Housing and Support Program (HASP): Final Evaluation Report

activities, while others tried to connect clients to
existing disability support groups in their communities.
The intensity of support provided to each client
remains unclear as it was based on client needs and
the willingness of the individual to accept support.
Stage one provided support to 100 people with
complex mental health problems and high levels
of disability. The majority had schizophrenia (71.9%)
and almost all (86.4%) had been hospitalised prior
to entering the program. One in 10 had been living
in unsatisfactory accommodation, including boarding
houses, crisis accommodation, tents, or squatting.
The most signifi cant outcome was the reduction in the
need for acute inpatient care. Prior to joining the HASI
program, clients had a total of 12,486 days in hospital.
This is compared with 1,461 days (or a 90% decrease)
in the 12 months following the program (Morris et
al., 2005). Cost-effectiveness analysis indicates that
the cost per person was estimated for start-up at
$110,337.88 and a recurrent annual cost of $57,530.
This does not include a number of cost factors, such
as the recurrent program management costs by the
NSW Health Department, the cost to HASI participant,
family and other services providers (such as GPs),
or foregone costs because resources (such as
management and housing stock) were spent on
HASI rather than elsewhere.
‘Project 300’ – (Queensland)
‘Project 300’ was established in Queensland in 1995
with the aim of relocating 300 long-stay clients who
were resident in the three psychiatric hospitals in that
state back to their community of origin or choice.
An independent evaluation of the initiative found
that the Project 300 ‘model’ was able to maintain
a group of formerly institutionalised people in their
chosen community. Days spent in the community
remained high and most people were engaged in
some form of structured activity outside the home.
The cost of keeping individuals in the community
was about one-third that of keeping the same
individual in hospital (Meehan et al., 2011).
Follow-up at seven years post-discharge to the
community found that while the majority of people in
the study remained unemployed, many were involved
in community activities. While some individuals had
made signifi cant progress, there was no evidence of
systematic gains in general functioning for the group
as a whole. The evidence of successful community
tenure, notwithstanding in many cases, a history of
unsuccessful discharge prior to the introduction of
Project 300, suggests that the support worker role
actively contributed to successful community tenure.
Indeed, follow-up found that 40% of those discharged
had not required admission to inpatient care in the
seven years since entering the program. This is a
remarkable fi nding given that almost all of the clients
in the program had been in hospital for the two years
prior to entering the program.
Individual Tenant Support Program –
(South Australia)
The Individual Tenant Support Scheme in South
Australia was established in the inner-south region
of Adelaide and was designed for people with
long-term mental illness at risk of relapse through
an accommodation/support crisis. The scheme, which
was in place from November 1994 to November 1996,
was designed to provide support to tenants on a
fl exible basis. This was achieved through a partnership
arrangement between service users, service providers
and community-based organisations (Deslandes &
Kilner, 1997). The project had the unexpected diffi culty
of being able to recruit the minimum target of 15 tenants
at any one time. The reason for the low referral rate is
unclear, but could have been a consequence of inbuilt
prejudices, which made it very diffi cult to create good
working relationships across the different sectors
(Deslandes & Kilner, 1997). The project used a model
of support based on Direct Care Workers (DCWs), with
each individual receiving up to 21 hours of support per
week. The fi nal report was critical of some DCWs being
more enabling than others and this may have restricted
the manner in which DCWs interacted with tenants and,
therefore, limited options for community integration.
The report was generally descriptive and very little
information was available on the background of these
workers, other than that they were non-professionally
trained staff employed for a minimum of four hours per
week and received training and orientation.
Housing and Support Program (HASP)
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