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11-16 May 2014 and beyond.... T HE G OAL To identify the must vulnerable people in inner city Perth To prioritise them for housing, health and other support.

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Presentation on theme: "11-16 May 2014 and beyond.... T HE G OAL To identify the must vulnerable people in inner city Perth To prioritise them for housing, health and other support."— Presentation transcript:

1 11-16 May 2014 and beyond...

2 T HE G OAL To identify the must vulnerable people in inner city Perth To prioritise them for housing, health and other support services based on their assessed vulnerability To assess which level of housing support best matches each individual’s needs

3 T HE P ROCESS 85 surveyors in teams interviewed: Individuals sleeping rough on Perth inner-city streets between 4am and 6 am on 13th-15th May 2014 People accessing homelessness services during days and evenings of 13 th -15th May (Day Centres, Women’s Refuges, Soup Runs, Nyoongar Patrol, Youth, Mobile GP & Street Dr)

4 T HE S URVEY T OOL : VI-SPDAT (P RE -S CREEN T OOL ) Recently-released (2013) amalgamation of VI and SPDAT Both original instruments and the amalgamation are evidence-based, extensively tested, valid and reliable Vulnerability Index (VI) Measures chronicity and medical vulnerability Shows level of risk of dying if not housed Was used at 2012 Perth Registry Week Service Prioritisation Decision Assistance Tool (SPDAT) Identifies best type of support and housing intervention

5 L OCATIONS OF I NTERVIEWS LocationsNumber Perth CBDForrest Chase, William St, Murray St, Hay St, Anglicare, Train Station, Langley Park, Supreme Court Gardens, Tranby, State Library 62 East PerthAnglicare, Royal St, Wellington Square, Victoria Gardens 22 NorthbridgeAnawim, ALS, Beaufort St, Ruah Centre, Ruah Refuge, Weld Square, Parker St 71 MaylandsShopfront13

6 THE RESPONDENTS 204 people identified as experiencing primary homelessness 168 agreed to be surveyed 127 agreed to photos for identifying them later for housing and support assistance 79 assessed as needing Permanent Supportive Housing - the most intensive of the intervention options identified by the VI-SPDAT

7 DEMOGRAPHICS 41 respondents (24.4%) were under 25 years old The youngest was 15 years old 6 (3.6%) respondents were older than 60 years The oldest was 77 years old

8 AGE AND GENDER 41 respondents (24.4%) were under 25 years old The youngest was 15 years old 6 (3.6%) respondents were older than 60 years The oldest was 77 years old AgeGender <24>25Total Male Female Transgender 022 Total

9 C ULTURAL IDENTITY 11 (26.8% of Youth and 54 (42.5%) of Adults identified as Aboriginal or Torres Strait Islander Total of 65 Aboriginal respondents – 38.7% of homeless people surveyed 2011 Census: Aboriginal people 3.1% of total WA population AboriginalityCultural Identity

10 A T -R ISK I NDICATORS Youth (24 and under) Adults (25 and over) Total Total homeless 6 months or more Trimorbidity of co-occurring psychiatric, medical and substance use problems A&E visits or hospital admissions in last 6 months A&E visits in last 6 months >60 years old 066 HIV/AIDS 033 Liver Disease Renal disease 088 Wet/cold weather injuries Alcohol daily for past 30 days Injecting drug use 33841

11 D ETERMINING A CUITY OF N EED Pre-Screen total score based on domains of History of Housing and Homelessness Risks Socialisation and Daily Functions Wellness ScoreAcuityYouthAdultTotal 10+Ongoing Support Short Term Support No Support7815

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13 C OMPARING A CUITY

14 YOUTH AcuitySleeping rough Family and friends Other temp accom Total surveyed Ongoing Support9 (56%)6 (38%)1 (6%)16 Short Term Support10 (56%)5 (28%)3 (17%)18 No Support2 (29%)3 (43%)2 (29%)7 Total surveyed ADULTS AcuitySleeping rough Family and friends Other temp accom Total surveyed Ongoing Support53 (84%)3 (5%)7 (11%)63 Short Term Support35 (62%)9 (16%)12 (21%)56 No Support4 (50%)3 (37%)1 (12%)8 Total surveyed W HERE T HEY U SUALLY S LEEP

