Approaching leaving care support as early intervention into homelessness

1. Approaching leaving care support as early intervention into homelessness Dr Phil Crane School of Public Health and Social Work Queensland University of Technology strength to strength National Conference, Canberra, 22 November 2013

2. In this session … • Homelessness and leaving care • The intersection of two fields of practice • The homelessness agenda • Homelessness • Our study • The character of support needed to prevent homelessness with a focus on the period after leaving care • Why early intervention into homelessness is a useful frame • The relevance of complexity theory

3. Homelessness … and leaving care • Approximately half of all people defined as homeless are under 25 • Young people can experience homelessness before coming into care, whilst in care, on leaving care and as young adults after leaving care • The risk of this is high (30-50%) across various studies • There is a growing body of research and evaluation examining what could be termed transition from care practice- and the nexus between in care and post care

4. Defining homelessness • Primary homelessness includes all people without a ‘roof over their head’. This means people who are living on the streets, sleeping in parks, squatting in derelict buildings or using cars or trains as temporary shelter. • Secondary homelessness includes people who frequently move from one type of shelter to another. This includes people living in homeless services, hostels, people staying with other households who have no home of their own (‘couch surfing’) and people staying in boarding houses for 12 weeks or less. • Tertiary homelessness refers to people who live in boarding houses on a medium to long term basis (more than 13 weeks), who live in accommodation that does not have ‘self-contained facilities’ for example they do not have their bathroom or kitchen and who don’t have the security provided by a lease. They are homeless because their accommodation does not have the characteristics identified in the minimum community standard for housing.

5. Other important perspectives on homelessness • ‘Felt’ approach- factors in a persons sense of safety, security and belonging- notion of ‘home’. Particularly relevant for early intervention and person-centered practice • Spiritual approach- factors in connection to land and kin. Particularly relevant for Indigenous homelessness • Intergenerational homelessness- factors in the way vulnerability to homelessness is not simply a characteristic of individuals but of intergenerational and systemic processes that affect families and communities • Homelessness is not a status but a multi-faceted relationship

6. The National homelessness landscape • Development of a multi-faceted approach to understanding and responding to homelessness • The Road Home- ‘No exists into homelessness’ • National Partnership Agreement of Homelessness • National Homelessness Research Agenda • Our study

7. A little history- The emergence of early intervention into youth homelessness - Came to prominence during Burdekin Report (1989) Our homeless children • Youth homelessness broadened from ‘street kids’ (hidden homelessness). Many factors contribute • Homelessness as a temporal process (not an event) underpinned by structural, institutional, situational and intra-psychic factors • Being in care identified as one important pathway to homelessness and leaving care seen a critical focus for homelessness prevention intervention

8. That a suite of (or continuum) of responses is needed • The PM Youth Homelessness Taskforce (1996-1998) and development of the Reconnect early intervention program • Early intervention practice language and practice principles developed and validated over past 17 years • Early intervention distinguished from broader prevention • ‘Pathways into homelessness’ research further sharpens focus on leaving care as a focus for early intervention

9. Our study • Small and qualitative • Focused on two states- Queensland and Victoria • Partnered with CREATE who • Contributed to the literature review • Recruited young people to participate in interviews & focus groups • Facilitated focus groups • Organised focus groups with service providers • Main source of data is young people: Interviews with 27 young adults 19-23 who had been in care. 17 of these interviewed twice across 4 months. Visually mapped on an A3 sheet their experience over time, and what did and did not help • Focus groups- some with young people, others with service providers • Consultations with state government departments and peak bodies

10. Their experience of homelessness • All had experienced primary or secondary homelessness before or after the formal point of leaving care • 24 of 27 indicated described at least one instance of primary homelessness • All reported multiple factors had interacted with their experience of homelessness (e.g. violent relationships, problematic AOD use, financial hardship, mental health issues etc) • Correlation between in care and post care stability cited in other studies also evident- volatile and smooth transitions (Johnson et al. (2010). Homelessness pre and post.

