Jordan, a 21-year-old male, was accepted into the Boost Program, moving into a 1-week Short Stay bed at the Brunswick West refuge. Jordan engaged well with his BOOST specialist case managers. At the completion of his Boost stay, Jordan was offered and accepted into a 6-week refuge bed stay within the refuge. At the time of referral, Jordan was experiencing significant family displacement and transience which resulted in homelessness.

Through his time at the refuge, Jordan worked diligently with the support of their specialist case manager and developed a case plan noting his goals. Jordan was very eager to gain employment and to find longer term accommodation, a Victorian Housing Register (VHR) housing application was completed, and a referral was made to the Bolton Clark Youth Homelessness Nurse (visits Hope Street refuge) to support him with medical, dental and optometry needs.

Throughout his time at the refuge the Boost specialist case manager completed a referral to a Transitional Housing (THM) property managed by VincentCare. The outcome was successful in Jordan obtaining the property. Jordan moved into the property shortly after.

Jordan was recently successful in obtaining a Community Housing long-term property in Prahran and the Boost specialist case manager has assisted with this transition providing support with information around the bond and rent in advance, supporting him to obtain furniture and settling into his new home.

Hope Street acknowledges the Wurundjeri People, the Traditional Custodians of the land on which we operate.

October 14th marked a year since the Referendum on a Voice to Parliament. Hope Street Youth and Family Services proudly supported the First Nations Voice to Parliament and accepted the invitation offered through the Uluru Statement from the Heart, acknowledging that it was developed through consultation with First Nations people across Australia.

The Hope Street staff and Board are committed to the principles of self-determination, social justice, access, and equity. We commit to walk hand in hand with our First Nations people, partners, and allies, to yarning, listening, learning, and owning our responsibility for educating ourselves, and enhancing our knowledge. In doing so we aim to strengthen cultural safety for First Nations young people and their children accessing our services.

Drawing on our values of; Fairness, Collaboration, Social Justice, Integrity, Diversity and Hope, we stand in solidarity with First Nations people, partners, and allies, committed to ongoing learning, identifying ways of how and where we can improve our ongoing commitment.

Donna Bennett, Chief Executive Officer.

October 10th is both World Mental Health Day and World Homeless Day. At Hope Street, young people experiencing homelessness are supported through counselling and a safe place stay. It is well understood that individuals with mental health conditions are at heightened risk of homelessness and that, in turn, homelessness exacerbates the risk and severity of mental illness.

*Originally published in Volume 37- Issue 3, edition of Parity, Chapter 3.

Comprehending the missing pieces of the mental health system and youth homelessness services begins with early intervention psychological and mental health support with established community outreach services and local GPs. Fair and equitable access to mental health services is vital to ensure at risk vulnerable young people receive the services they need to function day to day.   This starts with access to bulk-billing doctors. Unfortunately, many young people find such services out of reach due to cost and a lack of established connections to primary healthcare providers which makes it difficult for young people to keep track of their health conditions or to receive a mental health care plan for better targeted health care. 

In Victoria, the Inquiry into Homelessness and Royal Commission into Mental Health, highlighted that primary health services, mental health plans and youth homelessness services are inherently linked to affordable medical treatment from bulk-billing GPs and a long-term plan to provide support to people that present to services, beyond just 10 sessions. The need for better healthcare for vulnerable young people to succeed with interdependent living is connected to robust housing solutions with wrap around support services.   

It is well understood that individuals with mental health conditions are at heightened risk of homelessness, and in turn, homelessness exasperates the risk of and severity of mental illness. This is so evident that the CEO of Mental Health Australia Frank Quinlan stated, “poor housing and housing stress, together with other life stresses, reduce psychological wellbeing and exacerbate mental illness”. Yet, those who are recognised as being at such heightened risk, or presently experiencing such severity, find it the most difficult to access robust, best practice services primarily due to the unaffordability of health care and early intervention mental health support.  

There are many conversations, reports and papers in the media, unions, social services sectors and individuals on the strain on health and support services for the working poor, people on social benefits and income poor people.   From these reports and Hope Street experience with young people the norm seems to be extended wait times, sometimes more than 6 months, financial out of pocket cost to access general or specialist medical care. While there was an increase to the Medicare Benefit Schedule (MBS) bulk billing incentive payments in November 2023 for concession card holders and children under 16, it remains difficult to see improvement in affordability for the young people and children who Hope Street provide essential support.  With no demographic experiencing this harsh reality greater than those experiencing homelessness, the most severe being unaccompanied children and young people experiencing homelessness who lack the knowledge or finances to navigate the health care system.  

