“It’s all connected” — housing and mental health

This article was published in the September issue of Parity magazine, a Council of Homeless Persons publication, which cohealth supported.

The Mental Health and Wellbeing Local in Brimbank is connecting people experiencing homelessness with a compassionate network of support.

In 2023, as part of its response to the Mental Health Royal Commission, the Victorian Government established a series of ‘Mental Health and Wellbeing Locals’ across the state.

The Locals are designed to provide free, no barriers mental health support to people aged 26 and older. Through the service, people can access counsellors, dual diagnosis workers, psychologists, peer workers and other mental health professionals.

In Brimbank, in Melbourne’s west, the program meets an acute need. As well as some of the highest levels of mental health need in the state (1) the City of Brimbank also experiences high levels of homelessness.

The 2021 census saw the local government area rank fifth for homelessness rates in Victoria. (2) The need has only grown since, with the council reporting 267 rough sleeping requests between June 2024 and May 2025 – a 200 per cent increase from the previous year. (3)

With cohealth as lead service provider, the Mental Health and Wellbeing Local in Brimbank has become a trusted point of community care. While it can be accessed by anyone, it is frequently accessed by people experiencing or at risk of homelessness.

Birhane Gebremeskel has been an assertive outreach worker with the service for two years. In that time, he has seen his role morph in scope, resulting in a response that gives people experiencing homelessness a clear pathway to both housing support and free and compassionate mental health support.

“Mainly at the start, [the role involved] introducing ourselves and connecting with the community, with people who were experiencing homelessness and with other services in the area,” says Birhane.

“Because of that earlier groundwork, we have had some really successful outcomes.”

Once Birhane is aware of someone sleeping rough in the area, he begins the process of building trust with them. It is this trust, he says, that opens the door to support beyond housing.

“As we gradually develop trust, we can identify what people need and want. Once we’re really talking to them, you can see a lot of things going on. There’s mental health challenges or physical health concerns, a history of substance use, or family violence – all these things that people don’t want to talk about until they trust you.”

Although the connection between housing and health may be clear to the health workers at the service, Birhane says that clients experiencing homelessness often do not want to talk about their health. Their priority is housing.

“If you don’t have somewhere to live, it’s quite hard to for people to say, ‘Hey, I want to work on my health’ or to disclose if they have mental health struggles or issues with alcohol or drugs,” says Birhane.

“When you don’t have anywhere to live, you’re always trying to prioritise somewhere to stay. But it’s all connected. The clients I see have multiple needs that need multiple responses.”

Birhane says external responses he provides can be helping clients with a Victorian Housing Register application or taking them to the Salvation Army to get short-term housing support.

Internally, at the Mental Health and Wellbeing Local in Brimbank, people experiencing homelessness can get support from psychiatrists, psychologists, support workers, alcohol and drug specialists, peer workers and creative therapists.

Internally, at the Mental Health and Wellbeing Local in Brimbank, people experiencing homelessness can get support from psychiatrists, psychologists, support workers, alcohol and drug specialists, peer workers and creative therapists.

“As we know, mental health is stigmatised. It’s not easy for someone to open up and say, ‘Hey, I’ve got this going on and I need help,’” says Birhane.

“So, it takes time. But once we get to the point where people want to hear what we have to say, we can tell them what services are available, and what kind of support they can get.”

Birhane says another aspect underpinning his work is the cultural makeup of the City of Brimbank and the particular challenges that rough sleepers from refugee or migrant communities face.

“There’s a language barrier and they have no idea how to access the system and navigate it themselves. And often they’ve experienced things like civil war and other traumas and they have no idea how to start expressing that.”

The result is people who feel isolated and stigmatised due to their mental health and housing situation and also confused by a system that isn’t easy to access.

Birhane reflects on a recent case where he connected with a student from Pakistan. While studying, he had ended up with nowhere to live and started sleeping rough.

“Things didn’t go to plan for him,” says Birhane. “When he was referred to me by the Council, he’d been sleeping rough for a few years. Together, we were able to slowly rebuild things for him.”

Birhane connected him with the Asylum Seeker Resource Centre and Life Without Barriers. He was supported to get a bridging visa and is now working towards a substantive visa. He now has a place to live and regular mental support from a psychologist with the Mental Health and Wellbeing Local.

None of this work would be possible without strong collaboration with key partners in the area. Referrals and notifications come through to Birhane and the team from Brimbank City Council and from Western Health, ensuring that both community and hospital settings are points of access.

Fortnightly, cohealth coordinates its outreach with IPC Health. As well as making sure resources are used efficiently, this serves as an important opportunity for knowledge sharing and networking. The Salvation Army Access Point is a vital partner in making sure people have access to the short-term accommodation and, when needed, Birhane has built good connections with local rooming houses.

Every month, providers gather at the Tin Shed Neighbourhood House in St Albans, giving people an opportunity to come by and see what support is available for them, while accessing a food bank. Birhane attends this, as do his colleagues from cohealth’s Footscray homelessness team.

“Over the two years, we’ve developed and established a strong and collaborative network with different services,” he says. “Everyone benefits from sharing and talking and does their bit with the same goal in mind.”

Whilst the Mental Health and Wellbeing Local in Brimbank anticipated that people experiencing homelessness would access the service, the numbers and complexity of supports have exceeded expectations. As part of improving available supports and service, the program has bolstered its work with cohealth’s homelessness and AOD programs and introduced additional, dedicated outreach workers.

The philosophy is a simple one: people deserve to have a safe, secure place to live and they deserve good health. Those things, says Birhane, are closely intertwined.

“It’s a human right. We need to have somewhere to live where we feel safe, where we cook, where we sleep, where we keep ourselves warm. We all need that,” he says.

“If you don’t have that, it impacts your physical health, your mental health. Going through this stress, your health will deteriorate and you’re at risk. You just can’t separate any of it – it’s all connected.”