11. Profile of young adults interviewed

12. In care summary

13. Transition from care (TFC) planning • 70% did not recall any TFC planning (given when left care there is some retrospectivity in this) • Those who experienced planning often spoke of the process as very limited in scope and orientation (instrumental V personal and relational) • Often limited in quality: not meaningful or inviting genuine participation over a period of time • More commonly available to those in Victoria

14. ‘Home’ • A home is somewhere you feel safe and happy and you have people around you that you like. Like I’d say it’s warm and inviting. (male 21 years) • Just hanging out there and like laughing and just being happy, like having that like, that bond I guess. And just feeling like I could walk into the house and I’d open the fridge and I’d pick out what I wanted and I’d go to what was my room and you know, whatever. (Female, 20 years) • But my grandmother’s has always been home. It’s always been somewhere that I can go. (Female, 23 years) • Somewhere where I can like feel safe and wanted and needed and not have to like hide anything and where I can know that I’ll be there for a long time. (Female 19 years)

15. Indicators of ‘home’ • People: that home is where a particular person is, for example a grandmother, or partner. Having a ‘bond’ which means people do ‘little things to show they care’. • Feeling safe • Continuity: a sense of ‘ongoingness’ (relational and/or spatial) • A sense of autonomy and control: being able to do everyday things without having to ask permission, or being able to personalise their living space. • Feeling happy and laughing with others • Providing amenity such as proximity to shops and transport. • These could inform indicators that are built into pre-post care monitoring. Those with more volatile pathways tend to feel they haven’t had/ don’t have a home or see home in a very literal sense (roof over my head).

16. A sense of future I was just sitting around with my friends and just realized they were all addicted to drugs and alcohol, and none of them had future career goals, and they were probably going to end up on Centrelink or with three kids to three different guys for the rest of their lives and I just didn’t want to be that. (Female 20) • Wanted to feel that they had a future- dreams and aspirations are critical • A particular worker often cited as important who nurtured this • Young people with volatile backgrounds struggled most with having a sense of future • Assisting young people build/ identify aspirations is a key aspect of good practice

17. A relational frame • Relationships with people typified by continuity are key for the prevention of homelessness • Both informal and formal sources of support • Need assistance in negotiating and re-negotiating relationships • Support that bridges across the administrative point of leaving care • Family of destination providesan important lens for practice

18. If you could design a service for young care leavers what would it do? • Aplace where young people could go before and after leaving care to get information and advice on a wide range of matters For some young people support is imagined as having a strong relational (trust) element. Some others see support in more practical terms Pretty much a call in service pretty much like the leaving care hotline, but a little bit more accessible. You know, everybody can just call up sort of stuff. … Where you can go and ask what can I do, this has happened. Or who do you go and talk to about this. You know, someone who has that information on them already and can give you advice.

19. Emotional and mental health support 60% of the young people we interviewed indicated they had mental health conditions or issues They can’t just treat us all the same, we’re all different.… Cause mental health problems do get worse too... My depression has gotten a lot worse since they’ve left me and I just want them to open their eyes. • Access to housing which is undertaken in a consultative way There is a strong case for a ‘housing first’ approach where support is configured around a stable ongoing place of accommodation. However a rapid change in housing circumstances can be expected and not all change is negative • Support beyond the point of stability Clear many young people living at ‘the edge of chaos’ • Education and training support • Formal and accredited • Life skills

20. Worker- service attributes • A service/ worker who will advocate for them and assist in negotiating systems that are often experienced as complex and/or hostile • ‘Youth friendly’/ respectful- Someone who you can trust, is approachable, proactive in contacting, understands vulnerability, understands systems and acts as a broker, to assist negotiate relationships, listener, point of continuity, with literacy around trauma and mental health • At least 12 months continuity of worker

21. Characteristics of post care support • Proactive I didn’t really know who to call for help, or I can’t. I’ve kind of always found it hard to ask for help, so by the time I was asking for help it was desperate and I was trying to sort it out by myself and stuff. And like by the time I got around to asking for help it was just like I was just so far gone.. (Female 19years, Victoria) Almost all happy to be proactively contacted periodically after leaving care but character of this important- how are you going? Fits with a recognition in homelessness practice that we need to adopt a more proactive approach that doesn’t wait for young people to seek assistance but still respects self determination eg Assertive outreach models