On the 3^rd of February 2021 the Royal Commission into Victoria’s Mental Health System delivered its final report with recommendations grouped around four key features: 

·        1. A responsive and integrated system with community at its heart.  

·        2. A system attuned to promoting inclusion and addressing inequalities.  

·        3. Re-established public confidence through prioritisation and collaboration.  

·        4. Contemporary and adaptable services.  

On the surface, there appears to be strong, proactive recognition and prioritisation of mental health in the community.   Yet what Hope Street Youth and Family Services team members witness is the harsh reality that those in most in need of services face the greatest barriers in accessing services. Hope Street is not isolated in this experience, according to Orygen’s ‘Productivity Commission Draft Report into the Social and Economic Benefits of Mental Health, the provision of accessible mental health services for young people is outlined in their submission to the Productivity Commission. ‘Many young people do not seek help. Young people aged 15-24 with a mental health condition were almost twice as likely to not see a GP because of cost barriers compared with those without a mental health condition and two and a half times more likely to delay or not get prescribed medication due to cost compared with those without a mental health condition.’ 

As always, the answer sits with greater funding, advocacy, and prioritisation by all levels of government regardless of political party. As service providers inter-organisational collaboration and wrap around (multidisciplinary) support is essential to assist and resource young people and children to overcome their hardships and promote multidimensional self-actualisation. In practice, as a service model, Hope Street provides young people with residential support workers, case managers, youth reconciliation (counselling) practitioner and the Bolton Clarke Nurse, as well as link in support to other services such as a local GP. The challenge is that more funding is needed for mental health services to support young people with no wait times. This would mean bolstering the workforce responding to youth homelessness with a robust mental health practitioner workforce for early intervention. Arguably, there needs to be more funding for early-intervention mental health support specific to the established youth homelessness service providers, across Victoria and around Australia. A significant gap for young people experiencing acute mental health issues and presenting to psychiatric wards is a specialist who can liaise between homelessness service providers, social services and mental health practitioners. There is a lack of homelessness specific understanding for mental health practitioners, currently there is no designated role in psychiatric units dedicated to servicing the youth homelessness service sector .  

According to Orygen’s Productivity Commissioner Draft Report into the Social and Economic Benefits of Mental Health: ‘Young people aged 15-24 with a mental health condition were almost twice as likely to not see a GP because of cost barriers compared with those without a mental health condition and two and a half times more likely to delay or not get prescribed medication due to cost compared with those without a mental health condition.’ (Orygen Institute, Health Economics and Cost).  

To access primary youth mental health services, commonly a mental health treatment plan is the first hurdle to overcome. Having a young person willfully engage with a GP to ascertain the mental health treatment plan can encounter the barriers of their own historical marginalisation or trauma through self-recognition, then financial. If a bulk billing clinic is in an organisation’s local area it can make it more affordable for clients, if not, then State Government must do more to organise how accessible GP clinics are to different areas and provide incentives for affordable bulk-billing GP clinics to operate and provide primary care. “Early intervention for young people experiencing mental health issues and other health issues during or after homelessness is a means to prevent their healthcare from deteriorating further.”- Sue Scott, Operations Manager, Hope Street.  

In Victoria, there is a need for healthcare reform that protects through legislation, the right to accessible medical care, including mental health services that is affordable and acts as a means of early intervention before a young person experiences an acute mental health issue due to a lack of affordable services. The protection of young people on low incomes to receive State funded mental healthcare would alleviate pressure on the already strained hospital system. Headspace confirms the link between homelessness and mental illness for young people: ‘Homelessness is a risk factor for mental and physical ill-health and mental illness is a risk factor for homelessness. 48-82% of homeless young people have a diagnosable mental illness (including mood, anxiety, substance use and post-traumatic stress disorders),’ the lack of adequate funding for specialist services that provide support to this vulnerable cohort is not acceptable and further marginalises young people and increases the risk of homelessness and acute mental health issues.  

“Due to a lack of support and a lack of sustainable housing options for young people with complex mental health issues and / or emerging psychological issues, the risk of becoming homeless long term inevitably increases. This is a loss of opportunity and an immediate and short to long-term cost to community as vulnerable people continue to remain disconnected from society and their health and mental health further deteriorates.” Sue Scott, Operations Manager, Hope Street Youth and Family Services.  
 
To link a young person to mental health support has its challenges, due to financial constraints and due to private providers being unable to accommodate at risk young people experiencing homelessness that are on low-income. The health care and mental health services infrastructure that accommodates young people experiencing or at risk of homelessness needs to be protected by legislation to ensure that as Victoria grows in population and urban spawl, services can match the community's demand.  

