1. 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 .

2. 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

3. 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:
people concerned in 2015, + 15% since the 2011 legal reform
Human rights violated repeatedly in the mental health system
people concerned in 2015 or + 15% since the 2011 legal reform. Coldefy 2017

4. 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.

5. 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

6. 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