The Costs of Homelessness: Politics, Advocacy and Research Nicholas Pleace and Eoin O’Sullivan European Observatory on Homelessness

Why are we interested in the Costs of Homelessness? Homelessness leads to a much higher use of mainstream public support services such as health and justice services than is evident in the general population. Services supporting homeless people and increased their housing stability and sustainability can assist them in reducing their use of mainstream health, justice and welfare services. If homelessness generates significant costs to non- homelessness budgets, then an a priori case for significant publicly-funded interventions to prevent and end homelessness is established.

If it can be shown that homelessness programs produce positive outcomes for clients at relatively low cost, provide significant cost savings to mainstream health, justice, income support and welfare support programs then the case for intervention can be justified on economic grounds. The efficient and effective use of publicly-funded interventions is a key task of public policy makers at supra- national, national and local levels, and, once identified, the moral argument regarding the use of current expenditures can carry more weight (and potentially more resources), than simply a purely economic analysis of homelessness.

The potential of such research is that government Departments / Agencies and the public can be shown that existing resources can be reallocated to more effectively assist people who are homeless, to end their homelessness. In thinking about costs, we also need to include the value to persons and to society of having stable and sustainable housing, improved health, enhanced employment prospects and productive relations with family members, and the costs to the individuals of not facilitating such inclusion in society.

Existing research in Australia and the US suggest that people receiving housing support are, on average, less likely to utilise health, welfare and justice services than those who do not receive such support. “Regardless of whether one can guarantee a net positive return on investment, introducing an understanding of the cost of homelessness into the research and policy analysis communities will serve a critical function for homelessness advocacy. People, including the general public and legislators, need to appreciate that homelessness is not a cost neutral phenomenon.” (Culhane, 2015)

Costs and Housing First HF interventions for homeless adults with mental illness lead to cost offsets - are these offsets are likely to exceed the cost of the intervention itself? A recent review of the Canadian literature (ly and Latimer, 2015) suggests that HF programs may result in cost offsets that equal the cost of the intervention, but that this is not certain to occur. But, why accept implementing HF if it must pay for itself – we don’t in the majority of other social, health, educational interventions – we do do because they are judged to yield sufficient benefit to merit the cost?

Challenges in measuring the costs of homelessness: Methodological Issues Diversity in homelessness service types and in data available on services. Issues in determining cost offsets. The scale of homelessness and fixed service costs. Challenges in assessing the wider economic costs of homelessness and the wider benefits of homelessness services. Issues in monetizing the costs of homelessness for homeless people

Costs of Homelessness: Political Issues Independent Review of Homeless Services (2015) Exchequer or state funding of approximately €95.9million was extended to service providers in 2014. “Whilst it has not been possible to determine the total value of additional income raised by non-governmental service providers in most cases, in the larger organisations such income is often quite substantial, adding to the income provided by the State by as much as 300% in the areas of fundraising/donations, charity shops, rental and investment income.” “When total income is considered and assuming a total sectoral “other funding” model of 145% we can extrapolate on a very crude basis that total sectoral funding is likely to be in the region of €234m in 2014.”

Recommendations “Consider the extent to which the level of current emergency funding and funding model is consistent with the Government’s stated aim of ending long term homelessness.” “Consider if the funding of a very large number of non- governmental service providers represents the most efficient use of limited funds and the most effective mechanism to deliver services.” “Consider the extent to which cross or duplication of service provision exists within the sector.”

An estimation of the financial costs of single homelessness in the UK