22. She fought for me to get my Centrelink money. She fought for me to stay in my placement, she made sure I got into a lead tenant property and that I was safe. Yeah, made sure I was attending school too.... [She made me feel I was being heard because] she always used to keep in contact with me and used to always hear me out… She was really friendly, like nice caring person too.... While I was in lead tenant I had another worker and she used to make sure that I went to school. She’d be at my door at 8 o’clock in the morning banging on my window, ‘Get up for school’. But she helped me out heaps. She made sure I had a clothing allowance, you know everything was covered for school excursions, you know just all that kind of stuff. (Female 20 years, Victoria)

23. I left care this year. I was on a six month voluntary order. It’s where they still check up on you, they call you up every now and then. They help you with organisations and stuff like that … I was referred to [agency name] Aftercare when I exited the care system. They helped me with getting a house, because I was down living in Ipswich. When I exited foster care I ended up moving in with friends and a guy I was dating at the time. He made it difficult to live there, so I had to move…. I was in a violent relationship ... which was my first [relationship]. I was living with him for nearly a year. I broke up with him this year just after February. I was with him while I was in foster care. And he jeopardized most of my accommodations because he’d have fights with the residential carers … The Department made that referral, but [the agency] are the only ones who have helped me so much. They’ve helped me find a stable place where I’m actually enjoying myself. Have my own privacy; don’t have to deal with drama… He (agency worker) would call me up, see how I was. If I needed anything like I had to go, I went to the dentist and they said my bill would be $900. [The agency] paid for that, they got my teeth fixed. They got me new glasses because I needed new glasses. They got me $1,000 on gift cards for [furniture]... My room is fully furnished.They just helped me out of Ipswich, they helped me be able to get the strength to dump ... [the abusive boyfriend].(Female, 19 years, Queensland)

24. Support available until well stabilized (not chronological but definitely beyond 21) • Apparent critical role of youth services which have a target group till 25 for those who age out of leaving care support services (Youth Connections, Headspace etc). What is the interface? • Relational in character • Assists young person build relationships that are future oriented (with people, institutions, with self) • Comprehensive, multi-faceted flexible approach (whatever it takes!)

25. It means we have a relationship.... And we’re very close. I can tell her almost anything about my life and not be worried and I know I can trust her and I know she’s going to be there for me. Whereas I’ve had workers who have come in and out of my life so often and have stayed for maybe a few months and by that stage I’ve just built up a relationship and they’re gone again. I’ve got to start again. Whereas with my worker I’m able to keep moving forward and not step backwards all the time. And she also knows me, she knows my problems. Even without me knowing that I’ve got a problem with something, she knows, because she picks up on it. She knows my body language, she knows my facial features, she knows when something’s wrong. (Female 22years, Victoria)

26. Wanted characteristics of service support

27. Reconnect good practice principles Generated through participatory process during pilot phase(RPR 1998). • accessibility of services (including capacity for fast responses) • client driven service delivery (youth centered family inclusive) • holistic approaches to service delivery • working collaboratively • culturally and contextually appropriate service delivery • ongoing review and evaluation, and • building sustainability These have proved to have enduring relevance.

28. ‘Connections Practice’ from a front line practitioner perspective • The Brisbane North and West YC Consortium comprises of 5 youth services • Youth Connections provide a flexible, individualized and responsive service to young people aged 14 to 18 years who are most ‘at risk’ of and who have disengaging from education or training and therefore not attaining Year 12 or equivalent and not making a successful transition to further study, training or work. The objective is … to assist them make a successful transition through education and onto further education, training or work. • Workers and managers were supported individually and collectively to identify and undertake PAR into challenges they faced http://salvos.org.au/youthoutreachservice/site-information-and-programs/youth-connections-program/

29. Re-engagement = A + O + C (in Crane and Kaighin 2011) The clear expression by the young person of aspirations (A) (needs, wants, hopes, possibilities) re education/ training + The availability of appropriate options (O) (in terms of accessibility, content and learning process, level of difficulty) + Sufficient fit between their life context and what is realistically required for re-engagement (C) (refers to emotional fit arising from prior experiences, helpful/ unhelpful life habits, adequate living situation stability including housing, and adequate practical and emotional support).

