The Real Cost Of Youth Homelessness

1. The Real Cost Of Youth Homelessness Paul Flatau(UWA Centre for Social Impact) and Monica Thielking(Swinburne Institute for Social Research) David MacKenzie, Adam Steen; and Matthew Farrugia (Swinburne Institute for Social Research) and and Alicia Bauskis (UWA Centre for Social Impact) The Costs of Youth Homelessness in Australia project is an ARC Linkage research project of Swinburne University’s Institute for Social Research and the University of Western Australia, in partnership with The Salvation Army, Mission Australia and Anglicare Canberra Goulbourn.

2. “The U.S. Department of Housing and Urban Development upped its cool quotient when Secretary Shaun Donovan appeared on The Daily Show with Jon Stewart (March 2012)."The thing we finally figured out is that it’s actually, not only better for people, but cheaper to solve homelessness than it is to put a band-aid on it," Donovan said. "Because, at the end of the day, it costs, between shelters and emergency rooms and jails, it costs about $40,000 a year for a homeless person to be on the streets.“” Costs of homelessness In recent years, a number of research studies have provided evidence on the costs of homelessness. Most studies indicate that homelessness is more expensive to society than the costs of solving the problem and there is an economic case for spending money to tackle homelessness. Homeless people use a variety of public services in an inefficient and costly way. Preventing a homeless episode or ensuring speedy transition into stable permanent housing can result in significant cost savings, as well as dramatic improvement to the lives of homeless people.

3. Issues • Can a case for more resources for homelessness programs be made on an economics basis? • Should the findings of a robust cost-benefit analysis of homelessness programs (the likes of which we have not yet seen) be the basis for policy judgement? And what is a robust cost-benefit analysis look like? • Is it all about economics?

4. Overview • Motivation: The costs of homelessness and the promise of effective service intervention • Background: Policy and Literature • Aims of the study • Method and challenges • Early findings

5. MotivationThe costs of homelessness and the promise of effective service intervention

6. Personal and social costs • Educational outcomes and educational attainment - lower lifetime income • Poor physical health + exacerbation of existing conditions • Mental health and well-being impacts • Drug and alcohol dependency • Participation in crime and justice consequences • Social exclusion • Alienation, boredom and social relationships

7. Economic costs • Direct specialist homelessness service costs • Indirect costs on mainstream service system and therefore government budgets • Health • Mental health • Drug and alcohol • Justice • Child protection • Higher income support payments and lower taxes • Long term economic impacts: • Productivity • Available workforce • Economic growth

8. Homelessness as both the cause and consequence of social outcomes generating both personal and social costs

9. Background – Policy and Literature

10. Background - Policy • ‘Our homeless children’: Report of the National Inquiry into Homeless Children (the “Burdekin Report”) by the Human Rights and Equal Opportunity Commission (1989) • ‘The Road Home’: A National Approach to Reducing Homelessness (FaHCSIA, 2008) • National Affordable Housing Agreement (COAG, 2009) and National Partnership on Homelessness (COAG, 2010) and related State and Territory Implementation Plans • Mental health and drug and alcohol Australian and State/Territory plans

11. Background - Australian youth homelessness studies • Numerous examples • Pears and Noller (1995) on abuse, gender, and theprocess of adjustment to life on the streets. • Chamberlain and Mackenzie (1998) on youth homelessness, early intervention and prevention programs. • Reid and Klee (2000) on young homeless drug users and their coping mechanisms • Mallett, Rosenthal and Myers (2001) on providing services to homeless young people in Melbourne. • Milburn et al. (2007) on the return to home of homeless youth  • Johnson et al. (2010) on pathways from out-of-home care 

12. Background- Economic focus • Early youth-focused studies touching on the costs of homelessness and potential savings from effective early intervention programs • ‘Urban Poverty as it Effects Children: Some costs of child and youth homelessness’ (Carter, 1990), • ‘The Economic Costs and Benefits of School-Based Early Intervention’ (Pinkney and Ewing, 1997) • ‘Economic Benefits of Supporting Homeless Young People’ (Dixon, 2003)

13. Background – Economic focus • The call for more robust economic studies of homelessness: • ‘Counting the Cost of Homelessness: A Systematic Review of Cost Effectiveness and Cost Benefit Studies of Homelessness’ (Berry et al., 2003) • ‘The Costs and Pathways of Homelessness: Developing Policy-Relevant Economic Analysis for the Australian Homelessness Service System’ (Pinkney and Ewing, 2006) • Cost and cost-effectiveness studies in the adult homeless population: • The effectiveness and cost-effectiveness of homeless prevention and assistance programs Flatau, Zaretzky, et al. 2008. • The Michael Project (Flatau et al., 2012) • The AHURI Cost of Homelessness study – on-going

14. Aims of the Study

15. Aims of the study • Understand the experiences of young homeless people and their position on entry to homeless services • Determine the economic and social costs of youth homelessness • Calculate the net cost of service provision accounting for cost offsets • Study the impact of service provision on outcomes over time • Understand the impact of length of time in homelessness on costs, experiences and outcomes for youth

