The following is the executive summary of a rapid review on assertive outreach with women experiencing homelessness by Tamara Blakemore, Joel McGregor and me. The review was done as part of a research project we are doing in partnership with Nova for Women and Children. The full report is available from here.
The aim of this rapid review was to identify key themes in the existing literature that could help develop a specialist assertive outreach program for women experiencing homelessness in the Hunter region of NSW. Rapid reviews are a relatively quick, but structured, approach to finding and synthesising evidence from research and other literature and are particularly suited to policy and practice contexts (Featherstone et al., 2015). This review identified 30 key sources that discussed assertive outreach approaches for working with homelessness that were culturally relevant and did not exclude women. These sources were then analysed for key narratives and themes.
Assertive outreach practice is distinguished by the situations and settings in which workers come into contact with, and continue their work with, clients. In practice, assertive outreach often means taking our work to people, working with them where they are at and prioritising client preference and pace in our work. It is worthwhile noting here that assertive outreach approaches are often used with people for whom homelessness has become a chronic or cyclic process – rather than a situational crisis where different responses to homelessness may be more appropriate. In Australia, there has been a revival of interest in outreach with homeless people, with a particular emphasis on assertive outreach, since 2008 and the release of the White Paper, The Road Home: A national approach to reducing homelessness (Homelessness Taskforce, 2008).
Phillips et al. (2011) and Homelessness NSW (2017b) suggest there are several differences between ‘traditional’ outreach with homeless people and ‘contemporary’ assertive outreach which has been the focus in Australia since the White Paper. For both approaches, ‘service delivery takes place within the service user’s environment rather than requiring service users to attend a designated service centre’ (Phillips et al., 2011, p. 15). ‘Traditional’ outreach approaches often provide a street-based continuum of care to those sleeping rough including providing clothing, food, and emergency relief; facilitating access to counselling, alcohol, and other drug services; and assisting with referrals to shelters or accommodation. By comparison, Phillips et al. (2011, see also Homelessness NSW, 2017b), highlight ‘contemporary’ assertive outreach methods as much more explicitly focused on securing housing for those sleeping rough. Three distinctive features of contemporary models include: the aim to end homelessness rather than simply supporting people who sleep rough; services adopting an integrated, multidisciplinary approach, to attend to the needs and potential root causes of homelessness, as well as a more ‘persistent’ approach providing sustained resources to people who are homeless and to support them to move into, and sustain, stable housing often with wrap-around support.
It is important to note that efforts to end homelessness are always dependent on housing options being available. If assertive outreach teams, particularly those working from a contemporary model of work, cannot access emergency and longer-term housing, then the goal of ending homelessness is extremely difficult, if not impossible (Coleman et al., 2013; Homeless NSW, 2017; Mackie et al 2019; Phillips et al., 2011). Mackie et al. (2019) go as far as suggesting that assertive outreach is ‘potentially unethical if it is not accompanied by a meaningful and suitable accommodation offer’ (pp. 88-89).
Narrative synthesis of the literature noted key themes that largely coalesce around the intersecting concepts of people and practice in place. Key themes that relate to people include: the attributes of assertive outreach workers, safety, and the unsettling silence of the voices of those experiencing homelessness in the existing evidence base for practice. Key themes that relate to practice, including engagement, models of assertive outreach, principles of practice, and interagency collaboration, are all relevant to working with women.