New feature analysis provides insight into people who received support from a Specialist Homelessness Service in their last year of life

Content warning: this article contains information about suicide.

Around 12,500 people received support from a Specialist Homelessness Service (SHS) in their last year of life between 2012–2022. More male SHS clients died (7,800) than females (4,700).

A new first-of-its-kind feature analysis released today by the Australian Institute of Health and Welfare (AIHW) examines health and specialist service use prior to death, with a focus on people with housing insecurity, drug and/or alcohol issues and risk factors associated with specific causes of death.

SHS support is provided by a specialist homelessness agency to a client and aims to assist people who are already experiencing or are at risk of homelessness, ranging from general support to immediate crisis accommodation.

The AIHW respectfully acknowledges the people who have died who are described in this article.

Experience of homelessness in the last year of life

Of the 12,500 SHS clients who died in 2012–2022, around 39% did not experience homelessness in the last year of life, 24% had been rough sleeping (non-conventional accommodation), and another 32% were experiencing other forms of homelessness. The remaining 5.8% are among SHS clients who didn’t have homelessness status available.

A higher proportion of SHS clients who were rough sleeping die each year (around 1%), compared with clients experiencing other forms of homelessness and unstable housing (0.3–0.5%).

Age at and rate of death

The age profile of people who died and received SHS support in the last year of life in part reflects the age profile of people receiving SHS support, that is, SHS clients tend to be younger than the broader Australian population.

The median age at death among SHS clients rough sleeping or experiencing other forms of homelessness in the last year of life was 46, 8 years younger than the median age of clients who did not experience homelessness in the last year of life – noting that the median age of SHS clients in 2022–23 was around 30 years.

Among the 12,500 SHS clients who died, almost half (46%) were aged 35–54, 12% were aged 25–34 and 6.3% were children and young people aged 25 and younger.

The age standardised death rate among SHS clients was around 1.8 times the rate for non-SHS clients in 2021–22. During 2012–2022, 6.5–9.4% of all deaths among the 24–34 and 35–44 age groups were SHS clients. 

Cause of death

The most common underlying cause of death among SHS clients was consistently accidental poisoning (14–20% of deaths), followed by suicide (12–15%) and coronary heart disease (6.2–8.6%).

As a proportion of all deaths across 2012–13 to 2021–22, SHS clients accounted for around:

• 14–18% deaths by accidental poisoning
• 4.2–6.2% deaths due to suicide
• 0.4–0.7% deaths from coronary heart disease

The material presented in this article may be distressing. Support is available at the following:

• AskIzzy for connections to support services
• Crisis and support services for a comprehensive list of organisations providing support.