None listed
Conditions
Brief summary
HYPOTHESIS The J2SI Mark II enhanced service model will lead to improved housing, employment, social, and mental health and well-being outcomes for homeless participants when compared to those receiving a standard service. AIMS To break the cycle of chronic long-term homelessness and improve housing outcomes and the health of those experiencing homelessness. The J2SI Mark II research project aims are to: - Evaluate the impact of a new enhanced homelessness intervention compared with existing service provision with regards to outcomes in: Education, Employment and Income; Social Inclusion; Mental Health; Physical health; Housing and; Service Usage. - Examine the cost of the new homelessness program compared with existing service provision and assess the cost-effectiveness of the J2SI service Model – Mark II; and, - Provide a framework for scaling up the intervention pending positive evaluation findings. OBJECTIVES - Investigate the impact of an integrated homelessness prevention intervention on positive mental wellbeing, mental ill health, quality of life and behavioural risk factors at baseline, during and after the study - Identify changes in protective and risk factors for mental health (e.g., social support networks, loneliness) and behavioural risk factors (smoking, alcohol, drug use) at baseline, during and after the intervention - Model the relative and combined contribution of housing support, educational and employment opportunities, access to services and support to the health and wellbeing of participants at baseline, during and after the intervention - Evaluate changes in health outcomes and service usage at baseline, during and after study and - Model the cost effectiveness of the program in relation to service usage, emergency admissions, and contact with justice services.
Interventions
Deliver intensive individualised support for up to 3 years to 60 people experiencing long-term homelessness in areas of high prevalence in metropolitan Melbourne. Enhanced J2SI service model will operate across 5 key service elements:
1.Intensive case management & service coordination
2.Tenancy support and capacity building to maintain housing
3.Trauma informed practice
4.Skills for inclusion
5.Fostering independence
Year 1 has a focus on accessing housing and staying housed using a sustaining
Deliver intensive individualised support for up to 3 years to 60 people experiencing long-term homelessness in areas of high prevalence in metropolitan Melbourne. Enhanced J2SI service model will operate across 5 key service elements: 1.Intensive case management & service coordination 2.Tenancy support and capacity building to maintain housing 3.Trauma informed practice 4.Skills for inclusion 5.Fostering independence Year 1 has a focus on accessing housing and staying housed using a sustaining tenancies approach with the assistance of a Key Worker (6:1 client ratio). Year 2 shifts the engagement to a team approach to coach and empower clients to progress goals (6:1 client ratio). Year 3 will focus on supporting clients to strengthen their connection with their local community and broader system, and increase a sense of social inclusion through enhanced social and economic activity (12:1 client ratio). 1. How each component will be administered. - Each component is administered by the Intensive Case Manager (ICM) through approximately 5 hours per week of client work. - This includes direct and indirect contact with the client using a case management approach that is tailored to the individual. - Because support plans are individualised each component and its delivery are in response to the clients identified goals, the time allocation varies for each component to ensure tailored and responsive interventions. - Each component is administered through the process of case management and service co-ordination- some provided directly by ICMs and some by other services coordinated by J2SI ICM, these may be individual, group activities, in an office, in the home, or community. It is all tailored to provide the best response to achieving goals as negotiated by the client. 2. Frequency and duration - Frequency is tailored, but overall between 3-5 hours per week (6-10 per fortnight), is attributed to each client (includes admin/ travel time). - Allocation of time (duration) is tailored to meet the agreed support plans, if it takes 5 short visits or 1 extended visit with the client, then this is provided each week. - But clients need to be offered same amount of support over a monthly period so all clients receive the same allocation of intervention. 3. Brief description of any strategies used to monitor adherence to the intervention - Fortnightly supervision reviews by supervisors- to confirm intervention is provided as per model - 6 monthly case file audits - 6 weekly clinical supervision of staff - Case reviews - Practice reflections - Support plans are used to set goals, identify service interventions, and monitor progress - Outcomes survey completed by client as part of case management are also used every 6 months (for those consenting) to track outcomes - Monthly reports by ICMs and Coordinator, and Manager - SHIP reports that provide breakdown of time, and identify that all 5 outcome areas of J2SI are being translated into support plan during the three years - Partnership agreements with specialist and mainstream agencies have regular reviews to ensure compliance.
Sponsors
University of Western Australia
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
25 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
1) Have been sleeping rough continuously for more than a year OR who are homeless and have experienced several episodes of homelessness over the past three years OR who are currently permanently housed, are at risk of homelessness and have been homeless at some point in the last six months; AND 2) Have received some level of case management response from Sacred Heart Misson, VincentCare, St Marys House of Welcome OR are well engaged with an on-site Program but have been unable to secure a case management response; AND 3) Are aged between 25 – 50 years; AND 4) Are a permanent resident; AND 5) Are eligible to access public and/or community housing; AND 6) Agree to participate in the program.
Exclusion criteria
1) People who are currently receiving other long term intensive support (e.g., Street2Home); OR 2) People experiencing language barriers that require an interpreter service but budget constraints limit the ability to provide interpreter service support; OR 3) People experiencing an unmanaged mental illness of a severe nature affecting an ability to provide consent and complete a survey even with a guardian present; OR 4) People who for any reason are unable to a) give informed consent or b) participate fully in the intervention or study even with guardian present; OR 5) People deemed by agency staff to pose an identifiable safety risk to agency staff, researchers, other people or the participant themselves.
Outcome results
None listed