A Choice or the Only Option? Supported residential services and private supported boarding houses
This article delves into the critical policy challenges surrounding Victorian Supported Residential Services (SRS) and private supported boarding houses, an enduring national issue. Originating from an article by Dr Elroy Dearn published in Parity Magazine Vol 37, Issue 2 (March 2024), it aims to shed light on the urgent need for reform and advocacy in these institutional settings.
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A national groundswell of interest in Victorian SRS and private supported boarding houses in other states has emerged in recent years in Australia. These settings developed nationally in the context of deinstitutionalisation to accommodate people with disabilities who were being discharged from institutions.
Research and inquiries reveal a long-standing national problem in SRS and private supported boarding houses. Residents - most of whom experience psychosocial disability - experience chronic poverty, higher mortality rates, increased hospital readmissions, and limited opportunities for participation and recovery. (Dearn 2021) Women living in these settings are at significant risk of sexual violence. (Bedson 2012) These settings are not consistent with optimal recovery outcomes for people with mental illness. (Dearn et al 2022)
An edition of Parity Magazine launched last week sought to profile problems in these settings as a national issue. At the same time, last week’s federal government response to the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability (DRC) handballed the only recommendation relating to SRS and their equivalents (Rec. 7.38) - for better safeguards and independent advocacy for residents who wish to move out - to state and territory governments. (p 288)
Many decades of inquiries have asked whether these settings provide an appropriate level of accommodation and support for vulnerable people. This has resulted in a myriad of reforms of state-based legislative safeguards. However, not until the introduction of the National Disability Insurance Scheme (NDIS) has the systemic nature of the vulnerability of residents in these settings been in the public spotlight.
The 2021 Age Newspaper headline, ‘How Denise Morgan escaped Albert Park’s house of horrors’ outlined the shocking conditions in one Victorian SRS and the neglect of residents, necessitating its closure by the responsible government department. Since then, there have been reports in Victoria about SRS residents being ‘trafficked’ for their NDIS funding, while advocates in Queensland have reported having no choice but to place residents with disabilities into boarding houses. Additionally, ABC Four Corners shed more light on the exploitation of Victorian SRS residents’ NDIS funding.
While a lot of the attention has been on Victorian SRS, residents are falling through the cracks of state-based and national safeguarding mechanisms in these settings across the country – in ‘assisted boarding houses’ in NSW, ‘psychiatric hostels’ in Western Australia, ‘residential services level 3’ in Queensland and ‘supported residential facilities’ in SA.
The lack of separation of housing and support endemic to the model provides inadequate protection for residents’ rights. Alongside this, the Convention on the Rights of persons with Disabilities (CRPD) has driven a focus on whether these institutional environments are consistent with the right of people with disabilities to live where they wish and with whom, and in non-segregated settings.
In her statement to the DRC public hearing 26 into homelessness including experience in boarding houses, hostels and other arrangements, Ms Tracy Mackey, former NDIS Safeguards Commissioner reported that:
‘Participants who have resided in SRS may be more comfortable remaining in this style of accommodation as it suits their preferences and needs’. (p 388)
However, living in SRS is not much as a ‘choice’ but a fall-back option when all other options have been exhausted. The capacity of residents to originate and make choices about their housing is limited by their low economic and social capital and the tacit acceptance of this model by people supporting them. (Dearn et al 2022)
These settings remain an accepted part of the service framework, despite their obvious incompatibility with non-segregated models of housing for people with disability and the violence and abuse endemic to these settings. This complacency is revealed by the statement made by Ms Sherri Bruinhout, Executive Director of Housing Pathways and Outcomes at Homes Victoria, who in her testimony to the DRC public hearing 26, described SRS as part of a:
‘continuum of housing responses for vulnerable Victorians’. (p 441)
There is no comprehensive national data on the demographics of people living in these facilities. And there is little understanding of the housing needs and preferences of residents. Whilst the Victorian government conducts an SRS census every five years, it has not undertaken this census since 2018.
The introduction of tighter regulations in most states has led to a decline in the number of settings and numbers of residents overall. However, significant numbers of people continue to live in private supported boarding houses. In many states, there are the default discharge option for people leaving mental health services who have no alternative place to go.
The recent recommendations from the DRC and the Independent Review of the NDIS stress the necessity for reforms to guarantee that people with disabilities can choose safe, non-institutional housing and support options. It is crucial to advocate for this issue now, to ensure the protection of residents' rights to safety and providing pathways out of these institutional settings.
With the DRC recommendation relating to SRS and private supported boarding houses now falling to state and territory governments, along with their responsibility for addressing safeguarding concerns, gathering comprehensive data on the demographic profiles, housing needs, and preferences of residents in private supported boarding houses should be their top priority. Equally important is providing the provision of advocacy for those residents who aspire to transition to more suitable living arrangements.
Dearn E 2021, Choice and control? Understanding how residents with psychosocial disabilities remain in ‘transinstitutional’ settings despite the ‘once in a lifetime’ opportunity of the National Disability Insurance Scheme, unpublished PhD thesis, Melbourne. https://onlinelibrary.wiley.com/doi/full/10.1002/ajs4.233
Bedson L 2012, Sexual assault in supported residential services: four case studies, Office of the Public Advocate, Victoria.
Dearn E, Ramcharan P, Weller P, Brophy L and Johnson K 2022, ‘Supported residential services as a type of “total institution”: Implications for the National Disability Insurance Scheme (NDIS)’. Australian Journal of Social Issues, vol. 58, no. 2, p. 12.
Moderator: Dr Elroy Dearn, Research Fellow, RMIT University