Knowing what works: a model for addressing women’s homelessness
This article first appeared in Parity, the Journal of the Council to Homeless Persons, August 2023.
‘I feel like I’m becoming the person I always wanted to be. I’m not that angry anxious person anymore.’
These are the words of Roma*, now living in long-term, independent accommodation. Previously, she had been homeless, or lived in unstable housing, for 15 years. Through a five-year connection with McAuley, she has had the space and time to address trauma, mental illness and addiction.
Her story illustrates the multiple impacts of homelessness on women, and how an approach that responds at the points where they intersect can bring about long-lasting change.
While it seems obvious that women’s homelessness differs from men’s, a gender lens and perspective is not always reflected in the design and delivery of services. McAuley’s model of support is firmly based on our knowledge of the intersecting challenges for women in a community where gendered violence remains prevalent. It responds to their experiences in navigating a homelessness system which doesn’t consider gender as a homelessness factor and is traditionally geared towards the needs of (generally male) ‘rough sleepers.’ In fact, while men make up 56% of the homeless population in Australia, women accounted for 82% of the increase of people experiencing homelessness between 2016 and 2021.
McAuley provides safe and secure, women’s only accommodation with a mental health focus at its core, and recognition that rest and recovery may take time. Roma saw this as critical when she stayed at McAuley House Footscray, which accommodates 25 women and provides 24-hour support. ‘I felt safe, looked after, and nurtured. For the first few weeks, it was just enough to relax, find my feet, and begin to heal,’ she says.
On arrival, Roma was worn down by the effects of chronic, long-term homelessness. She had moved up to 30 times before she was hospitalised with depression and anxiety, as well as a growing dependence on alcohol. It was only recognised then that the constant physical and verbal abuse she’d experienced living alongside men in community housing was a major factor in her deteriorating mental health. Her housing needed to change for her to recover.
McAuley House’s atmosphere and environment began a process of healing. She became involved in a project to revamp the House’s rooftop garden, and a program called “Women’s words” which helped give voice to her experiences. Meditation and art therapy were other activities she enjoyed – all part of slowing down, being in the moment, and helping to let go of her thoughts and traumatic memories.
After 18 months, Roma felt ready for independent living. She moved into transitional housing, while remaining supported and connected with McAuley and many of the women who’d become her friends. An NDIS package further assisted her with ongoing counselling and daily activities. And now her latest move to long-term, secure accommodation means she has somewhere she can really call her own.
Mental health and homelessness intersections
With social and mental health support AND secure housing in place – Roma now looks forward with optimism. Her previous experiences, though, reflect the compounding effects of housing instability on mental illness. Roma had presented many times at emergency departments, but without a change to her living conditions, the system could not meet her needs. This also reflects what has been called a ‘missing middle’ in mental health support. Her needs were too complex to be addressed by primary care alone, yet not severe enough for entry into specialist mental health services.
Women are almost twice as likely to experience mental illness, yet it has been noted that ‘most male health services operative on a male-centric model’. Roma’s situation demonstrates how limited consideration of gendered factors ‘can lead to women’s mental health concerns being overlooked, dismissed or misdiagnosed, and/or adaptive responses to traumatic experiences may be pathologised.’
McAuley brings together housing and gender-focused mental health support for women, most of whom have had long histories of trauma, family violence and mental illness. In one snapshot of 39 women, 85% had experienced family violence, and 79% had a formerly diagnosed, or recognised indicator, of mental illness. Forty-three per cent had been sexually abused, and more than 40% reported childhood trauma.
To address this complexity, women receive case management and co-ordination, with no pre-determined limit on how long the support can take. A nurse from Bolton-Clarke works on-site, providing direct support and linkages to health services. Legal and financial support is available through our partners WEstjustice. A partnership with mental health provider Wellways Australia enables training and upskilling of McAuley teams including in mental health service navigation and referral pathways, while also providing opportunities for secondary consults regarding mental health.
