An innovative approach to address homelessness in regional Australia: Participant evaluation of a co-payment model

Objectives: Homelessness is not only about lack of secure housing, it is sometimes caused by simple reasons such as lack of money to travel home. The purpose of this study was to investigate whether the participant co-funded assistance program (‘Return to Country’ [R2C]), when offered to low socio-economic individuals experiencing homelessness, represented an effective use of scarce resources. Study design: In northern Australia, a remote and sparsely populated area, Indigenous persons who travel to regional centres cannot always afford airfares home; they therefore become stranded away from their ‘country’ leading to rapidly deteriorating health, isolation and separation from family and kin. The R2C program was designed to facilitate travel for persons who were temporarily stranded and were voluntarily seeking to return home. The program provided operational support and funding (participants co-funded AU$99) to participants to return home. Methods: Using a descriptive, case series research design, university researchers independently evaluated the R2C program using semi-structured interviews with 37 participants. Results: An investment of AU$970 per participant in the program with partial co-payment was associated with high participant acceptability and satisfaction in-line with harms reduction around substance and criminal abuse, which is suggestive of long-term success for the model. Conclusions: Findings from this study can contribute to the development of best practice guidelines and policies that specifically address the needs of this unique population of stranded persons, who are seeking to return home. The acceptance of the co-payment model can be adopted by policy makers involved in homelessness prevention in other locations in Australia or internationally as an add-on service provision to mainstream housing support. © 2017 The Royal Society for Public Health