Housing and Support Program (HASP): Final Evaluation Report

Section 1
Introduction
Since the 1970s, mental health policy in Australia has promoted the downsizing of
‘stand-alone’ psychiatric hospitals and the decentralisation of mental health services
into the broader community. The rationale for these reforms was based on the belief that
community alternatives would provide a therapeutic and rehabilitation function such
that individuals would move from higher to lower levels of dependence and eventually,
to independence (Bachrach, 1989). Underpinning the process was the desire to provide
a range of community supports that best suited the needs of people leaving hospital
and also, new consumers with serious mental illness.
There was an underlying belief that many of the
services provided in the institution could be better
provided in the community or in the individual’s own
home (Bachrach, 1989). The movement towards the
closure of psychiatric hospitals was driven in part by
the philosophy of freedom, independence and the
hope of providing a better quality of life for individuals
with mental illness in the community (Meehan, 2007).
Mental health policy in Queensland has also been
infl uenced by these broader trends in service reform.
Over the past 20 years, a signifi cant number of
individuals have been relocated to the community
under hospital downsizing programs such as
‘Project 300’ (Meehan et al, 2011). While many of these
former long-stay clients are now elderly or deceased,
a new group of individuals with severe disability has
emerged. This group is made up of young, mostly male
clients with a diagnosis of schizophrenia, frequently
complicated by substance misuse (Meehan, 2007;
Reuland, Schwarzfeld, & Draper, 2009). Many of these
clients are too disabled or fearful to make and keep
appointments at mental health centres and are at high
risk of homelessness and frequent contact with police
and other community agencies (Fry, O’Riordan, &
Geanellos, 2002; Commonwealth of Australia, 2006).
In Queensland, a continuum of housing options has
emerged to cater for the needs of those with more
severe problems. These services range from 24-hour
residential care (in the form of Community Care Units)
through to independent living options. One of the
initiatives in this continuum includes ‘supported’
housing. Individuals are provided with public housing
and are supported by visiting workers, typically
employed through the non-government sector. This
non-clinical support is aimed at assisting the individual
to access required services in their local community,
manage day-to-day living activities and sustain their
tenancies (O’Malley & Croucher, 2005).
One of the earliest supported housing models to be
introduced in Queensland was known as ‘Project 300’.
The program was established in 1995 with the aim
of relocating 300 individuals with severe psychiatric
disability from the three existing psychiatric hospitals.
In 2006, a similar supported housing initiative, known
as the Housing and Support Program (HASP), was
established to support individuals who were unable
to leave acute and extended treatment mental health
facilities due to lack of housing and appropriate
supports. This report focuses on the evaluation of the
Housing and Support Program.
Housing and Support Program (HASP)
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