What can “Housing First” contribute to Mental health French Policy? Vincent Girard Regional Health Agency, Marseille, France Consultation on Human Rights and Mental Health Identifying strategies to promote human rights in mental health 14 and 15 May 2018 Geneva UNITED NATIONS Hello, My name is vincent girard, I would first thank the Un for this invitation to exchange. i am a doctor and a reseracher and i work for a Regional Health agency for one year. I have spent the last 15 years working on the street as psychaitrist in a mobile team helping homeless people to have a home with differents strategies. I hava the chance ton convince the french state to set up a research intervention program call « housing first » which cost arround 35 million dollars. Today i will try to give you some informationa bout how housing first influence the mental french policy .

Presentation outline 1- Chosen facts about France and Mental Health 2- How Housing First works 3- Main Scientific data 4- Mainstreaming and transferability to other issues and fields

Chosen facts about France and mental health Global burden attributed to mental health is very high and increasing Second Highest budget/inhabitant in mental health in Europe (10 billion Euros in hospitalisation) Nearly 45,000 people with a psycho-social disability living in the street, and 25,000 in jail in 2015 Psychiatric coercion is rising dramatically: 90 000 people concerned in 2015, + 15% since the 2011 legal reform Human rights violated repeatedly in the mental health system 90 000 people concerned in 2015 or + 15% since the 2011 legal reform. Coldefy 2017

How Housing First work It is the person who chooses where and how she wants to live in her home. There is no requirement to accept care in exchange and/or stop consumption of psycho-active substances. the person is supported by a team coordinated by a social worker and with peer workers.

Main Scientific data Multi-site Randomized control trial shows that after two years: 27% of normal costs that would have been incurred are avoided. 70% of these avoided costs are related to a decrease in hospitalizations Other needs, such as “supported employment” and other inclusion strategies have been identified

Mainstreaming and transferability to other issues and fields Shift of homeless policy step-by-step to Housing First lever of action to change mental health policy Using scientific evidence to change policy Jail avoidance program Emergency/crisis program (with peer for crisis and Open Dialogue) New policy in disability in France: inclusive Housing