Use of hospitals and homelessness services by refugees and humanitarian entrants

Between 1 July 2011 and 30 June 2021

Demographics

Of the total humanitarian entrants who used a Specialist Homelessness Service (SHS) between 2011–12 and 2020–21:

• The most common age group was 25 to 34 year olds (23%)
• 22% were under the age of 18
• 45% of clients had an address registered in Victoria on the Medicare Consumer Directory. This is consistent with the overall SHS data which also has high rates of SHS clients in Victoria (AIHW 2024).
• There was a higher proportion of females than males in all age groups except 0 to 9 and 10 to 14, where the proportion of males was 52% for both age groups in humanitarian entrants and 51% for both age groups in other permanent migrants
• Sudan was the most common country of birth (24%) recorded (Figure 11).

Figure 11: Demographic of SHS clients when they first access SHS services, by cohort 2011–12 to 2020–21  

Notes:

1. Age calculated at the 31^st of December of the financial year in which SHS was first provided to the client.
2. State of residence as recorded on the Medicare Consumer Directory on the 31^st December of the financial year in which SHS was first provided to the client.
3. Country of birth as stated in the Department of Home Affairs’ Settlement Database.
4. Migrants with a birth place listed as Sudan in the Settlement Database may include migrants whose birth place is in the area which is now the country of South Sudan which gained independence in 2011. Therefore a birth place of Sudan may include South Sudanese migrants.
5. Differences between states may not reflect demand or service availability but may reflect differences in humanitarian entrant populations, and state and territory policies and service provision models.
6. Victoria has the largest number of SHS services and high rates of SHS clients (AIHW 2024).

Further data on the demographics of humanitarian entrants and other permanent migrants can be viewed in the Data tables.

Living arrangement and presenting unit type

The living arrangement of a client describes who a client is usually living with when they present to a SHS. Presenting unit type indicates how a client presents to a SHS agency.

Between 2011–12 to 2021–22, among humanitarian entrant SHS clients first accessing the SHS:

• the most common living arrangement was one parent with child/children (27%)
• 61% of humanitarian entrants presented alone
• there were differences in living arrangement and presenting unit type reported for men and women (Figure 12).

Figure 12: Living arrangement and presenting unit type for humanitarian entrant SHS clients, by sex, 2011–12 to 2020–21

Notes:

1. Living arrangement and presenting unit type are reported when first attending for receiving SHS support.
2. Children may be reported as presenting alone to a SHS agency for several reasons, see the Technical notes for further details.

Comparisons with other permanent migrants can be explored in the Data tables.

Socioeconomic characteristics of humanitarian entrant SHS clients

The ability to sustain adequate housing can be impacted by various socioeconomic factors including, but not limited to employment, education and income. 

Among humanitarian entrant SHS clients when first receiving SHS:

• A high proportion were either not in the labour force (34%) or unemployed (42%) (Table 8a).
• Females were more likely to not be in the labour force (39% of females compared with 27% of males). Males were more likely to be unemployed (36% of females compared with 51% of males) 
• Government income support was the most common main source of income (70%) (Table 8b) with the most common payment type being different for males and females - JobSeeker (formerly NewStart -44% of males) and parenting support (30% of females).
• More than 1 in 4 (27%) were currently students of any kind compared with almost 1 in 6 (16%) other permanent migrants (Table 8c).

Source: Refugee health linked data set

Source: Refugee health linked data set

Source: Refugee health linked data set

Note: Definitions of the responses in the above tables and how these responses are collected can be explored via the SHS data definitions on the AIHW website. 

Further data on the socioeconomic characteristics of humanitarian entrants and other permanent migrants when they first access SHS can be explored in the Data tables.

Time since arrival when first accessing SHS 

A higher proportion of humanitarian entrant SHS clients first accessed SHS within 1 year of arrival in Australia (17%) than other permanent migrant SHS clients (13%) (Figure 13). 

Notes:

1. Time since arrival in Australia is calculated from the time between the arrival date recorded in the Settlement Database and the episode start date of the first SHS support for that client
2. The denominator is the total number of unique SHS clients who accessed support at any point between 2011–12 and 2020–21.

Referral source

No formal referral source was recorded for 31% of humanitarian entrant clients when first accessing SHS support. Of the humanitarian entrant SHS clients who did have a formal referral recorded:

• The top three referral sources were other agencies (18%), specialist homelessness agency/outreach worker (17%) and family or friends (13%)
• Immigration department or refugee support services were identified as the fourth most common referral source for 8.4% of humanitarian entrants.

For other permanent migrants, the most common referral source was the police (21%). In comparison, the police was a referral source for 6.7% of humanitarian entrants.

For detailed breakdown of referral sources see Data tables.

Clients with a mental health issue

Of humanitarian entrant clients who accessed SHS between 2011–12 and 2021–22:

• 1 in 4 (25%) were identified as ever having a mental health issue, compared with almost 1 in 3 (30%) other permanent migrant SHS clients- lower than all SHS clients (31%) (AIHW 2024).
• Females (27%) were more likely than males (21%) to be identified as having a mental health issue.

See Box 1 for how mental health issues were identified in the SHSC.

People with mental health issues are especially vulnerable to experiencing homelessness (Nilsson et al 2019). Mental health issues that increase psychological distress and impair decision-making in everyday life can contribute to employment issues, social support breakdown, and financial hardship (Johnstone et al. 2016, Kaleveld et al. 2018). These issues can lead to challenges with securing or maintaining housing (Brackertz et al. 2018). Also, people from culturally and linguistically diverse backgrounds experiencing mental health conditions may face additional challenges and vulnerabilities in accessing health services owing to shame, stigma and misunderstanding (Khatri and Assefa 2022) which may increase the risk of challenges with securing or maintaining housing.