6. Options and recommendations
This project has found that there are approximately 3,000 people in the veteran community who are experiencing primary, secondary and tertiary homelessness, and an unknown additional number who may be experiencing housing stress. Military and peacekeeping commitments by the Australian government mean that new groups of veterans and their families may become homeless in the future, unless preventative action is taken now. Coordinated responses are urgently required for the current cohort of homeless veterans, many of whom are ageing and in great need. Planning for the future is also essential to lay a solid foundation to ensure younger veterans and their families are assisted appropriately and do not develop pathways into homelessness, risk and marginalisation.
In recent years the Department of Veterans’ Affairs administrative budget has declined in proportion to the reduced number of living veterans. Consistent with this, DVA has generally moved away from delivering, to purchasing services for veterans, whilst seeking to ensure that veterans can access mainstream services. In particular, DVA has developed various strategies to help ensure that veterans have equitable access to mainstream services such as hospitals, homelessness and health services, aged care and others. Strategies have included the appointment of Hospital Liaison Officers; targeted training and communication packages; and veterans being designated as a ‘special needs group’ in aged care. In some instances DVA has found it necessary to retain program control, with service delivery contracted to mainstream services (eg. Veterans Home Care). For some groups of veterans at risk requiring a specialist response, DVA still provides direct services (eg. VVCS).
A clear rationale can be advanced for a special resource allocation to reduce homelessness among veterans in Australia. Firstly there is the moral argument that no veteran should be homeless, because he/she has made a special sacrifice or commitment to serving their country, including placing their lives at risk.
Secondly military experience, and/or inadequate transition support, can contribute to homelessness, and the government clearly has a responsibility to redress the harm which has been done. The government’s response to veterans with mental illness (including funded initiatives following the Dunt Review) is an acknowledgement of the deleterious impact of active service on some veterans. There is an established link between homelessness and mental illness.
Thirdly, adequately resourced programs, which are targeted to specific groups, can be shown to be effective in eliminating homelessness.
The Commonwealth government’s commitment to reducing homelessness is based on a whole of government response, involving a range of Commonwealth and State government departments. Because veterans represent a relatively small but particularly vulnerable proportion of the total homeless population, it is essential that DVA consistently advances the rationale for a targeted response for veterans, and that this response is supported by new funding and other resources.
Without a separate Commonwealth funding allocation for homeless veterans, it will be difficult for a number of the recommendations detailed below to have ‘traction’. This was the experience of the previous (1998) report. While promotion, awareness raising and education may have short term value, a funding allocation will have real impact and will help ensure that relevant services (including homelessness, health, housing, DVA services and ESOs) develop a particular focus on assisting homeless veterans. Dedicated Commonwealth government funding will also facilitate engagement of States/ Territories and their various departments, to address homelessness among veterans.
Each of the recommendations which follow vary in funding and resource requirements. A number of recommendations require little or no additional funding. Others require funding and resources to help ensure that mainstream generalist and specialist services are aware of, and provide the best possible response to homeless veterans. Most recommendations seek to build on existing service system resources, including the voluntary support of Ex Service Organisations, and existing specialist DVA programs.
A discretionary pool of government funds dedicated to eliminating homelessness in the veteran population in Australia, is required. The funds should be used to support the implementation of the recommendations shown below.
1) It is recommended that the Commonwealth Government provide dedicated funding to address homelessness in the veteran population in Australia.
This section outlines a range of opportunities and options for DVA and the government to ensure that the incidence of homelessness and risk in the veteran community in Australia is more effectively addressed. This section is set out as follows.
Seven broad strategies are presented. Each strategy comprises several recommendations, and each recommendation is preceded by a brief discussion or rationale, and various options for implementing the recommendation. Options are not mutually exclusive.
A multi-level approach is required. Some options require an injection of new resources, others are premised on cooperation and collaboration, and maximising existing systems. Fundamental to progressing the options and recommendations will be the utilization of appropriate organisational structures, both within DVA and between DVA and other key Government Departments.
