Post release support the key to better housing outcome for people leaving institutional settings: report

A lack of integrated housing support is driving higher rates of inpatient care, increased need for substance use treatment and ongoing offending by people leaving institutional settings such as rehabilitation, out-of-home care and prison, new AHURI research finds.

The research, ‘Enhancing the coordination of housing supports for individuals leaving institutional settings’, undertaken for AHURI by researchers from RMIT University, Curtin University and University of New South Wales finds that people entering and exiting institutional settings typically have complex health and social care needs and require significant post-care coordination between diverse care providers.

‘Not having adequate plans that support people’s safe transitions from institutional settings into secure and affordable housing can have catastrophic consequences for the individuals leaving these settings, with strong impacts on their housing security, health and wellbeing, and economic and social participation in the community,’ says lead author of the research, Associate Professor Cameron Duff of RMIT University.

For people leaving residential mental health and substance use treatment programs, the research shows a strong correlation between the volume and frequency of service use and the risk of housing insecurity. While the frequency of service contact is obviously an indication of service demand and the complexity of an individual’s health care needs, it is also the case that service contacts, particularly those that involve periods of residential treatment disrupt an individual’s housing arrangements over time.

For people leaving prisons, factors of disadvantage and need are highly prevalent, including mental health conditions (40%), cognitive disability (33%), substance misuse (up to 66%) and past homelessness (33%). More than half the people exiting Australian prisons either expect to be homeless, or don’t know where they will be staying when they are released. These individuals are all too often excluded from community based support services as ‘too difficult’ and end up back in prison.

Young people leaving government managed out-of-home care also experience considerable housing, health and social disadvantage. Research shows more than half (54%) of Victorian care leavers accessed homelessness services in the four years after leaving care and one in three had multiple homeless experiences.

‘What we found for all three groups of people was there is a need for strong transitional planning and support,’ says Associate Professor Duff. ‘Assertive case management, while resource intensive, is an effective means of supporting vulnerable individuals with complex needs to access and maintain stable housing.’

The research shows the benefits of more formal integration of housing, health and social supports demonstrates that long term stable housing can be sustained for persons with complex health, housing and social support needs. In addition, all discharge planning must begin from the point of view of the individual and their specific situation by shifting to more ‘person-centred’ approaches for care coordination and service delivery.

‘In particular, our research recommends that all Australian governments increase the age of young adults leaving out-of-home care to a minimum of 21 years,’ says Professor Duff. ‘This brings the leaving care age closer to community expectations regarding independence for young adults. Leaving care planning ought to be supplemented by attention to the transition from adolescence through to emerging adulthood, focussing on strengthening independent living skills and other key developmental tasks.’