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The Working Poor

At First Step, we are seeing an increase in people who we would call the ‘working homeless’, that is, they are employed but either couch surfing, or struggling to meet their rental commitments, or are actually sleeping rough.

Or those we might call ‘quasi homeless’, that is, they are in rental accommodation, but no longer using essential amenities, like heating, and might start accessing community services to help feed their family. Just because they have a roof over their head, doesn’t mean they’re ‘housed’.

There has always been a portion of the population that fell into the ‘working poor’ demographic and our services have been designed to support them. For instance, we’re in the City of Port Phillip, and our program was built to service people who were homeless, those that were chronically unwell and with mental health and substance use issues. For most of the people in this group, it’s a relatively slow progression from wellness to acuity and severity of risk.

But in the last 18 months, we’ve seen a shift in the demographic coming through the door.

People who came out of the pandemic holding onto a job, holding onto a rental and were relatively ok, all of a sudden are having to access services they never even knew about. Through no fault of their own, their work hours might have been cut, and along with the sky high cost of living, their mental health might take a hit, which then impacts their ability to function in the every day.

This change has been relatively rapid, it’s still manifesting and unpredictable.

The MHICC (Mental Health Integrated Complex Care) program runs for people with complicated high prevalence, low acuity illness – that is, depression, anxiety and substance use along with homelessness, legal issues and multiple medical conditions. But instead of this demographic growing, we’re seeing employed people requiring MHICC level of care. And unfortunately, by the time they get to us, they are teetering on the edge of unemployment, are already significantly unwell, and are probably already accessing community services.

How then, with the intensity of program we run, can they sustain their employment?

We need to monitor these changes closely and be prepared for structural redevelopment to meet the emerging needs of our community.

Joe Fishburn RPN,
Manager Mental Health Services

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