The 7 key strategies are:
q Strengthen cross government commitment to address homelessness in the veteran community
q Strengthen partnerships between DVA, FaHCSIA and the Department of Health and Ageing
q Improve point of entry responses to homeless veterans
q Contribute to capacity building within the homelessness and veteran specific service systems
q Build on VVCS resources and programs to assist homeless veterans
q Increase early intervention and prevention of homelessness among veterans
q Strengthen on going data gathering and research
6.2 Strengthen cross government commitment to address homelessness in the veteran community
There is at present no formal policy and program responsibility within DVA for veterans’ homelessness. In the first instance a Working Group is required to consider this report, and progress the recommendations. The formal establishment of responsibility for on-going policy and program development would also provide a valuable addition to the existing focus within DVA on health, income support and other areas.
A concerted and coordinated effort to address homelessness in the Australian veteran community requires collaboration between several Departments at Commonwealth and State/Territory levels. Of particular importance are DVA, ADF, Department of Defence, FaHCSIA, Department of Health and Ageing and State/Territory governments. Appropriate use of organisational structure(s) and mechanisms will be required to consider the report findings and to progress selected strategies.
The commitment of the current Government to address homelessness, and the strategies set out in the Government’s White Paper, represent an unprecedented opportunity to develop new approaches to meet the needs of homeless veterans. The Government commitment includes new resources targeted at the most vulnerable and marginalised people experiencing homelessness, including rough sleepers and older people. Veterans are included in both these groups.
An Inter-Departmental Working Group led by FaHCSIA is overseeing the White Paper on Homelessness, and will be a key group to consider the recommendations arising from this research into homeless veterans in Australia. In the context of additional funding resulting from the White Paper, DVA will have new opportunities to advocate for homeless veterans to ensure equitable access to homelessness programs and resources.
2) It is recommended that this report be presented to the Defence Links Steering Committee comprising senior managers of DVA, the Department of Defence and the ADF for consideration and discussion of findings and recommendations that affect each / all organisations.
3) It is recommended that the Inter-Departmental Working Group led by FaHCSIA to address homelessness in Australia be presented with the information, strategic options and recommendations identified in this report, with the request for a response to DVA.
4) It is recommended that DVA develops a formal policy and strategic plan in relation to housing and support for veterans who are homeless or at risk. The policy should be used to inform the development of relevant DVA policy and programs in all related areas, eg. housing, drug and alcohol, mental health, suicide, transition, aged care other. Priority should be given to ensuring that the strategic plan articulates with existing mainstream policy and programs (eg. the homelessness, housing and aged care service systems) at Commonwealth and State/Territory levels.
6.3 Strengthen partnerships between DVA, FaHCSIA and the Department of Health and Ageing
6.3.1 Strengthen the partnership between DVA and FaHCSIA
The estimated number of homeless people in the veteran community represents approximately 3% of the total Australian homeless population. The number and geographical distribution of homeless veterans is such that a separate DVA program for homeless veterans is neither realistic, nor compatible with broader government policy. Australia’s major response to homeless people to date has been through the Supported Accommodation Assistance Program (SAAP), administered by FaHCSIA, and delivered bi-laterally by the Commonwealth and State/Territories, with services provided by hundreds of non government funded organisations.
Partnership arrangements between DVA and FaHCSIA are therefore a logical and efficient way to ensure that homeless veterans receive appropriate assistance, and are not in a position of having to compete with other high needs groups for limited, often targeted homelessness resources.
The Government’s White Paper commitment to address homelessness provides a positive context for innovative initiatives, including joined up initiatives involving other jurisdictions.
5) It is recommended that DVA strengthen its formal partnership with FaHCSIA in relation to veterans who are homeless or at risk, and that DVA continues to advocate for the interests of members of the veteran community in the development of homelessness legislation, policies, and programs.
6.3.2 Ensure veterans are included as a designated target group in new homelessness legislation and programs
The needs analysis undertaken for this project shows that in addition to the disadvantage and marginalisation associated with homelessness, many veterans have an ‘overlay’ of need which renders them particularly vulnerable, and often less able to ‘compete’ for homelessness services.
Overseas precedents which designate veterans as a specific target group include the UK Homelessness Act 2002, and the US McKinney-Vento Act.
Designating veterans as a target group within the new Australian homelessness legislation (and data collection) would help ensure that homelessness services are alert to homeless veterans and are required to provide appropriate responses. Longer term this strategy should contribute to greater understanding within DVA and the homelessness sector of the needs of homeless veterans, and appropriate interventions. The strategy would require that homelessness services collect data and specifically report on veterans, thus contributing to more accurate information about incidence and outcomes.