15 Question: Where do you sleep most frequently?

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18 VIOLENCE: C OERCION AND F EELING U NSAFE YouthAdult Someone who forces me or stands over me to do things I do not want to do 7 (17.5%)39 (30.7%) People who take my money, borrow cigarettes, use my drugs, drink my alcohol 21 (52.5%)57 (44.9%) I engage in risky behaviours like unprotected sex with strangers, exchanging sex for money, running drugs, sharing a needle 9 (22.5%)25 (19.7%) I have threatened or tried to harm myself or someone else in the past year 21 (52.5%)44 (34.6%)

19 V IOLENCE, BRAIN I NJURY AND T RAUMA 21 of the 60 Adults who had been attacked or beaten since being homeless also said they had a brain injury No Youth attack victims reported brain injury 55 Adults said trauma they had not reported had led to homelessness – 17 of these had serious brain injury 19 Youth had experienced trauma – 3 of these had serious brain injury

20 J USTICE S YSTEM Multiple recent contacts with police 80% Youth and 72% Adults had some contact with police over past 6 months Pending legal issues (“Legal Stuff”) that may lead to fines or incarceration Previous detention (Watch House, youth detention, prison)

21 U NEQUAL R EPRESENTATION 13% of ATSI respondents had 20 or more contacts with police in past 6 months 76% have been to prison 76% in the watch house 54% in youth detention 48% awaiting outcome of “Legal Stuff”

22 U NEQUAL R EPRESENTATION

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30 F REQUENT U SERS OF A CUTE S ERVICES Mandelberg et all (2000): a small number of vulnerable people account for a large percentage of Accident and Emergency visits # People# OccasionsAverage A&E visits Ambulance trips Inpatient stays

31 A N E XPENSIVE W AY TO R ECEIVE T REATMENT # People# OccasionsAverage A&E visits Ambulance trips Inpatient stays Average cost per A & E attendance is $ Those 48 users would have cost $451, Average cost of inpatient stays $6245 per day Average cost of stay in authorised mental health unit $1320 per day Ambulance fees $468 per non- urgent use or $872 per urgent use: 238 trips could range from $111, $207,536.00

32 U SE OF H EALTH S ERVICES Ongoing Support 10+Short Term Support 5-9No Support 0-4 RPH Mobile GP Street DocRPH Street DocGPStreet Doctor None GPAboriginal Service/ Mobile GP TOP 5

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34 Perth Registry Week 2014 W HAT DO YOU NEED TO BE SAFE AND WELL ?

35 W HAT H AS B EEN A CHIEVED ? Using the VI-SPDAT across Perth Registry Week 2014 we have been able to Collect a consistent set of information about individuals sleeping rough in Perth inner city For most, have photographic identification Understand the acuity of their need Prioritise and match support to each person’s presenting needs

36 I MMEDIATE F OLLOW U P Ruah Street to Home in partnership with other agencies are searching for and where possible working with those in greatest need (transient, hard to find): High VI-SPDAT scores Pregnant No income Over 60 years

37 O UTCOMES S O F AR 1 woman housed with Department of Housing and linked with support (Street to Home) 2 young men accommodated through Passages transitional accommodation and linked with support (Street to Home) 1 young man accommodated in private rental with support (Medicare Local) 1 young man is linked with Street to Home while awaiting return to family and support in NZ MCOT are tracking people with highest mental health needs Mobile GP following up people who are physically vulnerable

38 N EXT S TEPS Discuss ongoing possibilities for use of VI-SPDAT database to inform effective service delivery Collective impact approach –involving various Govt Depts, WA Police, local Councils, NFP service providers and the wider community Develop an ongoing campaign (Registry Week is only a week, homelessness is an ongoing problem)


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