Young people transitioning from out-of-home care and Housing/Homelessness

Young people transitioning from out-of-home care and Housing/Homelessness: Keynote address by Philip Mendes to Victorian Youth Refuge Forum, 13 April 2016

 Just over 30 years ago, I commenced my first social work student placement at the Salvation Army Crisis Accommodation Centre in St Kilda. One of the first tasks I was given by my supervisor was to complete a sleepover which in those days meant taking sole responsibility for all late night contact via a bell that linked the front door to the upstairs bedroom. It also meant supervising not only the 8 young people sleeping in the upstairs bedrooms, but also an additional six or so people sleeping on the floor in the downstairs lounge. I guess this was definitely what you call throwing the student in at the deep end, and definitely no health and safety regulations in those days. But fortunately I swam rather than sank.

One of the reasons I have raised this experience was that even in those days, workers noted that many of the homeless young people attending the Crisis Centre and other refuges had state care backgrounds. And this sadly continues to be the case today.

So what is leaving care? Leaving care is formally defined as the cessation of legal responsibility by the state for young people living in out-of-home care. In practice, however, leaving care is a major life event, and a process that involves transitioning from dependence on state accommodation and supports to self-sufficiency. Care leavers are not a homogeneous group, and have varied backgrounds and experiences in terms of the type and extent of abuse or neglect, the age they enter care, their cultural and ethnic backgrounds, their in-care experiences, their developmental stage and needs when exiting care, and the quantity and quality of supports available to them.

The leading UK researcher Mike Stein has broadly categorized care leavers into three categories. The first he terms the ‘moving-on group’. Young people in this group are likely to have experienced secure and stable placements, be highly resilient, welcome independence, and be able to make effective use of leaving and aftercare supports. The second group he terms ‘survivors’. They have experienced significant instability and discontinuity. Outcomes for this group tend to reflect the effectiveness of after care supports provided. The ‘strugglers’ are the third group. They are more likely to have had the most negative pre-care experiences, and are most likely to experience significant social and emotional deficits. After care support is unlikely to alleviate these problems, but is still viewed as important by them. These are the group most likely to become homeless.

Only about 3100 young people nationally and just over 850 young people in Victoria aged 15-17 years leave care each year. That means this is a relatively small social problem which can be effectively addressed by policy and practice reform. Some do very well and have achieved prominence in sporting, political and public life. But too many are reliant on Australia’s income security, health and welfare, homeless, criminal justice and other crisis intervention systems.

The reasons for their disadvantage are very simple. Firstly, many have experienced and are still recovering from considerable physical, sexual or emotional abuse or neglect prior to entering care. Secondly, many young people have experienced inadequacies in state care including poor quality caregivers, and constant shifts of placement, carers, schools and workers. Thirdly, many care leavers can call on little, if any, direct family support or other community networks to ease their involvement into independent living.

In addition to these major disadvantages, many young people currently experience an abrupt end at 16-18 years of age to the formal support networks of state care. That is, the state as corporate parent fails to provide the ongoing financial, social and emotional support and nurturing offered by most families of origin. As a result, many care leavers face significant barriers to accessing the same educational, employment, housing and other development and transitional opportunities as other young Australians.

What policy and practice supports are currently available to these young people?

The state of Victoria legislated via the Children, Youth and Families Act 2005 for the provision of leaving care and after-care services for young people up to 21 years of age. The Children, Youth and Families Act 2005 appears to oblige the government to assist care leavers with finances, housing, education and training, employment, legal advice, access to health and community services, and counselling and support depending on the assessed level of need, and to consider the specific needs of Aboriginal young people. However, Section 16(2) of the Act emphasises that these responsibilities “…do not create any right or entitlement enforceable at law”,  suggesting that leaving care programs are in fact discretionary, and care leavers do not actually have any legal right to seek or demand support services from government.

To be sure, the government has established mentoring, post care support and flexible funding support for young people transitioning from care or post care in all eight regions, but too often these supports are discretionary and not mandatory. For example, there is no formal expectation that Victorian child protection services provide dedicated housing for the approximately 850 young people who transition from care each year. There remains a massive gap between out of home care and post-care funding.

