Background: In Australia, Indigenous peoples experience higher rates of complex disability including poor mental health and neurocognitive disability (NCD) (Baldry et al., 2012). Indigenous Australians with complex disability are particularly at risk of homelessness. The level and nature of complex disability among homeless Indigenous Australians is poorly understood, and their needs have been minimally serviced. Lack of knowledge and culturally safe assessments contribute to challenges for service providers.

Objectives: The study sought to:

establish and describe the extent and nature of complex disability in a cohort of (primarily) Indigenous people experiencing homelessness in Cairns, North Queensland;

increase service capacity to identify and respond to complex disability through training; and

contribute to a data repository.

Methods: A point prevalence study was undertaken. People using the Anglicare Quigley Street Night Shelter Cairns undertook a clinical assessment, including the Guddi assessment protocol (n = 60). Stakeholder interviews were also undertaken.

Findings: High prevalence of complex disability including: acute psychosis (n = 7); post-traumatic stress disorder; depression; NCD (n = 37), chronic illness, psychosocial issues, and functional impairment. Training in The Guddi Protocol increased workforce and organizational capacity.

Conclusions: Better understandings of complex disability in this cohort needed to inform policy and practice. Culturally safe and appropriate assessment processes and enhanced service capacity are vital to better outcomes for this underserved cohort.