The key finding and recommendations have been recorded and made using data from three sources, first, the survey of 50 people who have experienced homelessness, second, further discussions with those people surveyed other people who have experienced homelessness and third, workers from the health and community sector.

Medical issues dominated respondents’ reasons for their becoming homeless and re-occurring homelessness (42%). Many respondents and sector workers cited mental health and substance abuse as the most pressing issue. Depression and the lack of appropriate trauma counseling were also flagged as issues that need further investigation.

With 64% of respondents over the age of 40 years (6% were over 60 years) medical issues will continue to be an issue well into the future. Rooming houses are where most of the respondents live (48%) with the remaining respondents having lived in rooming houses previously.

Poor diet was another contributing factor. In a telling example, a group of residents of one South Melbourne rooming house organised themselves so that they could combine their resources and produce one good meal a day. They felt that their poor health and constant state of lethargy were due to a poor diet. They rejected the idea that they did not know how to cook properly and stated the real problem was the price of food. Sector workers agree.

Relationship issues were listed by 28% of respondents as reasons why people were not able to break out of homelessness. Relationships issues were not previously recognised as being important. The issues appear to be complex with relationships with spouses, peers, family and the "community" cited by respondents. Medical and other issues may play a part in relationship problems. Further investigation is required into this area of relationships and their significance.

For 20% of respondents, employment and income issues are of prime concern. Respondents cited lack of suitable work in the locality, lack of training, problems with Job Network, problems dealing with Centrelink and the Office of Housing when employment is commenced, and discrimination in employment.

The Inner South of Melbourne has lost many manufacturing industry employment opportunities since the economic changes of the early 1980s. These jobs have moved to the outer suburbs where a motor vehicle is needed to access most employment sites.

Although many former homeless people have the necessary qualifications and experience to work effectively in the community sector, there exists reluctance by the sector to employ homeless or formally homeless people. At least two of the larger non-government organisations have policies that state that anyone applying for a position must not have used the service for two years. One organisation told a volunteer, formally homeless, that he could not apply for a paid position for this reason, despite him already working in that position as a volunteer. These policies have no foundation in law. They exist because no one has questioned them previously, even though there are numerous examples of discrimination in the sector.

1. The Department of Human Services fund the Royal District Nursing Service Homeless Peoples’ Team to auspice and conduct a health and lifestyle audit of rooming house residents of the Inner South of Melbourne. The audit should have peer workers involved, predominantly in the development and completion of the audit. The audit to include issues of health, living conditions, types of relationship issues, income issues, service delivery and critical incident reporting.

2. The meals on wheels program to be promoted and extended into rooming houses in the Inner South of Melbourne.

3. The Department of Human Services install an affirmative action plan aimed at assisting homeless or formally homeless people find employment in the sector. The action plan should include an examination of existing sector employment engagement practices to eliminate any illegal practices.

Relationship Issues

4. The Department of Human Services further investigates the significance of relationship issues for people experiencing homelessness. As part of the proposed health and lifestyle audit relationship issues should be further explored.

The Prahran Mission & ConnectED Homelessness Education Video Project is producing an educational video examining and explaining the causes of re-occurring homelessness. The project is funded through a grant by the ANZ Trust with its core element being the employment of Peer Project Workers who had or were still experiencing problems associated with homelessness to complete the project. A research and training component was installed into the project and it was decided to complete a survey of people who had experienced homelessness.

The City of Port Phillip is home to just over 1,300 rooming house residents. The Cities of Stonnington and Glen Eira have approximately 200 residents between them. Only a few years ago it was thousands more but the changes and new developments in the City of Port Phillip have seen the sharp decline in the number of rooming houses. Fifteen private rooming houses have closed in the City of Port Phillip and City of Stonnington since May 1999 bringing about a loss of over 420 rooms. About half of the rooming houses in the City of Port Phillip are owned by the Victorian Office of Housing and managed by community housing organisations.

Rooming house residents are classified as Tertiary Homeless by government, not having the protection of a lease and having to share bathrooms, toilets and kitchen facilities. Many caravan park residents live in similar environment. Rooming houses may have from four residents to 100 residents. Primary Homeless people are street homeless or sleeping ‘rough’ in cars, squats, street, temporary shelters and in place such as parks. They may find assistance in the Secondary Homeless sector, the crisis accommodation sector that includes refuges, transitional housing and emergency accommodation. Re-occurring homelessness is where people continue to re-cycle, from street to crisis accommodation, to rooming house and then back to the street.