According to the 2012 Cummins Child Protection Inquiry, Victoria spent $90 million on residential care in 2009-10. In June 2011, 496 young people or 8.7 per cent of those living in OHC were in residential care. Overall they comprise 5.2 per cent of Australian OHC placements. The annual placement unit prices per child or young person ranged from $152,000 to 220,000. The most expensive is therapeutic residential care which averages $65,000 more annually in Victoria, and $112,000 annually more in NSW. Even if the young person is in home-based care, we are still talking a minimum of $56,000 per annum.

In contrast, Victoria currently provides approximately 11 million dollars a year to support care leavers including discrete Indigenous support and housing assistance programs. This sounds generous in principle, but in practice it is only a small amount of money to meet the needs of the more than 2000 young people who have left care in Victoria over the past three years (i.e. about five thousand dollars per care leaver per year). The only rationale for this sudden and massive drop in spending is that the young person leaving care has reached a random chronological age of 18 years.

Yet very few young people transitioning from care are developmentally ready to live independently at 18 years of age, and most of their non-care peers can expect to receive support well beyond this age. The reduction in support may result in the young person becoming homeless or involved in offending or long-term reliant on income security payments, and mean that the earlier massive expenditure is completely wasted. If I was the Finance Minister I would not regard this sudden cut-off as a great investment given that a few years more spending would result in massive savings in housing, criminal justice, mental health etc. down the track.

 Leaving Care Model: A Normative Commitment

The international research, summarized by Mike Stein argues that three key reforms are required to improve outcomes for care leavers:

Improving the quality of care; as positive in-care experiences involving a secure attachment with a supportive carer are essential for overcoming damaging pre-care experiences of abuse or neglect. But to use a football analogy we can’t just measure children’s progress at the age of 15 or 16 years and then stop there because if we do it is a bit like a football team which plays one half of a grand final, but fails to play the last half which actually decides the outcome.

Ensuring a more gradual and flexible transition from care that reflects maturity and developmental needs rather than just chronological age. Care leavers cannot reasonably be expected without family assistance to attain instant adulthood. It is not possible for them to successfully attain independent housing, leave school, move into further education, training or employment, and in some cases become a parent, all at the same time. Rather these tasks need to be undertaken sequentially. As reflected in the ‘focal model of adolescence’, they need to be given the same psychological opportunity and space as all young people to progressively explore a range of interpersonal and identity issues well into their twenties. This also means being given second or third chances when necessary.

• Providing more specialised after-care supports that incorporate messages from life course theory about the diversity of transition experiences. The research evidence suggests that effective after-care interventions can facilitate ‘turning points’ that enable young people to overcome the adverse emotional impact of earlier traumatic experiences.
• In summary, the outcomes for care leavers reflect the connection between two key factors: one is their Individual Agency or resilience (within a social context), and the second being the availability of positive relationships via what we call Social Capital through professional and informal support networks.

 Housing

One of the toughest challenges facing care leavers is securing safe, secure and affordable accommodation which is a crucial component in the transition from care to independent living, and also closely linked to positive outcomes in health, social connections, education and employment. Numerous reports and studies have found a high correlation between state care and later housing instability, transience and homelessness. While variation in the extent of homelessness reported among care leavers stems from different methodological approaches and different ways of defining homelessness, the overall picture suggests that compared to their non-care peers care leavers are at much greater risk of homelessness.

For example, McDowall (2009) reported that more than one third of the 196 care leavers surveyed nationally had at least one experience of homelessness in their first year of independence. The 2015 Costs of Youth Homelessness report identified that nearly two thirds of the sample of 298 homeless youth surveyed had previously been in out-of-home care. 63 per cent had been placed in residential care, 45 per cent in kinship care, and 33 per cent in foster care. They were first placed in OOHC at a median age of 14. Many seemed to come from backgrounds of family violence.

But that raw data provided poses a few questions: how long on average had the OOHC cohort been in care, and what was the average age that they left care? In short, it would be advantageous to know whether we are talking about short-term or long-term experiences in care, whether many or most left care at 16 or 17 years old or earlier, what supports including leaving care plans they received on transitioning from care, and whether their experience of homelessness occurred directly following their transition from care or even preceded their transition.