6) It is recommended that DVA advocate for veterans to be designated as a target group in the new homelessness legislation, and that any new homelessness data collection strategy which is established can identify all (entitled and non entitled) homeless veterans.
6.3.3 Enhance access by homeless veterans to appropriate long term accommodation and support
Access to affordable, appropriate accommodation and support is a critical component to address and to prevent homelessness among members of the veteran community. Supportive housing provides long term secure housing with a range of supports to meet the needs of people who are vulnerable and homeless, and would be a very important option for some homeless veterans. There are several ‘supportive housing’ models being established in Australia at present, for example ‘Common Ground’ projects, and the homelessness White Paper endorses such models.
Possible strategies include the following:
q Facilitate veterans’ access to various supportive housing options as they develop in Australia, through advocacy, resourcing and funding a veteran specific response in new long term supported housing developments.
q Policy change to enable veterans to have priority access to public and community housing (eg. UK government policy).
q Foster the involvement of ESOs in facilitating access by veterans to affordable housing, including ESOs obtaining nomination rights to public housing (eg. RSL Tasmania).
q Promote ESO partnerships with community housing providers to help ensure an appropriate response, and access by veterans, based on the National Rental Affordability Scheme.
q DVA sponsorship of community housing in collaboration with a homelessness based Housing Association which has the capacity to provide appropriate levels of support to residents.
q DVA sponsorship and advocacy for appropriate aged care for older veterans who are or who have been homeless (eg. Wintringham). This could be in the form of a capital contribution, or a guaranteed minimum operating contribution for a specified number of veterans who are, or who have been homeless.
q Rental subsidies (similar to private rental brokerage programs) to enable veterans to stay in communities of their choice.
q Use of the recommended new fund (Recommendation 1) to progress one or more of the options noted above
7) It is recommended that DVA considers and facilitates a range of approaches to contribute to increased access by homeless veterans to appropriate long term supported housing.
6.3.4 Strengthen ACHA’s response to homeless veterans
Homeless veterans are frequently socially isolated and may be reluctant to contact homelessness services, or disclose their veteran status. Homelessness services do not routinely ask people if they have ever served in the military, and are not generally aware of the various specialist services available to members of the veteran community. There are no DVA services which assertively outreach to disadvantaged veterans in the community, rather the system relies on veterans initiating contact with DVA, possibly facilitated by ESOs and VANs.
Assistance with Care and Housing for the Aged (ACHA) is a particularly relevant outreach service for older homeless veterans. ACHA is funded by the Commonwealth Department of Health and Ageing, which recognises veterans as a special needs group.
In addition to building on the mainstream homelessness service system, identifying and engaging with all homeless veterans requires a plan to ensure a comprehensive approach of active and assertive outreach, especially in those areas where no ACHA capacity exists, and where there is considered to be a high proportion of homeless veterans.
Under the option proposed below DVA would collaborate with the Department of Health and Ageing to help ensure that homeless veterans have equitable access to ACHA services. Strategies are also required to ensure enhanced responses to homeless veterans, through appropriate referrals to VHC/ HACC, CACPs, residential aged care and community based health and mental health services.
8) It is recommended that DVA works with the Department of Health and Ageing to develop a strategy to ensure ACHA services proactively identify veterans who are homeless or at risk of homelessness, and that homeless veterans are effectively assisted to access aged care services and alternative accommodation, as required.
Currently a small number of supported accommodation services specifically for homeless veterans exist throughout Australia (although not in every State/ Territory). Model components vary in terms of type and levels of support, lengths of stay, and capacity to meet a variety of veterans’ needs. Of particular note are specialist facilities sponsored by ESOs (eg. Angus House), and the emergency accommodation service provided by VVCS.
While there are different organisational and funding arrangements, most service models exist because of the energy and commitment by ESOs, which represent a potentially significant volunteer resource, and one which is valued by many homeless veterans.
Benefits of veteran-specific services include a culturally appropriate first point of contact, as well as peer support, and a mix of support services most suited to the immediate needs of homeless veterans. Veteran specific services can also provide a reference point/source of information for other mainstream agencies assisting homeless veterans.
As part of a coordinated and enhanced response, it will be important to develop greater consistency and coverage of these veteran specific service models. Government funding, through the proposed expansion of the homelessness program could contribute to the development and/or consolidation of existing services such as Angus House, and through the establishment of new similar services where there is a demonstrated need.
