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Homelessness and mental health

from YAPRap December 2002

by Lena Lum, Youth Accommodation Association

In the last two decades, research has been conducted on homeless populations in Australia due to the ever-increasing numbers of persons at risk. Studies show several factors are contributing to the rise in homelessness, however, it is difficult to obtain hard data on the actual number of homeless due to varying definitions.

Most research is conducted with varying definitions of what homelessness encompasses. The Australian Bureau of Statistics (ABS) has three specific categories of homelessness, which include primary, secondary and tertiary homelessness.

The ABS definitions are in contrast to the broad definition used by the Supported Accommodation Assistance Act 1994, (which governs the Supported Accommodation Assistance Program or SAAP). It states "a person is homeless if, and only if, he or she has inadequate access to safe and secure housing [subsection 4(1)]".

The transient and "hidden" nature of the homeless population also contributes to inaccuracy in numbers. Many find shelter with friends and relatives, squat in vacant buildings, and never engage with services for the homeless. Non-engagement can be attributed in part to stigma and difficulty in accessing services.

Numbers of homeless youth

An article on Youth Homelessness in Australia (ABC News, 16 July 2002) focusing on research completed by the RMIT University in Melbourne, places the number of homeless youth, ages 12 - 18 at approximately 26,000. This is noted to be an 8% jump from 1994, which puts the average at 14 homeless youth out of every 1,000 young people (ages 12 - 18) in Australia.  

Youth homelessness also varied by state in Australia with NSW and Victoria averaging 10 homeless youth in every 1,000 versus 69 in the Northern Territory.

The Supported Accommodation Assistance Program (SAAP) aims to "provide transitional supported accommodation and related support services in order to help people who are homeless achieve the maximum degree of self-reliance and independence" . SAAP also provides statistics on homeless persons utilising their services.

The SAAP National Data Collection Report 2000 - 2001, states SAAP supported 91,200 clients within the fiscal year. Of these clients, the largest group (19%) were aged 15 - 19 years.   Clients between the ages of 20 - 24 made up 16% of the total, and 2% of youth served were under the age of 15. 60% of all SAAP clients are under the age of 35.

Of the 91,200, there is over representation of Indigenous Australian clients at 10.7% when considering that only 2% of the Australian population is Indigenous. Clients from Non-English speaking Backgrounds follow second with 10.6% in SAAP services and making up 16.7% of the Australian population.

One of the only common factors agreed upon by all researchers, is that the number of youth homelessness is rising with each passing year.

Youth-specific issues

Age, education and lack of experience to obtain and sustain employment, often exacerbates homelessness among youth. Young people often find it extremely difficult to find work if they are unable to furnish an address or sustain work if they have insecure housing.  

Youth regularly relocate to areas with higher service provision to obtain housing, counselling or other support services, but negatively separate them from school and support networks.

The economic hardship faced by homeless youth was highlighted in a media release from ACOSS on 18 October 2002. The release focused on Youth Allowance, "a Centrelink payment that is meant to assist young people into employment, training or education" .   Michael Raper, President of the National Welfare Rights Network (NWRN) stated that the allowance, with payment amounts of $83 - $150 per week is inadequate and "forcing young people into a spiralling cycle of debt ". Consequently, many young people borrow advance payments, up to $500, from Centrelink to cover their expenses. Repayment of the advance then lowers the allowance by approximately $20 per week.  

It is noted that youth between the ages of 18 - 20 and living independently have the "highest incidence of debt" to Centrelink at 68% while 43% of this age group are also homeless. Those under 18 and independent are 57% in debt with 81% homelessness. Mr. Raper stated "A system that produces such high rates of debilitating debt among our most vulnerable homeless youth is seriously flawed and needs an urgent overhaul".

Other factors leading to homelessness is the lack of affordable housing and availability of public housing. In mid-September, the Real Estate Institute of Australia cited a rise of 23% in the price of Sydney homes within the last 12 months, bringing the average house price to $388,000.   The Australian Council of Social Service (ACOSS) called for a "public housing rescue package" in their 15 October news release. The release stated there are "more than 220,000 people on the public housing waiting list with a reduction of only 15,000 applicants since 1996."

Young people often encounter housing discrimination in the private rental market and sometimes have difficulty maintaining shared accommodation with others who may jeopardise housing with untimely payment of rent or utilities.

Youth are at a higher risk for exposure to violence while homeless and are commonly viewed as easy targets for victimisation. This exposure frequently leads to involvement with the legal system, which can further complicate the youth's attempts to obtain housing.

Homelessness places youth at higher risk of developing health issues involving hygiene, contraception, malnutrition, drug and alcohol dependence/abuse and sex work issues. They are more prone to contract sexually transmitted infections, HIV/AIDS, hepatitis C and have a high rate of cigarette smoking.

Mental health

Homeless youth are four times more likely to develop mental health issues than youth in safe and secure environments. Statistics show that 50% of young people accessing housing or homeless agencies have one or more identifiable mental health issues. Stigma regarding mental illness and the chronic nature it implies frequently leads to under utilisation of services among young people. This is an unfortunate cycle, as studies show delays in clinical treatment for diagnosable conditions often lead to more intense symptoms and longer courses of treatment.

Education around the nature of mental illness in schools and communities is extremely lacking. Most persons dealing with mental illness start exhibiting symptoms prior to age 30, and sometimes as early as their teen years. Education regarding symptoms, treatment and methods of monitoring mental wellness may lead to earlier intervention, stabilisation, increased compliance and greater chances for recovery.

Diagnosis of mental illness in young people can be complicated by many factors, including hormonal changes during puberty, abuse of illicit or prescription drugs, and environmental elements such as homelessness or family conflict. Many chronic mental illnesses need an extended timeframe to be accurate in diagnosis, especially if complicated by substance use. As such, practitioners are often reluctant to diagnose mental illness in young people.  

More often, young people are diagnosed with disorders of conduct, personality, adjustment, learning, opposition, attention deficit/hyperactivity, episodic anxiety, depression and psychosis rather than schizophrenia, schizoaffective, bipolar, or major depression disorder. Furthermore, it can be very difficult for young people to accept that their illness is chronic and may require a lifetime of medication and treatment. However, delaying a formal diagnosis of chronic illness is only beneficial to the young person if that time is used to educate them about symptoms, treatment and methods of management (holistic and/or medical).

Whatever approach is utilised, it remains that research and support services targeting youth are limited, and education and advocacy for youth, a dire need. It is not acceptable that young people are often accommodated within modified adult services. As implied by Hodges and Boscutti, young people require assistance that acknowledges their special circumstances, individual coping mechanisms and addresses wellness in conjunction with illness.


Notes

Opinions: are the author's and not necessarily YAPA's.

Be careful!
YAPA and the author took reasonable care to ensure that this information was correct at the time of publishing (above). The author/s may have no health qualifications (unless stated), and information provided is general - it is not specific advice. Do not rely on it - check with other publications and authorities and if necessary get qualified professional advice for your situation.



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