Housing First and Housing Led The Evidence from Europe and Beyond

A lot of what we already do ends homelessness

Existing services work Last year of data on Supporting People in England 2010/11 119,200 people entered short-term services with housing needs, 73% housed at exit St Mungos, London 2011-2017 Nearly 11,000 single homeless people, 77% into housing Liverpool City Region, 2017 March 2015- March 2017, 9,000 single homeless people, 60% into housing

Housing First has often been compared with other homelessness services that are not widespread in the UK

American/European Comparisons Housing First ending homelessness for 75%-80% of people with high and complex needs for 1 year plus Compared to 40-60% for ‘treatment as usual’ Housing First is more cost effective But ‘treatment as usual’ is often abstinence based, strict regime, limited service user choice Different from a lot of UK services

Housing First stops homelessness but there are questions around other support needs

Does not solve everything High success in stopping homelessness But its not 100%, typically around 80%, ranges between 70%-90% Outcomes in social integration more variable Same with drugs and alcohol And with mental and physical health

International use Federal strategy in the USA and in Canada Housing First England being led by Homeless Link Housing First Italia led by fio.PSD Development led by homelessness organisations in Spain and Portugal Housing First Europe Hub, led by FEANTSA National strategy in France, Finland, Denmark, Ireland, Norway, Scotland, Wales, Netherlands, Belgium…and England

Why is everyone using Housing First? Stops recurrent and sustained homelessness Gets people out of the revolving door/frequent flying Stops homelessness associated with high and complex needs Reaches people who get stuck in services, get thrown out of services and who don’t use services Increased cost effectiveness

Housing First stops homelessness but we need to be clear what exactly that means

Canada and USA Using Housing First to reduce homelessness among people with high and complex needs Including severe mental illness Specifically targeted on this group

United States The number of individuals experiencing chronic homelessness declined by 18 percent, or over 19,000 people, between 2010 and 2017 (small increase 2016-2017) Chronically Homeless Individual refers to an individual with a disability who has been continuously homeless for one year or more or has experienced at least four episodes of homelessness in the last three years where the combined length of time homeless in those occasions is at least 12 months. Widespread use of Housing First model Source: HUD (2017)

Using Housing First Finland is approaching a functional zero in homelessness Norway, Denmark are close to it as well Finland uses Housing First for homeless people with high and complex needs Within an integrated homelessness strategies This integration into wider strategy is crucial

Finland Housing First is integrated into prevention Focused on people with high/complex needs Works alongside other services targeted on other aspects of homelessness Effectively ends revolving door/frequent flyer and sustained homelessness Cost effective

Finland Prevention Low intensity floating support (housing-led) Supported housing Specialist services (e.g. former offenders) Housing First Housing programme to develop more affordable, adequate homes

Long term homelessness in Finland Source: ARA (2017

Denmark Prevention Emergency shelters Supported housing Floating support (housing led) Housing First Critical time intervention Skave huse

Homelessness in Denmark Source: SFI

Fidelity debate Fidelity High - Canada, France Lower - UK, Netherlands, Finland ACT/ICM All appears to work Following the core philosophy is important

Different target groups Mental health intervention in Canada and France Requires diagnosis Restricts scope Broader focus in Finland on recurrent and sustained homelessness Tangible effect on overall levels

Using Housing First Is an answer to recurrent and sustained homelessness It is meant for high need, high cost individuals You need other services for homeless families, for other groups of homeless people Prevention has to play a major role too

Using Housing First makes an Integrated homelessness strategy more effective

Housing First cannot be a homelessness strategy on its own

Housing First is not meant to be a strategy on its own

The case for Housing First International evidence shows that Housing First stops homelessness High need, repeated, sustained, revolving door Homelessness with the highest human cost Homelessness with the highest financial cost

But you also need other services

And prevention

Supported housing Potential for some reduction Still a need for emergency accommodation Specialist services, higher risk etc. But at least some capacity is absorbed by people in a revolving door/frequent flyer position A population that Housing First will reduce

A word on housing-led It is floating support, tenancy sustainment, resettlement Draws on Housing First but is low/medium intensity 2010 European Consensus Conference on Homelessness “Housing-led” terminology is used in the Irish strategy AKA “Housing First Light” These services are widespread in the UK and integrated into Finnish and similar strategies

Professor Nicholas Pleace Director Centre for Housing Policy, University of York European Observatory on Homelessness Women’s Homelessness in Europe Network (WHEN)