The service model would require further consideration by DVA and State/Territory Departments, but ideally would provide short, and medium term accommodation with links to longer term supported housing as appropriate. As an example, a suitable model for an 8-12 bed facility might include the following:
q SAAP funding for 2 staff and operating costs
q DVA seed funding/ grants for establishment
q ESO involvement
q Peer support, volunteer resources (including sleepover)
q Links to health, mental health and drug and alcohol support including consideration of co-location of some services
q Links with VVCS
q Links with the homelessness service system and long term housing options
A priority is to ensure all facilities operate on a consistent, good practice model, including compliance with homelessness standards.
In addition, increased accommodation could be provided by establishing a designated number of beds in larger crisis supported accommodation facilities, prioritised for homeless veterans. This could be progressed through DVA and State/Territory partnerships, and would need to be operationalised at the local level, with relevant providers (eg. Salvation Army, St Vincent de Paul, Mission Australia, etc.)
9) It is recommended that DVA works with State/Territory Departments, ESOs and other organisations to support the establishment and/or enhancement of a community based veteran specific homelessness supported accommodation capacity where there is a demonstrated need.
6.4 Improve point of entry responses to homeless veterans
6.4.1 Ensure assistance to homeless veterans while eligibility for entitlements is being determined
The research identified that homeless veterans whose eligibility for entitlements has not been established are particularly vulnerable. Suggested processes to assist homeless veterans in the short term while eligibility for DVA entitlements or compensation is being determined include the following. Homelessness agencies could:
- identify homeless veterans by specifically asking ‘have you or your partner ever served in the military?’, thus also providing important information about the number of veterans contacting the homelessness service system
- directly provide a range of appropriate assistance
- ensure that homeless veterans are effectively referred to/ assisted by other relevant services
- engage homeless veterans in a process of establishing eligibility for benefits
- coordinate with veteran specific services, particularly VVCS, and VANs with a view to fast-tracking applications.
The Canadian Veterans Ombudsman has suggested that homeless veterans should be assisted with a daily payment until eligibility is determined, assuming (as a point of departure) that homelessness has resulted in part from military service.
Consideration should be given to the availability of a subsidy in Australia, which would focus the attention of homelessness services on veterans, and potentially reduce the number of veterans who might be turned away from homelessness services.
10) It is recommended that DVA develop a range of processes to assist homeless veterans in the short term while eligibility for DVA entitlements or compensation is being determined.
6.4.2 Enhance access by veterans to homelessness outreach services
In addition to ACHA services (see section 6.2.4), there are a number of other relatively small scale services in the community which assertively outreach to people who are homeless or at risk of homelessness. These include some mental health services, inner city community health services, primary health care services, and day and drop-in centres. Some of these services are aware of veteran status, and provide appropriate responses.
The Australian Commonwealth Government White Paper proposes the introduction or strengthening of assertive outreach programs to rough sleepers, and the expansion of ACHA services.
- training and support for outreach workers regarding the specific needs of homeless veterans and services available.
- funding options to meet some additional needs of homeless veteran clients, if alternative funds are unavailable.
- advocating for changes to assessment tools and data collections of outreach services, to incorporate veteran status.
- development of a veteran homelessness liaison role to ensure mainstream and specialised outreach services are alert to homeless veterans; to provide information, and to coordinate appropriate (cross) training and support.
11) It is recommended that DVA develops a framework to ensure veterans have equitable access to new and existing homelessness outreach initiatives. This includes DVA developing, and advocating for strategies which will ensure homelessness and outreach services identify and respond to veterans who are experiencing or at risk of homelessness.
6.5 Contribute to capacity building within the homelessness and veteran specific service systems
6.5.1 Strengthen training, joint initiatives, working groups, and networking strategies
There is a need to strengthen the links between homelessness and veteran specific service systems to ensure enhanced coordination of services to homeless veterans.
q Ongoing training for homelessness services regarding veterans’ needs, and available supports. This information needs to be practical and focused on the specific needs of homeless veterans and services required, and additional resources and specialist services which may be available. Experience with the previous information kit (1999) shows that one-off training and promotional material will not provide a lasting commitment or systemic improvement in the response of homelessness services to veterans.
q Ongoing training for DVA and affiliated services such as VVCS and VANs, and ESOs regarding housing, homelessness and support services available for homeless veterans.