Inner Melbourne, including the Inner South East, has a particular problem with re-occurring homelessness because of the concentration of homelessness services in the area. Three factors contribute to the problem. First, the deistitutionisation of the mental health system has resulted in many people living with mental health issues gravitating to Inner Melbourne. Many exist with little or no proper support. Second, many people living with substance abuse issues are concentrated in the Inner Melbourne area. Thirdly, economic reforms since the 1980s have resulted in many unskilled and semi-skilled employment opportunities either moving to the outer suburbs or disappearing completely. People become stuck in a cycle of sickness and poverty.

Community rooming houses (owned by the Office of Housing and managed by community housing organisations) come under great pressure from emergency accommodation providers to house people living with complex issues.

The Department of Human Services Burden of Disease Study found the life expectancy of males living in the City of Port Phillip to be 5 years less that the rest of the state. Many believe part of the reason is due to poor health of the rooming house population, although no study has been attempted to try and identify reasons for the disparity. Although recent Burden of Disease studies demonstrate a slight improvement in male life expectancy in the City of Port Phillip it should also be noted the number of rooming houses declined in the same period.

Strong anecdotal evidence from sector workers and residents suggests that rooming houses are perfect incubation sites supporting the cross-fertilisation of health issues—for example, people living with mental health issues developing substance abuse issues and vice versa. The living environment and associated issues facing the rooming house and homes population are similar to those facing Indigenous Australians. One sector worker stated, "Rooming houses have become the detention centres for people who have been displaced by the policies of economic rationalism."

There were two key reasons for developing and completing a survey examining the possible causes of re-occurring homelessness. First, it focused the group on the issues that may contribute to re-occurring homelessness. As everyone in the group had, or were still experiencing homelessness, it was suspected that health issues played a major part in people’s ability to break out of the homelessness cycle. It was also suspected that also problems accessing appropriate service delivery also contributed to re-occurring homelessness.

Second, was to assist in developing the video content by identifying possible contacts and interviewees as well as selecting those issues that were of most concern.

Very little research has been completed about homelessness in the Inner South of Melbourne. None has been completed targeting health issues. In 2001 Phil Dalling, then Planning Manager DHS Southern Region and Bill McKenzie, then a community worker and rooming house resident, attempted to develop a homelessness and rooming house health audit in the Southern Region. One of the key elements of the project was going to tap into the existing expertise living in the rooming house sector. The Office of Housing indicated initial support for the project but the project lapsed when three community organisations rejected requests to auspice the project.

Bill McKenzie and the four Peer Project Workers developed a survey and an introduction sheet. Angela Savage, Senior Policy Officer with the Victorian Council of Social Services, provided additional and valuable advice as to the formatting of the survey.

The survey was designed to try and discover the original cause of first, why people became homeless and second, why those people were having difficulty breaking out of the homelessness cycle. Ten questions were developed to "flesh out" accurate responses.

All five project workers had experienced long term homelessness. One worker was living in transitional housing, two were living in OoH rooming houses, one was living in an OoH flat and one was living in private rental housing. All workers had some experience, either as a part time worker or as a volunteer, of working with homeless people.

All Peer Workers were still attempting to have their own issues addressed. To lower the impact and address some of the issues it was decided to install a support mechanism. Nick Ivanof, Senior Social Worker with the ConnectED Project agreed to provide this support.

All Peer Workers were paid award wages for the hours they worked. It was also decided to install a training component into the project. Although resources were limited, the hours available to the Peer Workers were approximately the same as those required to complete a TAFE Community Services unit. The Project Manager processed a Certificate IV Workplace Assessment and Training, the minimum TAFE subject delivery requirement, and agreed to collect evidence from the Peer Workers completed tasks to match with a suitable TAFE Unit. The evidence would be later submitted to a TAFE provider for Recognition of Prior Learning assessment and awarding of the unit.

Who We Surveyed

Only 6% of respondents were under 30 years of age. Sixty two percent of respondents were over 40 years of age. Six per cent of respondents were over 60 years of age.

Respondents listed six types of accommodation used as displayed below.

Forty eight per cent of respondents live in rooming houses. The 20% Primary or Street homeless people figure was surprisingly high. The OoH was responsible for the accommodation of 56% of respondents.

The majority of respondents (52%) have experienced more than six years of homelessness, with 50% of these experiencing 11 years and over (25% of total). Eighty per cent of respondents have experienced more than three years of homelessness.

Ten per cent of the total number of respondents had lived in a rooming house for 11 years or over. Forty two per cent had lived in rooming houses for three years and over. Of the total number of respondents, 26% had lived in a rooming house for less than a year.

Only 14% of respondents had lived in just one rooming house. Thirty seven per cent of respondents had lived in three or more rooming houses. The 10% of respondents that have lived in 11 or more rooming houses is a clear indication of the instability of many peoples’ housing situation.

20% drugs

6% could not list a reason

Respondents were asked to list in order the reasons they became homeless in the first instance. The first and second responses are listed below. Twenty two per cent of respondents did not list a second reason.