‘Somewhere that knows my name’
Many women become disconnected from family and friends when homeless. Through McAuley they can join a welcoming community and support network for years after their initial stay. Many attend celebrations, remain involved in activities and weekly lunches, provide informal peer support to more recent residents, or even just return to sit and enjoy the garden or play Scrabble.
The availability of a respite bed is a safety net for women facing new challenges or physical or mental stresses, such as Mary*, who had transitioned into community housing. She became a volunteer at community lunches, and this ongoing link has made it easier for fluctuations in her wellbeing to be noticed. She returned to McAuley House for respite after developing cancer, kept in touch with the House’s online activities during the difficult period of COVID, and gets support from the Bolton-Clark nurse when other health issues arise.
‘Not just a place to stay:’ women’s views
McAuley recently commissioned an independent evaluation by Deloitte of McAuley’s homelessness model. It found that after their stay in McAuley House, 87% of women had achieved stable housing, while 83% felt safe, 70% said they were mentally well, and more than 52% were now working or studying. These extremely encouraging outcomes, given the complexity of women’s presenting issues, validate McAuley’s integrated approach.
In other consultations, women described which specific types of support helped them. They endorsed the need for safe places and longer stays. They valued daily support which they felt helped them to make better decisions, enabling them to ‘stay the course’ when they were unwell. They said housing options should not be motels, tents, unsafe rooming houses or caravans.
They appreciated that the McAuley House model was a stepping-stone into independent housing. Prior to moving there, none had felt ready to move straight into independent housing because they felt they wouldn’t be able to manage. They were concerned they would feel isolated and find it harder to get help with all the other issues in their lives such as loss of their children, health, relationships and employment.
These women particularly valued the mental health support provided, the chance to make connections with others and gain new skills, the sense of belonging, and the availability of support within the one place.
Roma was one of the women consulted. Her message was: ‘We need more than a roof over our heads. Don’t let women rot in facilities that don’t meet their needs.’
Unmet need and services under pressure
McAuley’s support model helped a fraction of the 49,922 females over 18 who presented to homelessness services in 2021-22. Most women don’t even come close to receiving the kind of support we can provide through our partnerships and with the help of philanthropy.
Instead, they encounter gaps, silos and overwhelmed services. In 2021-22 one of two homelessness access points in Melbourne’s western suburbs, in which McAuley is situated, reported having to turn away 8,000 households without even an initial appointment. One youth homelessness service is now providing young people with tents. Meanwhile ‘exit points’ for women transitioning from McAuley’s services are clogged, with a severe shortfall of affordable and social housing. Victorians fleeing family violence, with priority access to long-term public housing, wait more than 20 months for a place to live. The average wait time increased by more than three months over the past year, to almost double the 10½-month target for priority applicants.
The family violence connection
Awareness of the high incidence of gendered violence experienced by women living in McAuley Houses has shaped our practice in our family violence crisis responses. Getting the support right at this early point, where traumatised women and children first leave their homes, can prevent the extended histories of homelessness of women living in McAuley Houses. A strong focus on holistic support and early intervention addresses debt, legal problems, disruptions to children’s schooling and wellbeing, and trauma to the whole family unit.
Our knowledge of the long-term impacts of homelessness and their connection to family violence has led to our advocacy of ‘Safe at Home’ approaches. These focus on women’s ability to remain at home after violence with the needs of the entire household addressed.
McAuley’s approach, combining integrated support, housing and a gendered lens, responds to what women want. Its value is demonstrated in positive outcomes: safe and secure housing, improved mental well-being, and participation in employment and study. It is a readymade, proven prototype, and should be rolled-out and adapted for other services.
Equal attention is needed to prevent homelessness for women, and its persistent connection with family violence. McAuley’s ‘Safe at Home’ research gathered countless examples of how a seemingly temporary event – moving out of home to escape – became a steppingstone to ongoing homelessness and poverty. Shifting attention to women’s ability to stay home safely, rather than beginning this trajectory, should be an urgent focus. Funding a ‘Safe at Home’ approach is critical in preventing the alarming growth in family violence-related homelessness over the past decade.
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