MQ Research: major study of homelessness finds housing policy is failing Sydney’s most vulnerable


MQ Research: major study of homelessness finds housing policy is failing Sydney’s most vulnerable


There is an urgent need for more low-cost housing and alternative housing models of supported housing for Sydney’s homeless, given the high rates of serious mental illness among the homeless, according to new research from Macquarie University and the Matthew Talbot Hostel Clinic run by the St Vincent de Paul Society.

In one of the largest studies of its kind, and the largest ever conducted in Australia, researchers reviewed the medical records of 2,388 people who visited clinics in inner-Sydney homeless hostels between 2008 and 2016.

The team analysed social-demographic information such as employment history, marital status, social security benefit, duration of homelessness and whether they had previously lost public housing tenancy; and clinical information, including psychiatric diagnosis, medication use, past psychiatric hospital admissions, cognitive impairment, substance use, and history of trauma.

The link between mental illness, substance use, and chronic homelessness is well known from past research, notes Olav Nielssen, lead researcher and Professor of Psychiatry at Macquarie University Medical School.

“It was no surprise to find that people who become homeless often have mental illness or substance use disorders – or both. What surprised us was the number of people discharged from institutional care to homelessness – including from prisons and psychiatric hospitals – and the number of people who had lost public housing tenancy, because public housing has been seen as a solution to homelessness,” says Dr Nielssen.

The study, published in The Medical Journal of Australia today, confirms that a significant proportion of Sydney’s chronically homeless are suffering from major mental illnesses, often complicated by substance use. The team found that 21% had lost public housing tenancy, 28% had been released from prison, and 21% of clinic attenders had been discharged from psychiatric hospitals with no permanent accommodation.

“It is very difficult to treat mental illness in people who are sleeping in the open – stable housing is a pre-requisite for continuous treatment of mental illnesses such as schizophrenia”.

“The fact that many people are moving from institutional care to homeless shelters, or are unable to maintain public housing tenancy suggests a failure of government policy in meeting the needs of people at risk of homelessness. Providing a place to live isn’t enough for people who can’t manage their mental illness or get support for substance abuse. People are losing housing a result of a lack of allied services,” adds Dr Nielssen.

“A major factor contributing to homelessness is substance use, because about two thirds of clinic attenders had a substance use disorder, but substance use can be both a cause and a consequence of homelessness. For instance, many people use drugs as a way to cope with trauma and loss, or with symptoms of mental illness. We found that half of people seen at these clinics had a psychotic illness such as schizophrenia and 43% of patients reported a history of trauma.”

Current policies do not adequately address the needs of the temporarily homeless, such as people released from prison, or those of the chronically homeless, which includes many of the people with severe mental illness.

“It’s clear we also need to do better support those people at high-risk of homelessness, such as those about to leave prison or psychiatric hospitals, with improved discharge and pre-release planning,” notes Dr Nielssen.

“Apart from the humanitarian case for an affluent society to provide shelter for people with mental conditions, there is a strong economic case for providing housing because the homeless generate costs in health and justice and other services that far exceed the cost of housing.”

Comments (7)

  1. Matt Daly

    Hi, my name is Matt Daly and i’m an MGSM Alumni. My business, HOW Social Construct specialises in the modular construction of social housing facilities to ensure this vulnerable portion of the population has a safe place to sleep.
    Who at Macquarie University can I collaborate with to help address these social challenges?
    I can help. This is me reaching out to help with an actual solution.


    1. Jeff Hargrave Post author

      Hi Matt
      Thanks for your comment and I will forward it to the Lead Researcher to get in touch.
      Thanks again for reaching out to help this social issue.
      Jeff Hargrave
      (Alumni Relations Office)

  2. John Wilson

    It is a pity that the decision makers across the political spectrum don’t want to understand what the reality is for the homeless. I hear too many people say “but it is their own fault”. Many of them drink alcohol, gamble unhealthily or smoke or use other substances themselves, “let she who is without sin cast the first stone” many of the fussiest have more to hide than the rest of us.

    1. Rosie Shea

      Hi Matt Daly and lead researchers,

      I am a Mac Uni Social Policy Post grad and I work for Corrective Services in a Policy Project role. My current project is exploring how I can best reduce Offenders exiting custody into homelessness.

      I am very aware of the issues we face with current policy and am happy to collaborate with others for ideas to improve outcomes, particularly housing outcomes for people exiting our Correctional Centres.

      Please feel free to contact me.

  3. Alan Moore

    Australia does not have a population policy but seems to be governed by the irrational concept that land and resources are infinite and so the population can grow infinitely large. There is no target for a sustainable maximum population. Australia has one of the fastest population growth rates in the world, largely fueled by migration and an economic model which is largely dependent on selling consumer products (especially housing) internally, and selling raw materials (agriculture and mining) to fund it all. In the long term this is unsustainable. The housing problem is largely due to the rapid population growth, lack of a sustainable economic model and the availability of domestic housing to foreign investors. Isn’t it time the politicians focused on the LONG term (ie. 25 – 50 years) rather than the next election? And economists on models that are long-term sustainable? It is no coincidence that Australia also has one of the worst records for animal extinction rates.


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