Medical issues dominated (40% and 26%). Employment and income issues rated second (32% and 20%). Relationship issues rated third (14% and 16%). Quality of advice and assistance from homelessness and other service providers rated fourth (14% and 16%).

When asked to list reason why respondents were having difficulty breaking out of homelessness, medical issues (38%) were paramount. The question was open ended. Employment and income issues were the main issue for 32% of respondents. Relationship difficulties (14%) were issues that had not been previously cited and require further investigation. Further investigation is also required into the citing of quality of service delivery by 14% of respondents. Peer Workers noted that those respondents were very vocal in their criticism. Only 2% cited gambling as a barrier to breaking out of the re-occurring homelessness cycle.

Respondents were asked to select from a list the reasons for their not being able to break out of homelessness.

When the reason for the interviews and the project was explained (see the Survey Information Sheet) all were eager to be involved. Comments were like, "It’s about time something like this was done, sure the money comes in handy." Informants were paid a $20 honorarium. I got the impression that it was the project itself of most interest to most people.

All seemed to be extremely honest, keen to tell there story and craved the opportunity to be heard. Several made aside comments about the difficulties they faced including with agencies, workers and the "system".

Following is a list, in point form, of the issues I observed.

1. All got stuck in a system.

3. There is not enough support and a lack of appropriate support.

4. Centrelink and money issues are common.

6. "Who cares?" –Informant

9. "Then they try to control you" –Informant.

11. Some were very happy with the support and assistance they received.

I felt very deeply moved by the experience and very frustrated that so many people are suffering in society.

I have been a peer educator with several community organisations. My work involved working with people who have complex needs, drug and alcohol issues, housing issues, general health and well being, mental health, homelessness issues and street sex workers’ issues. Recently I have involved in a project to do with people living in rooming houses and homeless clients. We completed a survey interviewing people on their experiences of living in rooming houses and being homeless.

Some of the issues the people were experiencing were of great concern to me. A lot of people had workers to help them with their issues but most of them said the workers did not know the system well enough, to the point the people knew more than the workers. Workers were also constantly changing.

Most of the people I spoke to had to deal with the system for many years. They know where to resource information. However, some people need extra support. If they have a worker that is not doing enough they think, "fuck it", and stay living in accommodation that is too expensive, unsafe and unhygienic. They end up totally isolating themselves within the rooming house. I also spoke to some people that had been in prison and they said life is so difficult when you are homeless that they would rather be back in jail. They simply just give up.

Some rooming houses are like one big family where people help each other out. But, you have people with huge needs that require extra support from workers.

I found a lot of people on State Trustee Orders. However, I was shocked to see they were still without basic needs like clothing, household items and television. I know of people who have enough money, held by the State Trustees, to even have their own flat. They however, have difficulty accessing their money even though they do not have any mental health issues and would be able to manage their money on their own with some support. People are still living with out basic items. What really "pissed them off" was that their worker could not help them with some of their Trustee issues. People wanted to get in touch with their worker but they could not, as they were not available. There seems to be a constant problem of workers not being able to assist. Workers need to be trained to understand a wide range of issues. Housing workers need to be trained in health issues. Health workers need to be trained in housing matters. Workers also need the support of peer educators to assist them. There is a definite need for more outreach to these rooming houses and to people sleeping on the streets. The whole housing situation is in total crisis. The Government desperately needs to build more housing.

There is an adage about living in a rooming house that goes, "If you didn’t have any issues when you moved in you can be certain you will by the time you move out".

During the survey I conducted, I found that one re-occurring problem was medical issues. Depression, boredom, isolation and low self-esteem, more often than not, seemingly led to a cycle of self-medication. An example being substance abuse, whether it is alcohol and/or illicit drugs, used to numb the reality of what at times can be a very debilitating existence. I discovered that even though some of those surveyed had a pre-existing drug issue, the homeless merry-go-round could exacerbate al issues to the degree that to just get out of bed (assuming you have one) can seem an insurmountable task.

The fifty people that participated in the survey, 32 males and 18 females, were in the 30 to 59 age group. Only six per cent of the participants fell into the 20 to 29 age group and the 60 to 69 years old. Therefore, practically all surveyed are currently within their prime working years. Some may have prior medical issues that would prohibit them to gain "normal" employment. Most fell victim to what being classified "homeless" entails.

The reasons and findings people gave for finding themselves homeless initially were medical issues, relationships, and employment/income and living environment.

