Mental Illness and Homelessness

Mental Illness and Homelessness

Mental Illness and Homelessness

Homelessness, poor health (both mental and physical) and substance abuse all go hand in hand.  In many cases, poor mental health and substance abuse can be both a cause and a result of homelessness.  The issue of homelessness cannot be addressed, solved or dealt with without looking at the issues of how to deal with poor mental health and substance abuse.

Mental illness in Australia is at epidemic proportions.  One in four Australians either currently has or has had a mental health condition.  Schizophrenia is on the rise, and affects about one in 100 or between 150,000 and 200,000 Australians ().  People with schizophrenia are often unable to participate in normal social events of conversations, and lack sufficient motivation for simple activities like bathing or cooking.  Many find themselves homeless.

Troy FosterThis brings me to the recent local incident of the death of Troy Foster.  According to the Gold Coast Bulletin Wednesday, November 26, 2014, he suffered from mental health for most of his adult life, potentially brought on by drug use.  His father is quoted as saying that while he was in jail, he was the best he had ever been mental health wise as he did not have access to drugs or alcohol and he was taking his medication.  It was after he was released that he did not have the capacity to look after himself, got back into old habits and his mental health slipped, leading to the incident described in the news article.

In June 2013, the Mental Health Commission of NSW issued a Final Report on Mental Health and Homelessness.  In this report, the writers identified one of the main barriers to effective mental health service as:

“The lack of coordination and integration within the service system creates greater risk of homelessness for people with mental health issues. Discharge from institutions (e.g. hospitals and prisons) demonstrates gaps in the service system as a result of uncertainty in responsibilities and accountability (NSW Ombudsman 2011)”.

Certainly this has been the case in the Troy Foster incident and in many other deaths of mental health patients.  It seems that with the closure of many mental health facilities across Australia, hospitals are only able to deal with mental health patients in a triage capacity.  The new policy of putting mental health patients amongst the community and dispersing them is putting both mental health patients and the community at risk, and unfortunately, putting more stress on Police Officers who need to intervene with, in many situations, tragic outcomes such as the recent shooting of Troy Foster.

There is a real need for all aspects of the community including health and hospital professionals and those dealing with mental health on a regular basis to work together.  Many health professionals are taught to ask 2 simple questions of a mental health patient whether admitted by themselves, the Police or concerned families and friends.  These 2 questions are in many cases used as the only tool to assess mental health capacity:  1) Are you going to harm yourself and 2) are you going to harm others.  Of course someone who has been through this before, is going to answer “no” and “no” and they are then discharged or not even admitted.  It is likely that in his mental health assessment, these were the two questions asked of Troy Foster before he was discharged and then ran at Police officers with a knife.

The Commonwealth Government’s (2009) White Paper, The Road Home: a national approach to reducing homelessness, sets the strategic agenda for reducing homelessness in Australia to 2020, with two headline goals:

  1. Halve overall homelessness by 2020.
  2. Offer supported accommodation to all rough sleepers who need it by 2020. Three strategies guide this response to homelessness:
    • Turning off the tap: services will intervene early to prevent homelessness.
    • Improving and expanding services: services will be more connected and responsive to achieve sustainable housing, improve economic and social participation and end homelessness for their clients.
    • Breaking the cycle: people who become homeless will move quickly through the crisis system to stable housing with the support they need so that homelessness does not recur.

In order for any of these goals to be effective, Government also needs to reform Centrelink payment processes for homeless and those at risk of homelessness.  Unfortunately, merely offering supported accommodation to all rough sleepers who need it is not enough.  Many of the clients we have seen at Sheltered by Grace are very au faux with processes and the Centrepay system.

They know very well that they can cancel their Centrepay payments to a housing provider the day before their payment is due and they do not need to provide evidence that they are in effect making themselves homeless again because they choose to spend all of their money on drugs or alcohol rather than pay for board and lodgings.

In this respect, the Government is merely allowing the perpetuation of homelessness and encouraging addictions and vagrant behaviour with no repercussions.

In the UK, Centrelink recipients do not get all of their monies in cash.  Part of their pension goes to the local Council to pay for their housing.  If welfare recipients did not get all of their pension in cash, but a portion either went to their housing provider or was held in reserve for a housing use, then it would have the potential of halving the homeless population overnight as they would be better off staying in supported accommodation rather than choosing homelessness in order to continue with their addictive behaviour. 

Let’s start a conversation about mental health and actually transforming homelessness!

About the Author Lisa Loakes