At present, Hope Street has two successful models that have been tested, one for 10 years and one for over 30years, to provide support for young people with general and specialist health crises as well as dual diagnosis crises. The Homelessness Youth Dual Diagnosis Initiative (HYDDI), and the Youth Homelessness Community Nurse, referred to as the ‘Bolton Clarke Nurse,’ has demonstrated its enormous benefit to a young person’s health with flow on economic benefits to the wider community.  Based on a youth crisis (refuge) service co-location model to respond immediately to young people’s needs when at crisis point and first entry to the youth homelessness sector these two specialist health programs are unique and highly successful. “To complement the youth homelessness services sector, these models can be scaled up across Victoria and around Australia with adequate funding. The ideal outcome would be to scale up these successful service models to enhance the current system, which has significant gaps due to lack of funding. This service model could be matched with opportunities for long-term social housing options including wrap-around support and would work directly with youth homelessness service providers and their in-house mental health teams, public healthcare providers such as GPs, hospitals and youth psychologists.” Sue Scott, Operations Manager, Hope Street Youth and Family Services. Currently, the need for the continued successful models to be funded and scaled up are the HYDDI model and the Bolton Clarke Homeless Persons Program Youth Nurse service is evident in the demand for youth homelessness services and the intersection between homelessness and health, including mental health.   

It is fortunate that in Hope Street Youth & Family Services’ case they have a strong relationship with a local area clinic where they have willingly provided bulk billing exclusively to clients in the inner Northwestern metro area, however, this isn’t guaranteed for all services and is a testament to said clinics proactive community care. Following accessing the clinic and gaining a mental health treatment plan, the primary barriers are now presented. Wait times following referral, and support options. The mental health treatment plan, being part of the Better Access Initiative, entitles an individual up to 10 individual and 10 group sessions with a mental health professional in a calendar year, starting with 6 sessions then a review by the referring doctor to determine if the further sessions are required. These sessions are subsidised or free, however, if there are any mental health services in one’s area providing free support then commonly, they have the greatest wait times (with no prioritisation on vulnerability) and following sessions being subsidised there can still be an out-of-pocket cost anywhere between $70-150 per session.  An unsurmountable expense when a young person’s weekly income is $256 per week and shelter and food are an essential priority. 

Finally, if some of the most vulnerable individuals are unable to access responsive mental health support due to excessive wait periods (3-6+months) they can continually destabilise to the point of becoming acute (significant and distressing symptoms requiring immediate treatment), requiring the Youth Assessment & Treatment Team (YATT) or police connecting to the area mental health triage, potentially leading to compulsory assessment and treatment as per the Mental Health and Wellbeing Act 2022. At this point the cost to the wider community increases significantly, when it could have been prevented. 

This overview serves the stark reality that many homeless young people encounter when navigating their mental health journey. That is, the difficulty to proactively engage with general and specialist health services, to the point where one destabilises and support is mandated for them, commonly reported as a de-humanising experience, regardless of legitimacy of care. The situation is also exacerbated by the housing crisis, severe poverty, cost of living crisis and social isolation.  

During this current housing and mental health crisis, services on the ground must be a government priority. In the Northeast areas of Melbourne, Hope Street Youth and Family Services is fortunate to have a Youth Reconciliation Practitioner to provide free, accessible counselling to young people experiencing homelessness. The need to have responsive, robust mental health support where it can meet young people in safe and neutral locations only highlights the clear need for further expansion of this role to encompass a team of practitioners, rather than a handful of youth and family reconciliation practitioners funded through specialist homelessness dollars, scattered across various metropolitan regions. Commonly, Hope Street young people are deemed too complex when referred to ongoing, youth focused services (public or private) and it has resulted in area mental health triage direction to contain young people as long as possible, then escalate to police when they become acute. This is neither sustainable nor acceptable for a youth mental health ecosystem. Now, more than ever, there needs to be strong, clear leadership standing up for the most vulnerable members of society, signaling to young people they are valued citizens as part of this community and that they can provide value to the community. Developing the youth homelessness workforce requires career pathways for more psychologists and mental health practitioners that specialise in youth homelessness. In reflection of the Royal Commission, resources must support the growth of the mental health workforce to provide comprehensive services to the youth homelessness sector.   

Solutions need to also include a greater expansion of youth services, significantly increasing capacity to provide youth focused support, specialist youth accommodation and housing options for young vulnerable Australians.  This is paramount to lifting Australia towards its mantra of equity, opportunity, and a fair go.  A lack of action on community, State and Federal levels to provide early intervention mental health in tandem with housing options, further marginalises an already vulnerable population in crisis and prevents them from achieving their full potential as valued citizens.  

