Member Profile: Lisa Wood

| By Royceton Hardey 

When Associate Professor Lisa Wood received a congratulatory email regarding her nomination in the 2018 Impact 25 Awards, she was at first a bit suspicious. 

“I get a lot of email, and often spam congratulating me on being a winner!” Assoc. Prof. Wood said. “When I saw the ‘Congratulations’, I was unsure as to what it was all about. It is not often researchers get nominated for awards like this, so I was really surprised.” 

Pro Bono Australia’s Impact 25 Awards recognise individuals who are working in the social sector and for social causes to solve today’s greatest challenges through integrity, foresight, initiative and collaboration. The University of Western Australia (UWA) School of Population and Global Health Associate Professor still doesn’t know who made the nomination but was very pleased that the role research and evidence plays in relation to vulnerable groups was being recognised. 

“I know UWA is chuffed by this award nomination, as it is quite rare for research to be recognised as making a difference at the coalface,” she said. “There is an amazing list of people in there (nominated) and they are out there at the coalface doing fantastic things across many social and environmental issues, and whilst we try to do our bit in research, you often don’t feel like you are making a direct difference.”

Although in academic research now, Lisa’s career did not begin here.

“I started off in public health and health promotion, working with government and non-government sectors, so I guess I came into research with that real-world mindset,” Assoc. Prof. Wood said.

“Traditionally people often see researchers as being in an ivory tower where a researcher comes up with what they think is a great idea, they apply for a massive grant, and five years later publish its findings. That is not really my thing.

“I do it the opposite way. I look at the work people are doing out in the real-world such as Dr Andrew Davies, Homeless Healthcare; Dr Amanda Stafford, Royal Perth Hospital; Jonathan Shapiera, Founder of South West Australian Homeless People; and ask how research could help to evaluate the effectiveness of current programs or identify where the gaps lie.

Associate Professor Lisa Wood

“A lot of our research is with not-for-profit service providers reliant on precarious funding, where we undertake independent robust evaluation to assess the impact of such services. The Safe as Houses program coordinated through Tenancy WA is a recent example of this – it is doing amazing work to prevent homelessness among women and children impacted by domestic violence, but its funding is about to run out.

“So, in evaluating programs like Safe as Houses, we can provide independent evidence to help secure funding to continue or expand essential services that are helping to end homelessness.”

Lisa leads a rapidly growing program of collaborative research with Homeless Healthcare and Royal Perth Hospital (RPH) Homeless Team, both of which are key partners in the 50 Lives 50 Homes project that Lisa is also evaluating.

“It all began back in 2016,” explained Lisa.

“I was trying to find a homelessness project with some health data, so I approached Dr Andrew Davies at Homeless Healthcare and asked if they could do with some free research?”

The approach was greeted positively, and from this very small beginning, there is now a growing number of staff and students involved in UWA’s homelessness and health research. Last year the Home2Health team won a Public Health Association award for research and policy translation, and Lisa was also awarded a national Sax Institute’s Research Action Award.

“People who are homeless often present to hospital in crisis and typically have little access to a GP or preventive health services,” explains Lisa. “Through our evaluations of Homeless Healthcare, the RPH Homeless Team and 50 Lives, we have been able to show that hospital use, and associated costs can be significantly reduced when access to compassionate healthcare is improved, particularly once people are housed.

“We have also worked with Homeless Healthcare and the RPH Homeless Team to publish several papers in peer-viewed international literature, this helps put what we are doing in WA on the map.

“In the last six months, there have been several groups come over from Cairns and Sydney to look at how homelessness and health issues are being tackled in Perth, and the role of data and evaluation is seen as central to this.

“Increasingly we are using the data we have to identify where the service gaps are for people who are homeless. The needs of people with dual mental health and alcohol/drug issues is a case in point. People can go to a mental health service and get told it’s a drug problem, but then present to hospital with a drug use issue and it is deemed a mental health problem. The result is people languishing in the streets, bouncing around different parts of the health system.

“With Homeless Healthcare we were successful in getting a WA Health grant to pilot and evaluate a Homeless Outreach Dual Diagnosis Service (HODDS). This starts in February and will have a psychiatrist and mental health nurse working in tandem with the Homeless Healthcare GP’s to address this vital service gap.

“Another big gap in WA is the lack of somewhere for people who are homeless to go when they are discharged from hospital. Imagine trying to recover from hospital or complying with medications that need to be stored in a fridge if you live in the streets.”

Late last year Lisa and her team got a Raine Foundation Visiting Fellow grant to bring Dr Jim O’Connell out from Boston to talk about the benefits of a medical recovery centre to address this issue.

“This is not only the right and humane thing to do,” Lisa said, “but studies overseas have shown that having a medical recovery centre will reduce the likelihood that people return to hospital, and this will save the health system money.”

A 2019 goal for Lisa and her team is to continue to use data to look at how health disparities suffered by people experiencing homelessness can be reduced.

