Threshold Housing First Deborah Quilgars and Nicholas Pleace

Background Success in USA, Canada, Denmark, Finland, France, Norway as national strategy Successes at local level in Sweden, Portugal, Spain, Italy, Ireland, Scotland, England, Wales, Northern Ireland Stable exits from homelessness for people with high and complex needs Works with 7-9 out of every 10 high need homeless people Including long-term/recurrently homeless people

Background Nearly government policy in England Housing First is government policy in Northern Ireland, Scotland and Wales But Housing First was designed on the assumption that most homeless people with complex needs are men We starting to understand that this is not the case

Homeless women with high needs New evidence that women react to homelessness in different ways Use informal support, friends, relatives, acquaintances Includes women with high and complex needs Women’s Homelessness in Europe Network

Threshold Housing First First attempt in the UK to develop Housing First for homeless women with high and complex needs Women with histories of homelessness and offending behaviour One of the first attempts anywhere to develop a Housing First service focused on women Rather than, by default, men

Threshold Housing First Developed at a time when we are starting to see the potential of ‘PIE’ (psychologically informed environments) and trauma focused work providing opportunities to highlight women’s needs Has been working in three Manchester authorities for two years Tameside, Stockport and Oldham

Threshold Housing First Two full-time workers and a manager Supports up to 12 women at any time Integrated with other services Particularly women’s centres

Activity 33 women used Threshold Housing First over two years Average age of 32 97% White British 79% were parents, but children not with them 82% single at referral 58% homeless 33% in custody 9% at risk

Housing and Support Needs Most commonly hidden homeless But five women were living rough at referral Almost all had experienced domestic violence Almost all had mental health problems Seven reported stays in psychiatric hospital/ward Most had issues with addiction and alcohol Several reported being fostered and/or in care as children

Offending Histories Thirteen women had offended more than ten times Group included some prolific offenders Eight had offended just once This was a Housing First service focused on homeless women offenders Referrals often came from probation

Service Delivery A lot of variation Some women moved away, disconnected from the service or were returned to prison But most stayed with the service longer Provided with intensive case management Daily phone welfare check Motivational interviewing Holistic service High degree of choice and control Personalisation Co-production

Housing Outcomes 18 women housed in mix of social rented and private rented Two supported to remain in existing tenancies after being threatened with homelessness By June 2017, 20 formerly homeless women with very high and complex needs placed in housing 16 still housed, 80% sustainment rate Only 1 tenancy abandoned

Offending Outcomes Four out of 33 women returned to prison But reoffending dropped to very low levels among the others In most cases there was no recorded offending while using Housing First Seen as a key outcome Along with the successes in relation to housing

Health Outcomes More mixed picture But mental health and physical health are complex As is addiction There were some improvements e.g. around drinking But women were able to get away from abusive situations Were reconnecting with family And were stably housed

Views on Threshold Housing First Very positive Women using the service Staff providing the service External agencies

Views on Threshold Housing First There’s not one thing that I’ve asked for help with and they’ve not helped me, there is nothing that they’ve said no to or I can’t do that, absolutely everything, they are brilliant.

Learning Shows there is a case for services that are targeted on homeless women with high and complex needs Domestic violence Untreated trauma Separation from children Service for women, run by women No service is 100% effective, there are clear successes here in ending homelessness And in reducing offending Viewed positively by partner agencies

Learning A high fidelity model Follows the core philosophy of the original New York model, Pathways Housing First Also reflects the modifications to that approach developed specifically for Europe (and UK) in the Housing First Guide Europe Which involved Sam Tsemberis Successes reflect what has been achieved elsewhere in the UK and Europe

Learning There were some challenges Housing could not always be found quickly, particularly in the early phases of the Housing First service New relationships with landlords have been developed There was some attrition But these are challenges faced by most Housing First services

More about Housing First Housing First Guide Europe Housingfirstguide.eu Housing First England hfe.homeless.org.uk And, of course, the toolkit launched today

Thanks for Listening Deborah Quilgars Nicholas Pleace Senior Research Fellow, Centre for Housing Policy Nicholas Pleace Director, Centre for Housing Policy www.york.ac.uk/chp