Community unites to support young people experiencing homelessness in the City of Whittlesea 

In 2018, Hope Street Youth and Family Services embarked on a new project to provide supported crisis accommodation solutions to young people and young families experiencing homelessness in the City of Whittlesea. This is part of Hope Street’s vision for a society in which all young people and young families have a safe place to call home.  

‘Community wide partners are important for completing milestones that have a meaningful impact on youth homelessness.’ - Donna Bennett, Chief Executive Officer.  

Our philosophy is that resolving homelessness is the responsibility of federal, state and local governments; the community; families and individuals. Hope Street believes that young people have the right to safe, secure, affordable housing and to be treated as equal citizens in our society. This means equal access to resources, decision making and life options.  

Hope Street has spent six years on this important project that will be part of the community as a leading response to youth and young family homelessness in Victoria. Hope Street’s therapeutically designed First Response Youth Service sites are nation-leading to support young people and their children in need of safe accommodation and on-site wrap-around services. 

As a niche youth homelessness service provider, Hope Street collaborated for community needs with Local and State governments to address crisis level youth and young family homelessness in this fast-expanding growth corridor. This project has been developed in partnerships with the City of Whittlesea local council and the State Government’s Big Housing Build with significant support from the local Member for Mill Park, Lily D’Ambrosio, Federal MP Andrew Giles and the City of Whittlesea Chair Administrator Lydia Wilson.  

Through the State Government’s Big Build Youth Housing Grant, which was announced in December 2021, Hope Street applied for funding to build and operate a First Response Youth Refuge in response to community need. Through this initial grant Hope Street has been able to commit to building this new centre on land, leased from the local council and in Wurundjeri country.  

In 2022 Hope Street’s Board signed a contract to build a brand-new facility in the City of Whittlesea and consulted with Brand Architect for the design plans.  Thanks to the support of HWL Ebsworth Lawyers for their pro-bono legal consultation, this vital community project entered the next phase. 

Property Industry Foundation and Mirvac became key partners and came onboard in 2022 to support this project as industry leaders to advance youth housing solutions to address youth homelessness in Victoria. This newly designed youth and family centre showcases how to achieve great outcomes for the community services sector through targeted and tailored resources for young people and young families impacted by major disadvantage and homelessness. 

On Census night in 2021, 854 young people in the City of Whittlesea were recorded as experiencing homelessness, with many more suffering from housing stress and at risk of becoming homeless as cost-of-living pressures increase. On any given night, around 28,200 young people aged 12–24 years were estimated to have been experiencing homelessness on Census night in 2021, making up nearly a quarter (23%) of the total homeless population (ABS 2023). 

A sod turning event in April 2023 included Lily D’Ambrosio, City of Whittlesea local council and Minister for Housing Colin Brooks MP. The build site had an official Smoking Ceremony a couple of months later in June with Aunty Joy Murphy Wandin AO, a Wurundjuri Elder actively involved in Aboriginal Affairs for over 30 years and held positions in executive policy and community development in all levels of government.  The land features a beautiful gum tree which embodies the spirit of connection to country, and this new location will feature a designated unit for Aboriginal young people and their children. 

Construction commenced in October/November with concrete slabs down by the end of 2023 just in time for summer. As frames were up by April 2024, the site was visited by local Government including local youth mayors, and Chair Administrator Lydia Wilson.  Lily D’Ambrosio, Member for Mill Park and Andrew Giles MP, Member for Scullin, were able to visit and see the sites progress.  

Thanks to Gerald Lynch, journalist at the Star Weekly local newspaper, Hope Street featured in an article on youth homelessness for ‘Providing Hope for struggling youth.’ in late April 2024.    

In May 2024, Hope Street successfully recruited Bianca Nash as the Team Leader for the new centre and since this time have successfully recruited specialist case managers and youth residential support workers who will deliver the day-to-day services for young people.  They are welcome members to Hope Street’s growing team. Part of this new role is the opportunity to coordinate the interior of the building with donations including kitchen appliances, beds, linen and fridges.  

Hope Street’s First Response Youth Service has had community support through donations from – Comfort Sleep, Sheridan, Harvey Norman and Haier.  This is part of the value that together we can end youth homelessness. We work with young people, young families, local communities and our partners – believing that together we achieve more. 

The roof and frames on Building 1, 2 and 3 were complete by June 20th, 2024. This pivotal point in the First Response Youth Centre build project meant that the growing Hope Street team were able to tour the facilities and begin to plan the interior furnishings to create trauma informed, therapeutic spaces for young people and young families.  

On the 4th of October, the beautiful red brick, wide framed windows and wooden frame interior had been complete with walls and doors. Now the site is at lock up stage with teams of contractors busily completing the internal fitouts. 

The building is to be complete by late November for the opening of the new First Response Youth Service in early December.