Evaluation of a Residential Managed Alcohol Program for Aboriginal Peoples Experiencing Homelessness and Alcohol Dependence: Short-Term Impacts of an Australian Trial

Abstract

Introduction: Homelessness and alcohol dependence can be barriers to accessing essential services such as health care, housing, and social supports. Managed alcohol programs (MAP) have emerged as an effective harm reduction strategy for people experiencing homelessness and alcohol dependence. The aim of the present study was to evaluate the short-term impacts of the first MAP run in South Australia outside of COVID-19 restrictions and the first in Australia to be conducted in a healthcare setting. It was designed to be culturally appropriate for Aboriginal and Torres Strait Islander clients. Methods: Descriptive quantitative analysis and an inductive content analysis of case notes for 21 clients who stayed at least one night in the South Australian MAP. Results: Clients were mostly Aboriginal, female, of middle age and managing multiple health conditions. The median stay was 15 nights per client. The MAP contributed to client wellbeing broadly across five interconnected areas: culture, housing, medical support, government system navigation, and the building of capacity, resilience, and social connectedness. Discussion and Conclusions: The South Australian MAP provided various interconnected short-term benefits relevant to people experiencing homelessness and alcohol dependence in general and Aboriginal peoples additionally experiencing the on-going impacts of colonisation in particular. This evaluation supports international literature on the value of MAPs as an effective harm reduction approach to co-occurring homelessness and alcohol dependence and strengthens evidence for the feasibility, acceptability, and benefits of MAPs in Australia.