What we Know about What Works Nicholas Pleace

Different forms of homelessness Innovation in service design Overview Different forms of homelessness Different forms of need Innovation in service design Prevention Housing First and Housing-Led The importance of an integrated strategy Coherence and coordination Costs

Different Forms of Homelessness The common stereotype of a homeless person exists throughout Europe High and complex needs Severe mental health problems Drug and alcohol use Poor physical health Nuisance and criminal behaviour Economically inactive Male, early middle age

Different Forms of Homelessness But our understanding of who this group of people are has changed Support and treatment needs may exist before and arise during homelessness Clear American evidence that many long- term and repeatedly homeless people with high needs, become homeless with low, or no, support/treatment needs Some European data suggest a similar pattern

Different Forms of Homelessness Women do not experience homelessness in the same ways as men Women use relatives, friends and acquaintances to keep a roof over their head Male domestic/gender based violence is a major cause Exhaust informal support before seeking help Often living without no legal or physical security, or privacy, or amenities Evidence suggesting high support needs

Different Forms of Homelessness Family homelessness Highly gendered, relatively young Bulk of family homelessness is women lone parents with dependent children Poverty, poor life chances Violence and relationship breakdown are major causes Only a few have high or complex needs

Different Forms of Homelessness Young people (16-24) Strongly associated with disrupted childhoods Experience of child protection/social work systems Economic and social marginalisation Needs can be high and complex

Low intensity support services Support to prevent eviction Service Innovation Prevention Low intensity support services Housing advice and information Support to prevent eviction Financial Legal Practical

Housing access schemes Service Innovation Prevention Support services For people with higher needs Case management, service brokerage Direct practical support Housing access schemes Not ‘prevention’ technically, but rapid re-housing Social lettings schemes, rent deposit/bond schemes, assistance with rent

Service Innovation Housing-Led services Housing First Ordinary housing Combined with floating (mobile/peripatetic) support Low to medium support Housing First Of which more in the next presentation Related approaches, particularly Critical Time Intervention

Service innovation Common aspects to all these service models Based on recognising diversity of need Providing a bespoke/tailored response Supporting strengths, recognising and respecting the views of homeless people Flexible, non-judgemental Essentially reflecting best practice in health and social care systems

Service innovation Clear evidence that services that focus on making an individual ‘housing ready’ in an institutional setting are less effective Mass of data from EU/OECD studies on Housing First, CTI Person centred, flexible, tolerant services are more effective in preventing/ending homelessness and more cost effective

Integrated Strategies Thinking about homelessness across Europe has tended to be at the level of individual services or service models Truly strategic thinking is less common and tends to be at the level of individual cities or regions There are integrated national strategies, e.g. Finland

Integrated Strategies An effective strategy is a comprehensive strategy Recognising different forms of homelessness Different sets of needs to be met Directly (South and East) Interagency coordination (North West) And which is coordinated with health, social care and criminal justice systems

Homeless Families Some support needs will be present, but high support needs are unusual Facilitate access to suitable, affordable, adequate housing Preventative services Rapid re-housing when homelessness has occurred Access to training, education, employment

Young people Support needs can be high Both preventative and homelessness services will need to provide support and treatment An element of ‘parenting’ in a broad sense Access to training, education, employment Emphasis on social integration

Lone Women May not use existing homelessness services Alternatives that allow women to retain or secure an independent home Prevention and rapid re-housing Support will need to be intensive in some cases Recognition of the role of domestic violence in causation of homelessness is important

Lone Men Prevention is crucial Evidence that men deteriorate when homelessness is not resolved Costs increase, potentially dramatically, when homelessness is not rapidly resolved Good evidence on how to end recurrent/long term homelessness Housing First CTI

Needs may be high for some But many economic migrants are young Complex area Needs may be high for some Asylum seekers and refugees But many economic migrants are young Crucial balance is between humanitarian responses and maintenance of border controls Political risks

Integrated Strategy Prevention Emergency accommodation Housing-Led, Housing First, CTI High intensity services for most complex needs

Housing Must pay attention to housing supply Does not matter how comprehensive how effective how well tested how integrated, a strategy is… If there is nowhere adequate, affordable and secure to house families and individuals A strategy, indeed an individual service, will always be limited in effectiveness if housing supply is not in place.

Do nothing…

An Effective Integrated Homelessness Strategy Will at least partially pay for itself There may even be savings which can be redeployed elsewhere UK spent £600 million in 2016 on temporary accommodation for statutory homeless people in London alone Upwards of an additional £1 billion on other homelessness services/homelessness related spending (health, criminal justice) in 2016 Because systems to prevent and resolve homelessness rapidly were not in place

Thanks for Listening Nicholas Pleace Deputy Director, Centre for Housing Policy European Observatory on Homelessness Women’s Homelessness in Europe Network