“Whether things are working or not will show in the data and further gaps can be uncovered,” said Lisa. “Recently for example we identified with Homeless Healthcare that there are very low rates of preventive cancer screening among women who are homeless, and high rates of trauma and mental health issues, so through UWA we have submitted a grant to Perpetual to pilot and evaluate a clinic for women.

“This example demonstrates how our research is increasingly moving from evaluating what people were already doing to more of a hand in hand partnership to address service and policy gaps.”

The work of Lisa and her team is starting to garner worldwide interest.

In March she will present at an International Symposium in London on her team’s research work with Ruah Community Services 50 Lives 50 Homes campaign, Homeless Healthcare and the RPH Homeless Team. Lisa has received a travel fellowship from UWA Faculty of Health and Medicine to spend a month there looking at what work is being done in the U.K. regarding homeless health research practice and policy.

“One of the aspects I want to particularly look into in the U.K. is that they have done a lot of work around the involvement of people with lived experience in co-designing services and as peer advocates and peer researchers,” Lisa said.

“I want to get some ideas on how we can beef that up over here, to get some ideas and inspiration. Bringing more intentional attention to lived experience and how we can bring that into our research and the sector.

“There is also good work happening (in the U.K.) there on how to break the revolving door between prison and homelessness. I’ve tried to get a national grant to research how to tackle this twice without success and it sits on my heart as being a big issue especially when WA is building another prison and there are other ways you can spend that money to help break that cycle.

“Prisoners often really want to turn their lives around, but they didn’t know where they were going to live when they got out. I did some work in prisons a couple of years ago with Holyoake and its DRUMBEAT program and met people whose only options were either to couch surf with people they previously hung out with, who used drugs, or to start afresh; but how do you start afresh when you have no money or no contacts.

“It’s hard, and this is why we see that many people sleeping rough in WA have had prior contact with the justice system.”

While Lisa is interested in what the U.K. are doing, they are also interested in where WA is leading the way.

“One of the people I will meet with over there,” explains Lisa, “was spruiking to her colleagues that it was her belief that we had cracked it in WA in terms of a close partnership between a University, clinicians and service providers.

“This was a really encouraging thing to hear for WA and the strong partnerships we have built up with those working at the coalface of homelessness. People are seeing that we are not just producing reports that sit on a shelf, we were all actively seeking data together to help secure funding and find gaps.”

While the benefits of research are proven in Lisa’s field I wondered if it was something future research students would be interested in taking up as a form of study. In my mind it would be a shame to lose Lisa’s experience if successive plans are not in place.

“This is a really good question,” remarks Lisa.

“I teach two UWA health leadership units. One for undergraduate students and the other for postgraduate students which includes Master of Public Health and Pharmacy students. In these units I raise awareness about homelessness and health inequality. It has been exciting to see some of my students deciding to work with our team (even volunteering their time!), and this year we have an honours, masters and PhD student all doing applied research around homelessness health.

“Homelessness hasn’t traditionally been seen as a ‘health issue’, but this is changing as the social determinants of poor health and of homelessness massively overlap. Through my teaching I try to give students insight into the challenges and the importance of research and how evidence informed advocacy can help ‘change the world’.

“I am conscious of the fact that funding in the homelessness sector is tight and we need evaluation to be sustainable, so our team is also helping to upskill organisations themselves so they can collect data and evaluate better.

“There are some really good well-meaning organisations in this social sector but often the data they collect is just what the funders require. But what they need to become sustainable is to demonstrate outcomes, and measuring the right things, and measuring them well is a key to this.

“As we build trust with the organisations we are working with, they are open to suggestions about data collection and as is the case with Homeless Healthcare and 50 Lives, we have been able to improve collection systems, and this makes it easier for us to then link it to hospital and police data so that we can demonstrate wider societal impacts.”

In Lisa’s mind the goal would be for funders of organisations to recognise the importance of evaluation and to build it into contracts.

“Funders, both government and philanthropic, often only want to fund the frontline service delivery, but it would be wonderful if funders also supported organisations to collect better data to show they are making a difference,” explains Lisa.

“If organisations themselves can be collecting robust data and getting the good news stories about the impact they are having out there, then maybe you don’t need clones of me,” laughs Lisa.

“In the meantime, we have a growing team of enthusiastic students and colleagues passionate about homelessness and health, and we have a long-term dedicated commitment to reducing health inequalities faced by people who are homeless.”

You can view the full list of The Impact 25 Award nominees here.

"Shelter WA is an invaluable ‘go to’ for keeping abreast of the key policy issues, developments and areas of unmet need around homelessness and affordable housing. I have often drawn on information from Shelter WA submissions to various enquiries, and as a researcher, it is always pleasing to see the commitment to evidence-based policy and research. Its strong advocacy focus is a critical voice at the state and national level, often championing the housing related needs of some of our most vulnerable population groups, including rough sleepers, remote Aboriginal communities, and people living below the poverty line. Shelter has also recently led the way in WA on the involvement of people with lived experience of homelessness, and this is crucial if we are to effectively and compassionately achieve housing as a fundamental human right for all." – Lisa Wood, University of Western Australia (UWA) School of Population and Global Health Associate Professor.

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