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Royal Commission into Victoria’s Mental Health System

Case study:

Housing and Accommodation Support Initiative

Under New South Wales’ Housing and Accommodation Support Initiative (HASI), community‑based community support providers work in close partnership with local mental health teams to deliver flexible wellbeing supports and practical assistance to people who experience mental illness so that they can live and participate in the community, maintain successful tenancies and continue their recovery.

The foundation of the HASI program is the partnership between NSW Health, Housing NSW, community support providers and community housing providers. NSW Health is responsible for delivering clinical services (via local health districts) as well as funding the wellbeing support services that are delivered by community support providers. The community support providers work closely with government and community housing providers that manage the tenancies of HASI consumers who live in social housing. The HASI program also delivers targeted support packages to people living with mental illness who are living in private tenancies.

Services are tailored to the individual support needs of each consumer and involve consumers in decision making.

Since its establishment in 2002, HASI has evolved and expanded. Originally providing 100 support packages, it now supports more than 1,900 people under a flexible support model. Changing its model from ‘packages’ to hours of support has given HASI flexibility to adjust supports to meet changing consumer needs.

The evaluation of the HASI program in 2012 concluded that consumers receiving HASI had greater tenancy stability and used their relevant mental and physical health services more, leading to better mental health outcomes, social contact and participation in community activities, including education, training and work.

In addition, the evaluation found participants had significantly fewer and shorter mental health hospital admissions, leading to an associated cost saving and increased capacity for other consumers. Improvements included a 59 per cent decrease in the average number of days spent in a mental health inpatient unit per year and a 24 per cent drop in the number of admissions to hospital per year.

One HASI participant spoke about how they benefited from the program:

Without [the HASI Support Provider] I wouldn’t be in as good a place as I’m in now, not just physically but having achieved some of the things I wanted to achieve—like my independence in living and in running my own life and stability in housing.

In 2012, the annual per person cost of HASI was calculated to be between $11,000 and $58,000. These figures do not include the cost of clinical mental health services, the costs to social housing providers (as these costs would be incurred regardless of HASI participation) or project management costs. Between 2002 and 2007, there was an initial social housing capital investment of $26 million. Since this initial capital investment, housing acquisitions specifically for the program have ceased and HASI uses housing provision through social housing and private tenancies.

A follow‑up evaluation of HASI and related programs is expected in 2021.

Source: RCVMHS meeting with NSW Health, 11 September 2020; NSW Health, Correspondence to the RCVMHS, 2020; Jasmine Bruce, Shannon McDermott, Ioana Ramia, Jane Bullen and Karen R. Fisher, Evaluation of the Housing and Accommodation Support Initiative (HASI) Final Report, 2012.