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Evaluation of Innovative Health Services for Homeless Youth (IHSHY). Tracy Reibel & Tanyana Jackiewicz Telethon Institute for Child Health Research Western Australia. IHSHY Services in WA. Perth Primary Care Network Street Doctor Fremantle StreetDoctor Hills Community Support Group Inc
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Evaluation of Innovative Health Services for Homeless Youth (IHSHY) Tracy Reibel & Tanyana Jackiewicz Telethon Institute for Child Health Research Western Australia
IHSHY Services in WA • Perth Primary Care Network Street Doctor • Fremantle StreetDoctor • Hills Community Support Group Inc • Adolescent Mothers Support Service (AMSS) • RUAH Young Women’s Program
Background • IHSHY jointly funded by Australian Government and State and Territory Governments • Western Australian State Government provides 70% of IHSHY funding • Evaluation commissioned • Document service models and measure accessibility and acceptability/usability
Research Process • Evaluation still in progress • Informed by extensive literature review • Research focus on youth perspectives • Service users and service providers interviewed • Recommendations will assist the State Government and/or services to bid for further Australian Government funding
Young People…Quick Stats • About 13,390 homeless people in Western Australia • 32% are 12-18 year olds • 8% 19-24 year olds • More females in younger group, more males in older group • Aboriginal young people account for a significant portion of homeless or at risk youth
What Young People Say… Key qualities of Street Doctor services are: • Location is good – convenient • Social gathering – atmosphere around the van • Doesn’t feel like you are waiting • Don’t have to wait as long compared with visiting a GP surgery • Free service and don’t have to remember Medicare card
When asked why other young people might not use the services, the most commonly cited reason is that they probably don’t need it, or, “if they don’t come, it’s probably because they don’t want to be helped”.
What Young People Say… Key qualities of service providers: • Friendliness (most cited quality) • Trust • Respect • Won’t judge • Confidentiality • “Treat you like a person”
Many of the young people talked about being treated as a person, and providers “taking the time to talk to me rather than at me”
What Young People Say… Other services needed • Places for young people to go – drop in centre 24hr – weekends • Somewhere safe to go • Emergency accommodation • Counselling and mental health
Key Service Qualities • A place where people feel safe • Untimed/unbooked appointments • Flexibility • Clear boundaries • Follow up where feasible
What Providers say… Qualities required of providers • Non-judgemental • Staff philanthropically inclined • Passionate • Respectful • Easy going • Empathy with client group • Sense of humour
An outreach worker comments “all staff are philantropically inclined or they wouldn’t be working in that hot van…I mean the doctors could get a much more comfortable office you know, but they do it because they care…we all care”
A GP comments that: “Karen who practice manages…has such enthusiasm and passion and commitment for it, and she really understands what our clinical needs are”
What Providers say…about trust A nurse comments that “I feel for us because we’re fairly regular now, we’ve earned trust. And once you’ve earned trust, then [the clients] start opening up a lot more…they’re more comfortable”
Another GP says “Trust is an absolute condition. If they feel one bit that they are being judged, I mean, and they’re sensitive in that area and at that age, extremely…it just turns them off. They won’t want to come again”
Service providers identify… Improvements to service • Could be on site more • Going to more places • Psychologist on board • More time with each client • Shoes and socks • New van with electronic filing and printing facilities • Promotion of service
Young people identify… Improvements to services • “Nothing really” • Blankets/jumpers • Coffee • Psychologist • Better bus • Onsite pharmacy, free scripts
Acknowledgements • The young people who willingly participated in interviews and shared their views and ideas • The service providers who gave up personal time for interviews • The program coordinators for facilitating introductions to providers • Michael Robinson, IHSHY Manager, Department of Health