When Sonia and Linda Berton picked up their sister Katherine* from the psychiatric hospital and moved her into a hotel room in Melbourne’s north, they tried to make it safe.
They checked the room for hanging points. They replaced the metal knives and forks with plastic.
Then, for more than two months, they looked after their sister in shifts, day and night.
In every spare moment they lobbied mental health services, their members of parliament and anyone who would listen to help them find suitable housing so that their fragile sister would not become homeless.
Katherine, who receives a disability support pension, is one of the lucky ones: her sisters could afford to put her up temporarily in a hotel.
However, hundreds of vulnerable Victorians each year leave psychiatric treatment facilities straight into homelessness, and the numbers are growing.
Busy psychiatric services are under pressure to discharge patients and, when they do, there is a lack of suitable housing, both supported social housing and private rental.
More than 500 people presented at Victorian homelessness services in 2016-17 after leaving psychiatric services.
That’s a 45 per cent increase since 2013-14, according to figures from the Australian Institute of Health and Welfare, collated by the Council to Homeless Persons.
Katherine, now in her 50s, was diagnosed with schizophrenia as a “bright, bubbly and affectionate” 19-year-old who was working as a secretary.
Over 30 years, it has affected her life and cognitive ability so much she’s always lived with her elderly parents. But during a recent psychotic episode she was uncharacteristically violent towards the frail pair, and is no longer able to live with them.
When she was discharged from the private psychiatric hospital the only options were dangerous boarding houses and hotels. She needed intensive support but specialist accommodation has a long waiting list.
“I really had no idea it was this bad,” says Sonia Berton. “I’d heard stories the system was broken but I really didn’t realise it was in this much of a schemozzle.”
Lisa Hebel is a senior social worker at North Western Mental Health (which covers four mental health catchment areas in Melbourne’s north), and says up to a third of its patients are discharged into homelessness.
“Because some of the options are so undesirable some of clients actually chose to sleep rough,” says Ms Hebel.
While patients – who usually have chronic and severe mental health conditions – are linked to community clinics for outpatient treatment, most need help daily with cooking, cleaning and running a household.
“Access for clinicians to come and see people in unstable, unsuitable accommodation is difficult. it’s often unsafe for them to visit,” she says.
Council to Homeless Persons head Jenny Smith wants the state government to spend $40 million on building dedicated housing for people in existing mental health services, where they would be supported to recover.
“A cheap motel room or a dodgy rooming house is a recipe for disaster following a mental health episode,” Ms Smith says. “Without a safe, stable home, recovery is virtually impossible.”
The Minister for Mental Health and Housing, Martin Foley, said the government had made record investments in the supply of social housing.
“The relationship between psychiatric illness and homelessness is complex – and that’s why we’re tackling both of these issues together,” Mr Foley said in a statement.
“To break the cycle of homelessness, we are investing to get people housed quickly and ensuring they can maintain that housing, while dealing with the root causes of their homelessness.”
Since March 2016 the state government has committed more than $800 million in housing and homelessness support, including 2200 more social housing homes.
Katherine’s sisters could afford to put her up in a hotel while searching for a better option for her and lobby on her behalf. But it was a huge drain on their stress levels, finances and leave entitlements.
She was finally offered a place in a community care unit within walking distance of her sisters’ homes, where she can stay for at least two years with support. “It’s a great set up, there’s just not enough of them”, says Sonia.
*Name changed to protect privacy