q Joint organisational initiatives aimed at identifying and assisting homeless veterans (eg. VANs/ VVCS, ESOs and homelessness agencies). Possible approaches include referral protocols, joint working groups, shared/ reciprocal training, secondary consultation, and practical partnerships.
q Establishment of a dedicated (non government) working group to represent the interests of homeless veterans, and promote collaborative approaches to address veterans’ homelessness. ESOs could apply for DVA grant funding to establish such a group, provided the proposed group is collaborative, representative and appropriately focused, and does not overlap with the role of pre-existing groups.
q Appropriate level of participation by DVA, VANs, VVCS, and ESOs in homelessness networks, forums, and working parties. A range of current networks are in place at various levels in each State/Territory. Some VANs already participate in homelessness networks.
12) It is recommended that DVA develops strategies to strengthen links, knowledge and understanding within and between the homelessness and veteran specific service systems. Strategies include ongoing training, joint initiatives, a dedicated representative group, and joint participation in networks and forums
6.5.2 Pilot a veteran specific homelessness liaison role
There is a need for a formal approach to ensure homeless veterans are assisted in a timely, coordinated way, and to facilitate ongoing communication and coordination between homelessness and veteran specific services.
A veteran specific homelessness liaison role could be investigated. The purpose of the role would be to help ensure that homelessness and other outreach services (including SAAP, ACHA, mental health, primary health care) are aware of, engage with, and respond to the needs of veterans who are homeless or isolated.
There could be three parts to this role:
- providing information, advice, secondary consultation, and education about housing, support services and DVA entitlements, to homeless veterans and to relevant agencies
- providing assertive outreach assistance to identify and assist some veterans directly (providing information, advice, practical assistance, preliminary assessment and supported referral)
- networking and service system development.
The liaison role would include facilitating or providing supported referrals to homelessness, support and DVA affiliated services, as required, and provide tailored responses where veterans are averse to being in contact with service related organisations. The homelessness liaison role would be based initially in key areas where there are greater numbers of homeless veterans (eg. inner city areas).
Approaches to implementing this option include:
- Collaboration between DVA and State/Territory Departments to pilot a veteran specific homelessness liaison role in 3 capital cities, (based in SAAP and/or outreach services), with dedicated funding (consistent with the new White Paper initiative to target ‘rough sleepers’)
- Establish homelessness liaison as a designated role within VAN offices, with formal links to homelessness services (it is unlikely that this role could be performed solely by existing VAN staff without formal training and induction into the area of homelessness). Arrangements for co-location could also be made with major homelessness crisis or outreach services.
13) It is recommended that DVA and State/Territory Departments collaborate to establish a veteran specific homelessness outreach liaison role in the inner city areas of Melbourne, Sydney and Brisbane, and that this is reviewed for effectiveness, consistency and potential replication in other key areas.
This project has demonstrated the importance of veterans at risk having access to timely and appropriate housing advice and assistance, in order to prevent homelessness. Preventing homelessness following forced departure or eviction from all tenures, is a key strategy of the homelessness White Paper. Government commitments going forward include both financial (rent and other) assistance, as well as support to maintain a tenancy, where appropriate.
One of the first challenges is to identify veterans whose tenancies are at risk. ESOs and VANs have some capacity to identify veterans who are renting and at risk, but do not necessarily possess the knowledge or resources to provide all the appropriate assistance. ESOs are ubiquitous, and there are existing resources which could be well utilised to provide timely and accurate advice to assist homeless veterans, or veterans experiencing housing stress together with other risk factors. Resources include ESO Welfare Officers, Aged Care Advisors (in Victoria), and Day Clubs (to connect isolated veterans).
DVA funds an existing, well organised Training and Information Program (TIP) for ESOs, which could readily be updated to incorporate housing and homelessness issues. ESO representatives would only be expected to identify homeless veterans, or veterans at risk of homelessness, and provide supported referral to an appropriate agency. Currently there is limited awareness among ESOs about the complexity and inter relationship between homelessness, mental illness and other issues. It is intended that revised training would in part address this issue.
Training would need to include a component which would seek to address conservative views about homelessness, should they exist.
Incorporation of housing and homelessness information in TIP training is an important first step in achieving enhanced identification and responses by ESOs to homeless veterans and veterans at risk of homelessness.