30. Relevance of complexity theory • The domain of practice- the ‘person in environment’- underpinned by ecological systems thinking • Distinguishing between complex adaptive (living) systems V mechanistic ‘built’ systems approaches • Client complexity- Systems complexity- Complexity arising from the broader social, political and historical • Frame of complexity needed for considering the prevention of homelessness for young people leaving care

31. Complexity theoryKey concept 1: Non-linearity • Processes in complex contexts are non-linear not linear. Therefore need indicative not predictive models • Linear- if procedures and standards are followed then there is a predictable outcome- checklists, assessment as an administrative process, blaming individuals not systems for child abuse. These linear models can provide a false sense of security • Need non-linear models and practice approaches because sometimes the smallest changes can lead to the biggest changes • Source: Stevens and Cox (2008)

32. Key concept 2: Emergence • Understandings (knowledge), possibilities and behaviour ‘emerge’ through action (‘practice’) and cannot be entirely pre-known • Intervention effects in complex systems/ social groups can be very different to what is predicted given the knowledge and interaction of individual components • Larger systems emerge from local level processes and strive for order • Emergence can be facilitated not controlled

33. Key concept 3:The ‘Edge of Chaos’ • A ‘dissipative structure’ is essentially an unstable and evolving system and has the potential for abrupt shifts, and change may lead to a more stable system (eg earthquake releases pressure) but difficult to predict what type of stable system will emerge • In a dissipative system the components of the system never quite lock into place hence the system sits at the ‘edge of chaos’

34. Key concept 4: Bifurcation • As more factors are introduced a system reaches a bifurcation point. This is where the system oscillates between two possibilities and once one gathers force it cannot be reversed • Which way will it go? Small influences at particular points can have big impacts on what happens • Practice notions like prevention, early intervention and crisis intervention are based in such logic

35. Key concept 5: Attractors • An attractor is a force (or intervention however small) which directs how the system will emerge • Attractors create ‘boundaries of instability’ ie whilst the future is unpredictable it is unlikely to move outside certain boundaries. • Practice strategies or changing aspects of a persons/ groups/ communities context can act as attractors.

36. Implications for practice • Occurs within a boundary of instability • Linear models and an over reliance on procedures and standards wont be enough (sufficient) to maximise positive outcomes. Need to look for small interventions (innovations) that may have larger impacts as well as appreciate broader structural and institutional contexts which constrain • We need ways of working which • Recognise and develop a tolerance for uncertainty and move away from a narrow risk-averse approach • Avoid dichotomies (black-white) or single concept reasoning (this-therefore) • Adopt an inquiry approach to encourage and notice emergent knowledge as practice unfolds (e.g. action research embedded in funding)

37. In care placement instability should be understood as becoming homeless or being on a pathway to homelessness. Early intervention into youth homelessness understandings highlight how important it is to see young people’s lives as unfolding over time and that timely support can have a significant influence of future pathways. • A temporal lens in practice means going beyond checklists and a series of specific interventions to a way of appreciating and responding in a way that provides the best chance of young people moving to adult wellbeing: a future orientation • A relational approach to building and sustaining connections (personal and institutional) which bridges across the administrative point of leaving care. Best provided in a family inclusive way but from outside of ‘family’ or family proxy.

38. The moral imperative So ideally from your experience a service for young care leavers needs to include … ? Well these are all things that if you were a normal child, from a normal home environment, these were the things you would get. If you were at home or not at home. Why should it be any different for someone in care? Why can’t they when they’ve left care have that support and those things, options out there for them? (Female 22years, Victoria)

39. Thank you • I can be contacted at p.crane@qut.edu.au • A range of my publications can be found at http://eprints.qut.edu.au/view/person/Crane,_Philip.html