21
Housing First: Effective Solution
Housing First: Effective Solution
What is Housing First?
Significant departure from traditional ‘linear’ models of provision for homeless people with complex needs
‘Housing’ First as opposed to ‘Treatment’ First
Platform for Recovery
Essential Elements of the approach:Aim: To reduce re-occurring homelessness by supporting individuals with poor mental health or addiction issues
Underlying principles:Independent accommodation in scattered site housingNo requirement for housing readinessHarm reduction approachProvision of permanent housing and holistic supportRespect for service user choice re: apartment, levels of engagement, location and times of support24/7 support from multidisciplinary teamTargets most vulnerable – those that have difficulty coping with traditional services, resistant to service engagement
Self Actualisation
Self Esteem
Love/ Belonging
Safety/ Security
Physiological Needs
Ong
oing
Rec
over
y
• Independent living skills, development of social network, engagement in employability
Making a Home
• Gaining a tenancy, benefit maximisation, furniture, harm reduction, community integration
Getting a tenancy
• Develop a relationship. Gather relevant information, Support Planning/ Risk Assessment.
Assessment
Platform for Recovery:
Supporting Service Users in active
addiction
Full tenancy rights, scatter site housing
Motivational Interviewing/
Assertive Outreach
Harm Reduction approach
Peer support workers
No need to be ‘Housing Ready’
No time limits – support or tenancy
Partnership working
Flexible, 24/7 support available
Housing First - Glasgow
Tenancy Sustainment Outcomes:
Length of Tenancy Sustainment
Number of Service Users
< 6 months 4
> 6 months 3
> 1 year 4
> 2 years 10
Total Number of Service Users Supported to gain a tenancy by Housing First
21
Tenancy Sustainment Outcomes
No Evictions!
2 x supported to give up tenancy due to prison sentences over 13 weeks
1 x supported to move from tenancy due to harassment in local area
Service User Achievements to date:
Supporting individuals who have never engaged with any service
7 service users involved in education and training – including a university course 5 service users regularly attending day services (including community based addiction programmes) 2 service users involved in voluntary work 1 service user gained full time employment since engaging with Housing First
Substance Misuse Outcomes:
Number of individuals now abstinent from their problematic substance of choice
Substance Number of Service Users
Alcohol 2
Illicit Substances 10
Housing First Europe
Housing First in Europe
Housing First Europe – test sites
5 different test sites and 5 different welfare regimes Relatively high staff- client ratios 1:3-5 to 1:11 Mix of congregate housing and scattered housing in
Copenhagen, all others used scatter site housing Use of social housing in 3 cities, using allocation rights
with priority for homeless people in social housing. (UK and Denmark)
Budapest is a special case
Each service reflects the city and culture that it resources:
•Individuals from Greenland•Group tenanciesCopenhagen
•Supports those with mental health issues•True to original Pathways model
Marseille/ Lisbon
•Supports individuals with a ranges of need•ACTAmsterdam
•Clear forest of rough sleeper/ homeless people•Negative regime – homelessness illegalBudapest
•There are differing views regarding whether or not these are Housing First modelsHelsinki•Focus upon long term rough sleepers – (alcohol use)Dublin
•Housing First now developing in England•London 5 sites aimed at rough sleeping•Midlands – homeless/ rough sleepers
London/ Midlands
•Includes Housing First support to familiesVienna
Housing retention rates in Housing First Europe
Amster-dam
Copen-hagen
Glasgow Lisbon Budapest
Total number of service users
165 80 16 74 90
Positive Outcome
138(97.2%)
60(93.8%)
13(92.9%)
54(79.4%)
29(<50%)
Unclear Cases 23 16 2 6 N/A
Negative Outcome
4(2.8%)
4(6.3%)
1(7.1%)
14(20.6%)
N/A
Housing First United States of America: In the beginning ----------
Impact on Homelessness from Reagan recession 1979/80s
Development of warehouse type shelters by Federal and local Governments to increase provision
Those with mental health and/or addiction issues lost in the multiple systems
Creation of institutionalisation of mental health services in hospitals
Reagan cut-backs from 1981 on public housing only response accommodation
Creation of Pathways and Housing First in USA
• Concern about the volume of single homeless whose mental illness needs not being responded to
• Individuals caught in trap created by inadequacies and gaps in services
• Creation of services to support individuals with their mental health by multidisciplinary team
• Create support to assist acquiring property to provide them with ‘home’ security
Pathways - Assertive Community Treatment Team
First created in New York Respond to mental health issues but equally support the
individual in their tenancy ACT teams are likely to include: psychiatrists, nurse
practitioners, outreach nurses, occupational therapists and support workers, employment and education support worker and peer support workers
Canada’s positive response:
In USA, Pathways Housing First tackles homelessness for those suffering with mental illness
2008 – Canada invited 5 cities to develop ‘At Home’ (Chez Soi) programmes
Visited Calgary and Vancouver and spent time with an ACT team in each city.
Sustained funding recently agreed by Canadian government although staff funding moving to funding via health services.
Churchill visits and learning:
Visited services in Toronto, Calgary, Vancouver, Minneapolis, Washington/ Philadelphia and New York
Application of Pathways model within our services Responses to homelessness in general and not just
‘single’ homelessness - family responses (as per Minneapolis)
Housing First support to Veterans Sustained growth of the Recovery Network/ WRAP
models
For more information:
Contact: Ian Irvine (Operations Manager)T: 0141 427 8200E: [email protected]
Emma Hamilton (Development Manager)T: 0141 427 8200 E: [email protected]
W: www.turningpointscotland.com
SCO28827