14) It is recommended that the Training Information Program curriculum is updated to include information on housing, homelessness and appropriate referral sources for homeless veterans.
6.5.4 Develop an ESO - Statewide housing advice and referral capacity
One of the key findings from the review is the variation in knowledge amongst ESOs about housing and support options for homeless veterans and veterans at risk of homelessness. A Statewide housing advice and referral capacity for veterans at risk could be established in each State/Territory to assist homeless veterans, as well as those experiencing housing difficulties and other risk factors. The Statewide role would take referrals from, and provide information to ESO welfare and pension officers, VAN offices, VVCS staff, and other organisations which are in contact with veterans (HACC, VHC, CACPs providers).
The Statewide role would provide consistent, up to date housing information and advice, and make supported referrals to relevant services such as housing and homelessness services, tenants’ advocacy services, community housing associations, retirement villages, aged care housing, etc.
Some ESOs (eg. RSL in Victoria) already have some capacity to provide housing advice and assistance at State level. In addition, Aged Care Advisors (in Victoria) currently provide advice on aged care housing options.
The proposed role could be undertaken by one or more people in each State. The most useful location of the position would probably be State offices of major ESOs. ESOs might initially establish a housing advice and referral role using DVA grants or other grants.
15) It is recommended that DVA engage the ESO community to develop the capacity to provide a statewide housing advice and referral role in every State/Territory, which would include housing advice and assistance to homeless veterans, and those whose tenancies are at risk. It is recommended that DVA consider providing grant funding to develop this capacity.
6.5.5 Enhance capacity of VANs to respond to homelessness and risk
VANs have some capacity to identify veterans at risk who are living in private rental accommodation or substandard accommodation, and could provide information, advice and referral. DVA and VANs will need to keep track of initiatives within the homelessness sector which aim to prevent homelessness by supporting ‘at risk’ tenancies, and establish links with relevant services. Importantly, VANs need to have relevant information about housing and homelessness services, should veterans require assistance in this regard.
16) It is recommended that the capacity of VANs to provide assistance and advice on housing matters is enhanced through ongoing awareness raising strategies, and that staff are provided with relevant information and resource material to ensure appropriate referrals.
6.6 Build on VVCS resources and programs to assist homeless veterans
The VVCS provides counselling and group programs for veterans and their families, and has recently introduced a case management role into the service model. In terms of its capacity to assist homeless veterans, it may be most appropriate for VVCS to provide direct assistance to veterans who are at risk of homelessness due to imminent or recent relationship breakdown, rather than those who have been homeless for some time. Consideration could be given however, to VVCS strengthening its case management response to veterans who are experiencing homelessness, through formal collaboration with crisis supported accommodation services and other homelessness and outreach services.
The range of direct assistance for homeless veterans to which VVCS could make a valuable contribution include co-case management, supported referral to appropriate generalist and specialist services, counselling and secondary consultation to homelessness and other services regarding veteran specific issues. Of particular note is the need for VVCS to ensure veterans are linked to appropriate mental health and drug and alcohol services, as co-morbidity of these issues with homelessness is high (see also Section 6.7.4).
In addition, there would be significant benefits in the VVCS emergency accommodation program being re-configured to ensure a more accessible and appropriate response to veterans experiencing housing crisis and homelessness. Re-configuring the VVCS emergency accommodation program would require changing the eligibility criteria so that people with substance abuse and behavioural issues can be assisted. It will be essential to formally link support to provision of emergency accommodation. This will require developing formal linkages with the homelessness (SAAP) system (including development of protocols or MoUs), and positioning VVCS crisis support services within the broader suite of mainstream crisis supported accommodation options.
17) It is recommended that the role of VVCS in relation to homeless veterans be clarified, and that strategies are developed to ensure VVCS contributes to improved early identification and outcomes for homeless veterans, through collaboration and co-case management with homelessness and other services.
18) It is recommended that DVA consider redeveloping the emergency accommodation program managed by VVCS to ensure access by veterans who are homeless and at risk, including those with complex needs. Links with dedicated homelessness and crisis support services will be essential.
6.7 Increase early intervention and prevention of homelessness among veterans
6.7.1 Provision of enhanced mental health, alcohol and drug and counselling services for homeless veterans
The inter relationship between homelessness, mental health and drug and alcohol misuse has been well established. Mental health and drug and alcohol issues can be causative factors, as well as consequences of homelessness.