Some further related questions emerge as a result of an honours thesis on care leavers and homelessness completed by Social Work student Louise Rice at Monash University in 2013. The thesis, which was published in summary form in Parity Magazine, 27(2) 2014 was based on interviews and focus groups with a small sample of 13 homeless service workers.

Sample participants reported that homeless care leavers had distinct characteristics compared to other homeless young people including limited independent living skills such as poor financial management, and few personal supports. They often had disabilities plus mental health and substance abuse concerns, and were developmentally immature.

Participants also reported that care leavers often found it difficult to adjust to the responsibilities expected of them in voluntary services, such as actively participating in searching for housing and avoiding conflictual and aggressive behaviour. They reported that care leavers were accustomed to the paternalistic approach used in statutory services, and expected workers to carry out tasks on their behalf, and to not be held accountable for challenging behaviour. As a result, they were often evicted from refuges without alternative accommodation.

Those findings added to those of the Costs Report suggest some additional research questions:

1. What are the differences between the experiences of young people who transition from state out-of-home care and become homeless, and other young people with similar disadvantaged or traumatized family backgrounds who do not enter the care system, but also end up homeless?
2. What do these experiences tell us about the pros and cons of either pathway?
3. For state care the pros might include access to mainstream family supports and expectations (via foster or kinship care), or even for those in residential care at least access to professional supports and transition from care and post-care resources and funding. Conversely, state care can be a paternalistic experience which limits potential for the development of independent living skills and a capacity to cope with normative boundaries and restraints on violent or potentially harmful behaviour.
4. For the non-state care sample, the cons may mean being excluded from potential family and professional supports. But conversely, that cohort may have fewer illusions than the state care cohort about mum and dad getting their act together, relish their relative freedom from paternalistic controls, and be better able to develop independent living skills, and to adapt to normative boundaries and limits.

What are the key contributing factors to poor housing outcomes?

The high mobility of many young people while in care is closely associated with housing instability after care. Other contributing factors are the unplanned and unprepared nature of many departures from state care, and unsuccessful attempts at reunification with family of origin. The absence of sufficient personal and social skills such as shopping, cooking, and budgeting required to live independently have also been identified as issues that contribute to the poor housing outcomes of many care leavers.

Similarly, experiences of loneliness and social isolation, involvement in offending or substance abuse, mental health and emotional and behavioral problems, physical or intellectual disability, minimal education and poor employment opportunities are also linked to poor housing outcomes. In addition care leavers often experience relationship breakdowns with partners or friends, exposure to violence or harassment, eviction, poor quality accommodation or living in an unsafe area, and the lack of an option to ‘return home’ or ‘backtrack’ if the initial independent living arrangements do not work out.

A lack of affordable accommodation also influences the housing choices that are available when young people leave care. With few housing opportunities available to them, Australian care leavers are often forced to rely on inappropriate supported accommodation and assistance programs (Supported Accommodation Assistance Program) that were actually designed as short-term transitional housing programs, for those who are already homeless or escaping from domestic violence. Although Victoria has developed specialist leaving care housing support programs, most of these programs are not currently funded to assist care leavers past the age of 18 years. In short, because of a lack of dedicated housing, many care leavers transition directly from state out-of-home care into homelessness.

Particular groups of care leavers are likely to be most vulnerable to homelessness. They include those who leave care at a younger age, those who transition from residential care, those who have a disability, those involved in crime and offending, and those who have a range of mental health or substance use issues. These young people tend to have been excluded from education, experienced trauma as a result of abuse and neglect, and have few positive social or family connections.

Towards better Housing outcomes

Proposed solutions incorporate a range of structural assistance and relationship supports. UK research suggests the importance of ongoing “floating” practical and personal support from workers to establish and sustain stable accommodation. Particular emphasis is placed on providing a flexible range of accommodation options to meet differing needs including supported, transitional or independent accommodation in either public or private dwellings. Available forms of accommodation include: local authority and housing association tenancies, supported lodgings with former foster carers via the ‘Staying Put’ pilot schemes, training flats, voluntary sector schemes, private accommodation, reunification with family or relatives, and foyer accommodation linked to training and employment.