16. Method

17. Method • Who: national sample of young people aged 12-25 who are homeless or at-risk of homelessness – via specialist homelessness service providers and Reconnect • How: longitudinal study over three years (3 waves) of data collection using a case-worker + researcher administered survey, plus interviews with young people and caseworkers with associated agency cost surveys and use of administrative data

18. Measurement of economic costs • Homelessness service usage – and the direct costs in specialist homelessness services (and over the lifetime) • Contact with justice, mental health, drug and alcohol, health facilities/services – and the indirect costs to government budgets in mainstream service areas (and over the lifetime) • Participation in education and training – and human capital formation outcomes and potential loss of lifetime income • Income and receipt of government benefits and payment of taxes (and over the lifetime) • Calendars: Income; Employment; Education; Accommodation

19. Measurement outcomes • Mental health and wellbeing (e.g., K10; resilience; WHO QOL) • Physical health • Drug and alcohol use and dependence • Risk of homelessness for young people aged up to 18 and still at home (MacKenzie) • Participation in employment and education • Transition to permanent and safe and secure accommodation • Social relationships

20. Cost-effectiveness analysis Cost difference (difference between homelessness program and no program) Negative effectiveness from homelessness programs Positive effectiveness from homelessness programs Net costs from homelessness programs Outcomes difference (difference between homelessness program and no program) Net savings from homelessness programs

21. Cost offsets General Population Health & Justice Cost Offsets Difference between General Population & Client Population – referred to as “Population Offsets” Client Population Health & Justice Survey point 12 months prior 12 months later Cost Offsets Difference between Client use of services 12 months pre and post the Wave 1 Survey

22. Challenges of a Longitudinal Survey • Unpredictable availability of young people both at baseline and in future waves • Time-pressured staff • Staff turnover – retraining and reengaging • Youth crisis is main priority – not the survey • Keeping up the momentum

23. Results From the Baseline – incomplete and Preliminary

24. Profile • Service Types • crisisand transitional accommodation services for homeless youth • Outreach support services for young people on the streets, boarding houses and non-permanent accommodation • Reconnect services for young people at-risk of homelessness • Referral services for young people in need of homeless services • Baseline sample • 260 surveys completed and 140 entered (all results presented based on the group of 140 – largely representative but treat with caution) • States and Territories • NSW 34%Vic 30% WA 14% SA 22% and ACT 14%

25. Profile • Age • 12-24 scope; effectively 15-25 • 38% under 18; 34% (18-20); 28% (20-25); • Median age of 18 • Gender • Female 61% and Males 39% • Country of Birth • Australian born 86% and 15% Indigenous

26. Profile • Accommodation when presenting to service • House 49%, Emergency and crisis 22%, No shelter 14%, Boarding and Rooming House 4% and Other 11% (inc. D/Know/Couch surfing/Resid. Health) • Respondent perceptions as to whether they are living in ‘safe and secure accommodation’ • 77% Yes and 23% No

27. Profile - Accommodation Time since had permanent place to live AIHW SHSC Form

28. Profile – History of Homelessness

29. Profile – Parental Home • Out-of-home care prior to the age of 18 of any kind 70% [0.7% of kids aged under 18 are out-of home care Australia] • Foster care 29% • Kinship care 39% • Residential care 50% • Police visitation to home as a result of violence in the parental home • 52% No; 10% NA; and 38% Yes (17% more than 10 times) • Leaving the parental home due to violence • 44% No; 9% NA; and 47% Yes (19% more than 10 times)

30. Profile - Issues faced • Friendship: 30% without any close friends • Family: 30% no contact with mother/guardian and 42% no contact with father/guardian in last 3 months • Education and Training and Employment: 55% not enrolled in education and training institution and only 9% in jobs • Sources of income: 15% no income; 80% government income support (very small no. with wage income) and 5% wages and other • Impact on housing significant with large numbers reporting inability to pay rent and reliance on family and other sources of income • Long-standing physical health condition: 36%

31. Profile – Issues faced • Diagnosed mental health conditions: Around 50% • ABS National survey of mental health and well-being NSMHWB aged16-24 26% experienced at least one disorder in past 12 months • Mental health diagnosed disorders • 31% Mood disorder; 35% Anxiety disorder; 9% Personality disorder; Psychotic disorder 7%; 3% Dissociative disorder; 10% Substance use disorder;7% Eating disorder; 5% Impulse-control disorder • Unmet need in mental health in prior 12 months (needed support from a mental health practitioner but didn’t receive it) : 31%

32. Profile – Issues faced • Psychological distress: On the basis of the K10 scale 33% had very high psychological distress compared with 9% of those aged 16-24 in the 2007 National Survey of Mental Health and Wellbeing (NSMHWB) • At the same time 38% had low levels of psychological distress • Self-harm in last 6 months: 22% (half not received support) • Attempted suicide in last 6 months: 13% (42% no professional counselling)

33. Costs of Homelessness

34. Costs of Homelessness

35. Conclusion • These are preliminary findings! • Issues around mental health needs and psychological distress and access to support and low help-seeking for a significant number • Education and lifetime income and poverty traps • High health and particularly justice costs