Housing services established in Townsville and Brisbane.

Assertive Outreach

The Homeless Health Outreach Teams (HHOT) have implemented a service model based on ‘assertive outreach’.

Far North Queensland Demographics

Compared with the whole of Queensland the Far North region has a

• substantially higher proportion of people of Aboriginal and/or Torres Strait Islander descent

• Its age structure is roughly similar to that of Queensland as a whole but its median income is lower

Far North Region This region stretches from Innisfail in the south up to the Torres Strait and includes most of Cape York and the Far North hinterland area.

Homelessness in Far North Statistical Division

• higher proportion of homeless people per 10 000 population than Queensland as a whole with 11.6% of Queensland's homeless people but 6.3% of the population.

• Far North as a whole has an unemployment rate substantially higher than Queensland with some locations in particular some of the Aboriginal communities having extremely high rates of unemployment

Unemployment rates 2010

Location• Wujal Wujal 28.9%• Hope Vale 28.2%• Cook 25.5%• Mareeba 14.8%• Cairns 10.1%• Far North SD 11.1%• Queensland 5.6%• Source: Queensland Treasury (2010) Queensland

Regional Profiles

Far North QueenslandDepartment of Communities Disadvantage-Need-Risk Rankings

Homeless Health Outreach Teams

The aim of these teams is to minimize the health problems of homeless people and contribute to the prevention and reduction of homelessness through cross-sectoral collaboration to facilitate access to the most appropriate service .

• This is achieved through the provision of specialist mental health and general health care service to assist homeless people who are sleeping in public places, squats and other improvised dwellings.

• Consumer oriented, ensuring a focus on the person not the place.

• Community focused, community based and able to facilitate the development of effective partner ships.

• Culturally capable and sensitive and respectful of all cultures.

• Collaborative with all available services providing a co-ordinated and planned response

• (Queensland Public Mental Health Services 2012, p. 3).

• The HHOT is responsive to the needs of the consumer group ensuring a strong consumer focus that is supportive, non-judgemental and ensures access. It has a recovery approach recognising that consumers have the greatest knowledge and expertise regarding their needs and service requirements (Queensland Public Mental Health Services 2012, p. 3).

Health services provide part of the services to homeless people and cannot alone solve the problems or complex causes.

necessary to work to improve and maintain health outcomes through collaboration with non-government organizations the homeless community and other partners.

As a result partnerships have been developed with local health mental health and housing providers to link service users to services develop networks and referral pathways between HHOT and non-government organizations which in turn reduce barriers to service access.

After the initial development of a HHOT in Cairns in (2007) additional non-government organisation services were developed in Cairns as funding opportunities increased in response to the changing demographics of the local community. A HHOT service evaluation was developed in 2009 to map these local changes and track that HHOT service provision was appropriate to the requirements of the Cairns homeless population.

Capstone Project

Capstone Project

Due to time and staffing constraints the evaluation was not completed to include final recommendations and analysis and this project is designed to continue on from the last evaluation conducted in (2010) redesign the evaluation components conduct a 2012 evaluation and produce a final report.

An Evaluation of the Cairns HHOT Service by External Organisations

The Project aims to evaluate HHOT services from an external agency perspective. Agencies may be government or non-government service providers.

Goals

• evaluate HHOT services •make recommendations to improve service delivery appropriate to the requirements of local homeless service community and organisational policy directives.

Why? Key components, essential for the effective operation of a HHOT service;

3.1.0 Working with other service providers.

3.1.1 Strong partnerships will be developed and maintained with local mental health service providers.

3.1.2 Strong partnerships will be developed and maintained with DOCs and others government agencies

3.1.3 Networks collaborative planning and referral pathways between HHOT and a range of non-government organisations)NGOs) will be developed to reduce barriers to service access.

3.1.4 HHOT will engage non-clinical services to provide support for consumers. Service integration activities are essential for ensuring comprehensive local knowledge and assertive outreach.

3.1.5. When consumers have specific needs (eg. Sensory impairment, trans culltural) the HHOT will engage the assistance of appropriate services to ensure effective communication.

(Queensland Public Mental Health Services 2012, p. 4-5)

An Evaluation of the Cairns HHOT Service by External Organisations

•Stakeholders will be offered a survey questionnaire and also the opportunity to participate in one to one interviews.• Evaluation data will be sourced by both quantitative and qualitative methods between September and October 2012.

AASW Practice Standards

Direct Practice relates to the needs of the client being met through improved services;

Service Management the project will evaluate whether community expectations of government services and organisational goals are met in an appropriate manner; (Australian Association of Social Workers 2003).

AASW Practice Standards

Organisational Development, System Change and Policy

the project identifies if changes are required to reduce inequalities social barriers or injustices or if policy is in appropriate; (Australian Association of Social Workers 2003).

AASW Practice Standards

Research skills are developed and applied through critical analysis research methods and dissemination of findings of the evaluation process and

Education and Professional Development are addressed in the relationship between research and learning (Australian Association of Social Workers 2003).

Practice framework that aims to develop collaborative respectful communication oriented relationships with participants. Further the project is guided by systems

theory using task centred theory to develop prioritised outcomes and planning strategies solutions focused

theory to define recommendations from evaluation data using a narrative approach to gather the qualitative data and guided by evidence based research for example an

appraisal and comparison of best practice service models and outcomes.

Agencies • ATODS• ACCESS Housing• Anglicare ( Quigley Street Night Shelter, Lyons Street Diversionary Centre, St Johns House, St Margaret's. )• Bawu Living Skills Program • Centrelink• Centacare• Domestic Violence Service• General Practitioner• Homeless HUB• Mission Australia • Queensland Police Liason • Ozcare (Mens Hostel, Drug and Alcohol Rehabilitation) • Salvation Army • SHAC Shelter Housing Action Cairns• Womens Centre• WuChopperen • YouthLink• YETI (Youth Empowerment Towards Independence)

Evaluation Survey Questions • The Homeless Health Outreach Team (HHOT) in Cairns is currently

undertaking a review of the services it provides within the region. • To have your say, and help us to make informed decisions, we would

like to hear what you have to say about the service that has been provided so far.

• Your responses are confidential

• Determining the level of HHOT services• Evaluating Effectiveness of HHOT clinics• Overall evaluation of HHOT’s effectiveness in dealing with consumers• When contemplating referral options, which of the following services

would you consider referring to the HHOT for?

Executive Summary and Recommendations

IntroductionProject Plan

Main Research QuestionsMethodology

Literature ReviewAnalysis and Preliminary Findings

References