Financial assistance to access housing is important. Australian authors recommend that public housing be made available on a priority basis to care leavers, establishing separate transitional units available only for care leavers, providing a housing subsidy to ensure care leavers pay no more than 25 per cent of their income on housing, and offering assistance with the rental bond and establishment costs for setting up including the purchase of essentials such as bed, bedding, furniture, and a refrigerator and washing machine.

Given that 95 per cent of the Australian children in care reside in home-based care, one available option would be to provide continuing financial support to maintain these placements similar to the Staying Put model in the UK program which enables young people to stay with foster carers beyond the age of 18 years. Where this is not possible, care leavers should preferably be offered specific accommodation designed to meet their needs. A good example of such a model is provided by St Luke’s Anglicare in rural Victoria which offers care leavers access to secure and safe housing via a flexible range of housing options including subsidized rental properties and a boarder provider program.

Dealing with Trauma

 As already noted, many care leavers struggle to recover from earlier traumatic experiences. There is a strong argument for a trauma-informed service approach that would be underpinned by the following principles:

• Safety: The maintenance of physical safety across all environments;
• Stability: Stability in living environment and relationships, reducing the need for re-location and disconnection from networks;
• Connection: Supportive direct care and other family, peer and social connections as a key tool for addressing trauma;
• Understanding: An understanding of trauma and its impact across all service systems (including universal services) and concurrent support for young people to understand their own experiences, needs and strengths;
• Healing: Access to evidence-supported therapeutic interventions, particularly those addressing the impact of complex trauma;
• Continuous improvement: Ongoing evaluation of outcomes of interventions and services, and adjustment of policies and practices accordingly.

Positive Outcomes from Youth Refuge reform

 The provision of a continuum of care via youth refuge reform could provide significant benefits for care leavers in that system given that ongoing and consistent staffing models are more likely to facilitate positive attachments and mentoring-type relationships in contrast to rostered staff models that don’t allow for consistent connections.

• Evaluations of pilot therapeutic residential care programs in Victoria have suggested improved outcomes for young people including enhanced placement stability, better quality of relationships with carers and family, increased community connection and a greater sense of self, reduced risk taking and better physical, mental and emotional health.
• But it is worth keeping in mind that therapeutic intervention is more effective for young people with externalising behavioural problems (such as antisocial behaviours) than for those with internalising problems (such as withdrawal or anxiety).  Additionally, essential elements associated with improved outcomes in TRC include involvement of therapeutic specialists, trained staff and consistent rostering, engagement with the young person’s wider support network (including family where appropriate), teaching adaptive skills to facilitate community reintegration, and integrating post-care support to maintain any gains from such programs.
• Models: Therapeutic care is most effective when integrated with wider community support network.

• Workforce: Professional carer model including minimum level of training.

• Independent living skills: Young people who are developmentally ready to prepare for independent living are taught skills in cooking, health care, budgeting etc.

Summary of Limitations of current Leaving Care System

• Post-care supports for young people 18 years and over are discretionary, not mandatory;
• Many care leavers are not developmentally ready at 18 years to live independently;
• There is no guarantee of housing support so that many care leavers exit directly into homelessness, and others endure ongoing housing instability.
• Too many programs within and beyond OHC focus on preparing for independence, rather than for ongoing support or interdependence.

(Associate Professor Philip Mendes teaches social policy and community development, and is the Director of the Social Inclusion and Social Policy Research Unit (SISPRU) in the Department of Social Work at Monash University in Victoria, Australia. He has been researching young people leaving state care for more than 15 years, is the Australian representative on the Transitions to Adulthood for Young People Leaving Public Care International Research Group, and has completed major studies pertaining to  youth justice, employment and mentoring programs, disability, and Indigenous care leavers. He is the author or co-author of 10 books including Young people transitioning from out-of-home care: International research, policy and practice co-edited with Pamela Snow (Palgrave Macmillan, forthcoming July 2016), and a third edition of Australia’s Welfare Wars (forthcoming late 2016) – Philip.Mendes@monash.edu

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