A rise in the number of people sleeping rough in inner Sydney is being reflected in increased numbers of homeless seeking support and care at the city's main public hospital.
The City of Sydney's bi-annual street count of homeless people – which records the number of people bedding down in the city's streets, parks and public places – found 365 people were sleeping rough on Monday night (23 February).
This is the largest number of rough sleepers recorded by the count in five years – since February 2010 (418) – and is a 23% increase on August 2014 (296).
St Vincent's Health Australia, which operates St Vincent's Public Hospital in Darlinghurst – 'ground zero' for hundreds of rough sleepers in Sydney's inner city seeking health care every year – said, anecdotally, it had noticed an increase in homeless people presenting at its Emergency Department and being referred to its other health services over the previous 12 months.
"Certainly from what we're experiencing in our hospital and health services, the number of homeless people in Sydney's inner city is on the increase," said Jenny O'Mahony, Manager of St Vincent Public Hospital's Inner City Health Program.
"There could be a number of reasons why that's the case.
"Homeless services in NSW have experienced fairly significant reforms in recent times, including an emphasis away from crisis support in the inner city towards homeless prevention and services for homeless families and children in the suburbs.
"While we absolutely support that refocus, these latest figures show it might be inadvertently leaving rough sleepers short of the support they need.
"It's a welcome ambition to want to focus on homeless prevention or the needs of other vulnerable groups. But you can't expect homeless people in Sydney's inner city to take care of themselves or for services to do more with less. You have to put something in place to assist in the transition.
"Counting people sleeping rough is notoriously difficult. I wouldn't be surprised if the real number is actually higher.
"The government should consider stepping in and beefing up support for crisis services in Sydney's inner city, at the very least while its homeless reforms are bedding down.
"In recent years, we've seen an enormous amount of effort, resources and goodwill put into reducing homeless numbers – not just in Sydney's inner city, but across the country.
"Locally, initiatives such as Way2Home – in which St Vincent's is a partner – Common Ground and Connect 100 have all had an impact on reducing the numbers of rough sleepers by taking a 'housing first' approach.
"Simply put, 'housing first' means placing a homeless person in long-term housing and then building a range of support services (eg: mental health, drug and alcohol counselling, etc) around them to help them sustain their accommodation long-term.
"But with a shortage of social housing – and no other housing first initiatives in the pipeline – it feels the job has been left half done.
"Access to health services, in particular, are absolutely crucial in ending homelessness.
"Studies show that among rough sleepers, 90% are in ill health. Many suffer post-traumatic stress disorder and have a range of health problems including musculoskeletal, respiratory and circulatory. Three-quarters have a functional disability.
"On top of that, most homeless people are smokers and regularly misuse alcohol and other drugs.
"The only way to end homelessness among people with that profile is to make sure they can access health services that are integrated with efforts to find them accommodation.
"If a vulnerable person doesn't get the health support they need, it's very difficult for them to sustain their housing.
"We've had great success at working with the City of Sydney, other levels of government and homeless agencies to make sure people are able to access the health support they need, when they need it – which has been key to them sustaining a stable home," said Ms O'Mahony.