Discus Amsterdam Support in Life and Living Wessel de Vries, teammanager Discus Amsterdam Walter Kamp, City of Amsterdam

Homeless policy in the Netherlands 2006: Action Plan for the G4 Amstetdam, The Hague, Rotterdam, Utrecht). In total: 3.0 million inhabitants (out of 17 million) 10.000 people constantly very unstable: homeless, psychiatry, substance abuse, moving in and out of various services. Municipalities responsible

Homeless policy in the Netherlands Conclusion on the basis of research: 60-70% serious health problems but (mental) health care is absent. Conclusion: regular policies failed. Problems were not solved.

Homeless policy in the Netherlands Action plan meant: Extra funding Cities took control on different levels: Overall political responsibility Responsibility for acces to services Person to person logitics 10.000 people were taken into a program: Housing Medical care Income Labour

Homeless policy in the Netherlands Access to services controlled by City. Services were added to: housing, medical services (ACT, FACT), labour/day activities, hospitals. Cliënts are monitored. Prevention pojects started up

Homeless policy in the Netherlands Results 2006-2010: Home evictions down by 40% Rough sleeping down by 80% (but up on acount of migrant workers) 10.000 people in a stable programme Nuisance/criminality down by 65%

Homeless policy in the Netherlands Place of Housing First in all this: Experiment Not the initiative of the City No priority Skipping the promotion model made us skeptical Money made it possible

Discus Amsterdam Support in Life and Living Initiative in 2006 Housing Association Alliantie Amsterdam, OGGZ „Arkin“ (mental health organisation) HVO Querido (care for homeless people and mental health care) First year objective: 80% still in the programme: succes. Core bussiness: small housing association without property for special target group: double diagnosis

Discus Amsterdam Support in Life and Living Housing First principles Forget about the promotion model Make people an offer the can‘t refuse (cause they‘ve got something to lose) Few requirements up front (no references, no medical terms) Do not cause a nuisance and pay the rent Double diagnosis (psychiatry and substance abuse), history on the streets, shunning formal care

Discus Amsterdam Support in Life and Living Differences between New York – Amsterdam Little care, many opportunities versus a lot of care, few opportunities A choice to create opportunities with the right support Rehabilliation method-Empowerment, Strenght based (academic workplace) Close coöperation with medical professionals of mental health ACT-teams

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Discus Amsterdam Support in Life and Living Results after 5 years 90 housing first dwellings 20 housing first dwellings for aftercare for cliënts formerly in a 24 hour environment 10 special rental properties on the basis of housing first Projected growth in the yrs 2012 -2015 25% of client perform above expectation, 50% well-reasonable, 25% in danger zone Independent Research Radbout University of Nijmegen

Discus Amsterdam Results in Life and Living Results after five years

Discus Amsterdam Support in Life and Living Results after 5 years 123 clients taken into the programme until april 6 2011 Ca. 20% female and 80% male 7 cliënts left the programme and now live indenpendently 12 cliënts moved on to another facility (mental hospital, 24 hour care, detention) 6 cliënt have left the programme 3 cliënts deceased

Discus Amsterdam Support in Life and Living

Discus Amsterdam Support in Life and Living Changes in domains from a cliënts perspective

Discus Amsterdam Support in Life and Living

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Discus Amsterdam Support in Life and Living Cost of Discus versus 24 hour services: Discus: max €19.000 per client per year Reduction of costs after a certain period 24 hour services: 30.000-40.000 per year. No reduction

From a municipal point of view From skepticism to enthusiasm: Easy to build Results Problem solving Cost effective Flywheel for change

From a municipal point of view Housing First gives you something to talk about: Supported Housing is no longer a reward at the end of the line but (more and more) mainstream service From medical practitioners to social workers From health care to common sense

Flywheel for change: Six years ago: street Night shelter 24 hour services Supported housing

Flywheel for change Now: street Supported Housing Housing First 24hour services Hospital/ detention

Medical model versus Social Care Housing First started as a new ACT-team Soon: medical professionals were pushed back in their rol. Services are delivered by common sense professionals. Attitude is more important than training.

From a municipal point of view Limitations: Access should always be restricted Housing First is not for everyone Dwellings are a scarce commodity