It is important to ensure that homeless veterans have equitable access to appropriate mental health, drug and alcohol and counselling services, as part of a prevention and intervention strategy. Good access implies that these services are financially, geographically, and ‘culturally’ accessible to veterans.
Homeless veterans may be reluctant or unable to approach some services, and/or may be itinerant and lose contact with services, placing them at greater risk. This can occur at any stage following discharge from the military. It will be important to develop strategies to help veterans maintain links with health, and mental health and drug and alcohol services, as appropriate, following discharge.
Any strategies which are developed relating to mental health and drug and alcohol issues will need to consider matters arising out of the Dunt Review. In response to the recommendations of the Dunt review, the government has committed $83 million over 4 years to enhance services to veterans with mental health issues. A range of initiatives are being funded, some of which may contribute to the prevention of homelessness. For example, funding has been provided for 13 case coordinators to work with ‘at risk’ veterans.
19) It is recommended that DVA seeks to ensure that the development of new mental health policies and programs for veterans, for example those arising from the Dunt Review, and other research studies, specifically take homelessness into account.
6.7.2 Assist veterans to stabilise relationships, address family violence
Stable family relationships are a critical ‘protective factor’ for veterans who might otherwise be at risk of, or drift into homelessness, especially in the period following discharge from the military. Various research shows that veterans and spouses appear to be at higher risk of a domestic violence relationship than the general population. This may be associated with the effects of military experience, the effects of PTSD, and/or difficulties experienced by some veterans in transitioning to civilian life.
Relationship breakdown and domestic violence may also occur while a member is in the military, and this requires further research by the Australian Defence Force.
VVCS has a potential role in accurately identifying when domestic violence is occurring, or when risk factors are present, and appropriately assisting veterans and their families. One strategy is for VVCS to develop a greater focus on preventing family violence and relationship breakdown.
In the first instance a sound evidence base is required regarding the prevalence and nature of domestic violence in veterans’ families. This would provide an informed basis on which DVA would consider appropriate strategies. Strategies might include VVCS developing or linking into specific family violence prevention and intervention programs, and establishing formal linkages with the family violence sector.
Research is also required to identify critical points at which relationships start to break down and/or domestic violence commences, and consideration should be given to the potential roles and responsibilities and strategies by the ADF and DVA in relation to those findings.
20) It is recommended that the prevalence of family violence in the veteran community, and the role of VVCS in assessment, screening and linking/referral processes are reviewed, and enhanced responses are progressed through linkages with mainstream family violence services and perpetrator programs.
6.7.3 Ensure veterans are adequately supported during transition to civilian life
Transition from military to civilian life is a critical period when risk factors for homelessness may develop. The discharge experience for some veterans appears to be characterised by inadequate preparation, lack of relevant job skills, and harmful impacts of both the military and discharge experiences.
Sometimes a lack of understanding by family, friends and the community of the challenges faced by veterans, compounds difficulties experienced in the transition process. A consistent approach is required which provides support with preparation, acquisition of appropriate housing and job skills, and strategies for re-integration within family and community.
Preparation for leaving the Defence Forces, and settling into civilian life could commence several months prior to leaving. Support and leadership from the Commanding Officer for transitional programs such as Stepping Out, are identified as important. Other options include mandatory participation by personnel in transitional (exit and resettlement) programs; assessment of individual risk factors, and development of plans and strategies to reduce risks. These options would aim to ensure adequate living skills, and provision of training opportunities for veterans.
Re-training and employment assistance could be further developed for all veterans transitioning from the military.
- linking the level of assistance to length of service.
- DVA encouraging companies to sponsor training for veterans as a community contribution
- creating an employment training and placement program specifically for homeless veterans
- facilitating partnerships between mainstream providers, for example Job Search, disability employment network, educational institutions and employers to create opportunities for veterans (this would recognise re-training needs, existing skills, etc.)
- providing employers with incentives to employ veterans, and employment subsidies (eg. tax incentives)
- the ADF retain selected personnel who would otherwise be discharged on medical grounds, and provide training in non active (administrative support) functions.
21) It is recommended that DVA and ADF collaborate in the development and/or strengthening of an enhanced training and employment strategy for veterans transitioning out of the Defence Forces.
