In 2022, within my capacity as the Men’s Health Nurse Consultant at St Vincent’s Hospital Sydney, I sought a meeting with Pastor and CEO Jon Owen of the Wayside Chapel to discuss initiating a men’s group for men who accessed Wayside.
Jon introduced me to visitors of the Wayside Chapel and Chaplain Jason Lal who had similar ideas. Since then, the visitors and Jason have organically developed the Wayside Men’s Group to support men (a lot of whom who sleep rough and experience homelessness) to come together fortnightly.
Men’s health as it pertains to men who are homelessness is sadly absent from many platforms and mainstream discussions. However, the data does not lie—within metropolitan, regional and remote settings, homelessness is increasing in Australia for both men and women, and we need to acknowledge this more.
Homelessness In Australia
According to Government data it was estimated that 122,000 people were homeless on Census night in 2021, of these: 56% were male, 21% were aged 25–34 and 20% were Aboriginal and Torres Strait Islander (First Nations) people (ABS 2023).
Homelessness can be difficult to accurately define, and there is no one clear definition according to Homelessness Australia. The Australian Bureau of Statistics defines homelessness as ‘…when a person does not have suitable accommodation alternatives they are considered homeless if their current living arrangement:
- Is in a dwelling that is inadequate
- Has no tenure, or if their initial tenure is short and not extendable; or
- Does not allow them to have control of, and access to space for social relations (ABS 2012)’
Groups at Risk of Homelessness
The population groups in Australia known to be of particular risk of homelessness are; those who have experienced family & domestic violence, Indigenous Australians, children on care and protective care orders, young people and older persons.
Persons in their late 50s and 60s account for the largest cohort within homeless populations, and this is expected to grow with the ageing population.
Homelessness and Trauma
Trauma and homelessness are so tightly linked, they are almost impossible to separate according to social researchers. Experiencing trauma in early life is a strong predictor of homelessness in later life.
Traumatic events in adulthood such as domestic violence, natural disasters and accidents can directly or indirectly (due to psychological trauma) lead to homelessness according to research.
Homelessness and Older Men
A qualitative study of older men sought to understand their lived experience of chronic homelessness, and discuss the contributing factors from their perspective.
Four themes emerged after speaking with the men in this research study, which are discussed below.
Theme1: Trauma Precipitating Homelessness
Many of the older men who were interviewed spoke of profound childhood trauma. The time from childhood into adolescence was spent by many men in a variety of foster homes or child services. One man reflected (all quotes taken verbatim from the text),
“My mom, she couldn’t find a babysitter to babysit all of us so somebody called the state on us and they took us from her … I ended up in being in … seven boys’ institutions and 13 foster homes for my whole entire life.”
Trauma combined with unstable living situations led many to have underdeveloped life skills, such as unstable relationships and erratic employment. All the men in this study had spent time in prison.
“I wind up gettin’ on a binge after that cuz I felt a lot of resentment, remorse, and regrets and that kind of spiraled out, and that’s what caused me to go back to prison.”
Theme 2: Homelessness as Imprisonment
Homelessness removes autonomy and personal agency from people, with many men drawing the parallel between homelessness and imprisonment. One older man observed life living in a shelter as,
“It’s a jail cell. It’s no life. If you don’t want no life, go for it. If you want a life and a clean life, it’s time now to do it.”
The rules and restrictions imposed by shelters and short-term accommodation settings affected self-determination and freedom of choice for most of these older men. The adherence to rules, structured programs and regimented activity was a stressor for these men.
“It’s no use doing nothing except going by these rules. It’s been hard, because you got to, you got to be out at something to seven and then go to a transitional place like this, coffee, sit, and talk.”
Theme 3: Mistreatment by Service Providers
Service providers were observed by some men as lacking empathy, understanding and professionalism in their conduct with homeless people. These experiences were seen as compounding an already difficult pathway, with little or no opportunity to redress this due to their precarious living situations.
“I didn’t like what this guy done to me …My wife was laid up in the hospital dying. I said, “Man, I want to go see my wife. She’s dying.” “Well, you’re going to lose your bed if you go.” Excuse my language. I said, “Fuck that bed. My wife laying up in there dying and you going to tell me about a damn bed?” Losing a bed and I can’t go see her? What if it was your wife laying up there and you was in my shoes?”
Case managers were accused of apathy and insensitivity in their actions. Frustrations were expressed when promised interventions were not followed through by managers, which fuelled feelings of mistrust.
“They don’t care … Whereas back then, if they didn’t care, at least they gave you the feeling that they cared. Which makes a lot of difference because it makes you feel better about trying to get help or trying to do what you need to do … And that’s not there anymore.”
Theme 4: Physical Danger and External Threats
The real and constant danger from physical violence, environmental extremes and theft resulted in older men remaining hypervigilant and defensive. Many older people as they age accrue a variety of chronic conditions. These often affect mobility which exacerbates feelings of vulnerability.
“I got jumped on back in October … [hit] over the head with a crowbar on my left side. My leg is messed up. My hip is messed up … That’s why I stay in pain in my hip … They tried to rob me. Couldn’t get what I had. Dragged me in the alley … they left me in the alley for dead. I could barely walk. But I made it out of that alley. And I made it right up here to [the] Health Center.”
Weather extremes often placed these men in a precarious situation of choosing between sleeping rough and entering shelters. Shelters were seen also as dangerous places to remain in,
“The people that go there are just aggressive … just naturally aggressive.”
The researchers of this study into the experiences of older men and homelessness concluded by observing that the binds that tie homelessness and trauma remain present. The combination of ageing, co-morbidities, inadequate service support and constant physical threats amplifies the vulnerability these older men feel.
Listening without prejudice to the needs of vulnerable older men is key to providing supports that are fit for purpose and promote self-determination.
Expert Opinion: Jason Lal (Chaplain)
The connection between trauma and homelessness, in particular for older men, highlights the need to work with men across the lifespan.
Providing men with places where they can find support and be linked to other services, in earlier parts of life, can significantly help improve health and quality of life outcomes in later life for men.
Some of these places could be a men’s group, a men’s shed or some other type of support program. These types of groups and programs if designed appropriately can help mitigate some of the barriers that men or men facing homelessness can experience when trying to access mainstream services and health information.