In relation to regarding the possible obstacles that may assist in the inability to break the homeless or re-occurring homelessness situation, (see Question 10), I deduced from this information as well as certain points being eluded to regularly was that living environment hindered the possibility of rejoining society as a contributing participant. It rose from 6% as a cause of homelessness to 20% as a cause of re-occurring homelessness. As previously mentioned, (see paragraph 2), the atmosphere in Community Rooming Houses is usually anything but communal. Community Rooming Houses (where the majority of my part in the survey was conducted and where I currently reside) can be a breeding ground for self/social isolation, apathy, chaos, poverty and depression so much so that even day to day existence can prove to be an accomplishment itself.

Medical conditions, as previously stated, therefore become more prominent and complex. Substance abuse becomes more prevalent; often sited as a "coping" mechanism, which of course in itself hosts a myriad of problems not only to the substance abuser but also to the other residents, for example, violence. Unfortunately some substances affect certain individuals adversely and amplify an already combustible situation. The dealing of illicit drugs, which is common in rooming houses, often brings with it some of the more dubious people in our society. They have no compunction of abusing their presence with complete lack of regard for other residents; with disagreed needles, noise and arguments that are a by-product of this activity, intimidating others either directly or indirectly by their behavior.

In the mid 1990s changes to the mental health system that led to the closure of many of the old institutions that had previously housed people suffering from various forms of mental health problems. The ‘de-institutionalised’ mental health system led to many people finding themselves in a strange alien environment often lacking the ability of fundamental life skills to cope in the "outside" world. They are with out the assistance of a transitional phase to acquire some practical knowledge and adjustment necessary to cope with living in the community. At the same time the number of crisis accommodation beds was halved. Three quarters of private rooming houses in inner city locations fell prey to gendification and this led to a huge increase in homelessness.

Research indicates that there are clear casual and conventional links between homelessness, poverty and poor mental health outcomes. There is a direct correlation between the periods of time a person experiences homelessness and the worsening of that person’s mental health.

Commonly identified consequences of homelessness include low self-esteem and social isolation.

"Homeless people experience significantly higher rates of death, disability and chronic illness than the general population, access to health services is considerably less than the general population and discrimination is identified as significantly higher." Lynch 2005

Community rooming houses usually consist of such a diverse group of people, seemingly thrown together randomly without any critique or forethought for any individual needs be it physical or psychological. This often leads to a volatile situation, sometimes with very violent results. Residents are left to defend themselves if threatened and the police response is often lax.

Having resided in a community rooming house for the past two years I have witnessed this on many occasions, as well as being a victim. When I first moved in I had my once solid and heavy Tasmanian Blackwood door kicked in. This took some effort persistence whilst I sat terrified inside. Though clearly audible to the entire house not one person came to my assistance. The reaction is, "I don’t want to get involved, not my problem".

The community rooming house I live in consist of two females and fifty males. I felt incredibly vulnerable and agoraphobia developed. Depression turned to manic depression. Other medical conditions have worsened and new ones appeared. I am in the majority, not the minority, further validating Lynch’s findings.

Appropriate medical help and information, about various services, is obtained by word of mouth rather than being informed by Government and agencies. I f you do not know what assistance exists how can you utilise it.

Reproduced below is a reduced sized copy of the survey introduction letter. The letter was read by or to the respondents prior to the completion of the survey sheet.

Hullo,

We are producing an educational video about some of the causes re-occurring homelessness. The video aims to show to workers and students, who may come into contact with homeless people or homelessness issues, the complexities of homelessness and re-occurring homelessness.

Most of the video project workers have experience long term homelessness problems themselves. We hope to be able to show a "view from the ground" and draw up on the experiences of homeless people.

The survey aims to examine some of the causes of re-occurring homelessness and assist the production of the video. Listed on the survey sheet are seven possible causes of homelessness and/or causes of continuing or re-occurring homelessness. The seven causes listed are not displayed in any order. Some people will find that more than one cause impacts upon their situation.The questions are aimed at identifying the issues that impact greatest upon homeless people.

The Australian Bureau of Statistics estimates there are over 20,000 homeless people in Victoria and about 100,000 throughout Australia. However, these figures may not be accurate. Government defines homelessness into three categories.

Primary Homelessness - people sleeping on the street, improvised dwelling, in squats, in cars, in parks or sleeping rough.

Secondary Homelessness - people staying in crisis accommodation, refuges, transitional housing and with other people (couch surfing).

Tertiary Homelessness - people staying in rooming houses or anywhere where residents do not have the protection of a lease and have to share cooking facilities, bathrooms and toilets. Although caravan park dwellers may share similar conditions they are not included in the statistics.

The survey should only take about 10 to 15 minutes to complete. You will be given a $20 honourarium for your assistance. Your name, address or any other personal details will not be recorded and strict privacy considerations will be adhered to. Project Workers have also signed confidentiality agreements.

Thank you for your cooperation.

Prahran Mission & ConnectED

Reproduced below is a reduced size cop of the survey sheet.