Research shows that isolation and exclusion are key factors in homelessness. One strategy would be for members to maintain continuity of engagement with health and other services during transition from the military to civilian life (post discharge). Active case management by DVA, VVCS, or subcontractors, for veterans who are experiencing significant health and mental health issues following discharge would be one strategy aimed at achieving continuity and enhanced access to health and other services. Another strategy is for VVCS case management to be provided for 1-2 years, if a veteran is assessed to be at risk following discharge.
Follow up by DVA (and ADF), and maintaining contact with veterans for a period post discharge is a good preventative measure that may well identify and assist in addressing other needs. DVA is currently establishing a ‘Keeping in Touch’ program (one of the recommendations of the Dunt Review). This strategy can provide cumulative information about how veterans fare following discharge, and feedback into programs which can assist personnel during and after discharge.
In addition to the strategies noted above, access to counselling and support to facilitate reintegration with family and community is important for some veterans. Strategies are required which will help ensure a family and community based approach. Families provide structure and stability, and without family or community supports, veterans with predisposing factors may become isolated and drift into homelessness. Counselling and support is thus ideally provided within a family context, where appropriate.
While veterans may reject assistance at the point of discharge, ideally they would have the opportunity to access assistance and advice for a period of time after discharge.
22) It is recommended that DVA and the ADF strengthen and enhance transition programs and processes (consistent with the recommendations from the Dunt report), to ensure that veterans at risk of homelessness post discharge are provided with appropriate supports to re-integrate with family and community.
6.7.4 Develop increased rehabilitation options in the areas of mental health, and substance abuse
The White Paper stipulates that no person should be discharged (from any service or institution) to homelessness. Consistent with this in-principle commitment, health and mental health services (including detox facilities), should be required to assess the prospective housing situation of each veteran being discharged. For veterans with higher levels of need who are finding it difficult to live independently, this will entail the hospital or health service arranging appropriate on-going support as and when required.
There is a demonstrable need for medium term rehabilitation assistance for a proportion of homeless veterans. One strategy is for a mental health and/or drug and alcohol rehabilitation program, to be co-located with repatriation, or veterans’ psychiatric services. The proposed model would provide extended rehabilitation and preparation for independent living for veterans who have been hospitalised for mental health and/or drug and alcohol misuse, and who have no other supports. There are several organisations which support such an approach (including the RSL).
Rehabilitation programs (accommodation and support) would help to prevent veterans from being discharged to chronic homelessness.
Progressing this option would require:
- further review and analysis of the number of veterans who might benefit from medium term rehabilitation
- development of appropriate model(s) (location, capacity, length of stay, expected outcomes, roles of medical, psychiatric and community based organisations, staffing, program components, exit options, etc.).
- assessment of the value of such model(s), in terms of reduction in inpatient days and health services (due to recidivism); compliance with the requirement not to discharge people to homelessness; benefits to individual veterans, other.
23) It is recommended that further analysis is undertaken to determine the need for, and viability of mental health and drug and alcohol short to medium term rehabilitation assistance for veterans exiting inpatient care.
For the future, it is a priority for DVA to examine different approaches for gathering data on homeless veterans, in order to maintain an accurate understanding of the ongoing incidence of homelessness in the veteran population. Approaches to obtaining data will depend on the practices of relevant departments and organisations.
Pre-existing national programs such as SAAP and ACHA could collect relevant veteran specific data in their main collections, and provide DVA with regular reports. Services purchased by DVA which involve outreach (eg. VHC and community nursing) could collect data and report on housing circumstances where veterans are at risk.
DVA may also negotiate with appropriate State/Territory departments to obtain data from state based outreach services, such as mental health outreach teams, other
Data collection and research will inform and support several of the issues identified in this report, and in particular:
· The development of policy and strategic planning (Recommendation 4)
· Analysis of veteran specific homelessness data (Recommendation 6)
· Equitable access by veterans to relevant outreach services (Recommendation 8,11)
· Review of homelessness liaison role (Recommendation 13)
· Providing information for capacity building including training (TIP) (Recommendation 12, 14, 15)
· The prevalence of family violence in the veteran community (Recommendation 20)
· Establishing the need for a medium term rehabilitation program linked to mental health, drug and alcohol inpatient care (Recommendation 23)
24) It is recommended that a data gathering strategy be developed in relation to homeless veterans, and veterans at risk of homelessness, in order to inform ongoing policy and program development.
Back to Table of Contents