Transcript Slide 1
Overview of Housing First in Europe Suzanne Fitzpatrick, 9th May 2014 Origins of Housing First First developed in New York, by ‘Pathways to Housing’, for chronically homeless people with severe mental health problems Bypasses linear model/transitional accomm; places street homeless directly into independent tenancies with support ‘Housing first’ cf. ‘treatment first’ (or ‘employment first’) philosophy Strong evidence base from US, especially on tenancy sustainment Controversial initially; now widely endorsed HF in European Context • Rapid expansion of HF pilots/programmes • Endorsed by FEANTSA • Promoted by EU - Joint Report on Social Protection and Social Inclusion (2010) • Jury of European Consensus Conference on Homelessness (2010) called for: - shift away from use of transitional models - towards increased access to permanent housing (with support) ‘Housing First Europe’ Study • Funded by European Commission • 2 year project (2011- 2013) involving: a) research; b) mutual learning • Examined HF implementation and effectiveness in: • Test sites: Amsterdam (Netherlands), Budapest (Hungary), Copenhagen (Denmark), Lisbon (Portugal), Glasgow (UK) • Peer sites: Dublin (Ireland), Ghent (Belgium), Gothenburg (Sweden), Helsinki (Finland), Vienna (Austria) Robustness of Evidence Base The case for HF – and de-institutionalising homeless people – is now compelling We do not have ‘gold standard’ randomised control trial evidence in Europe, but the sheer consistency and 'weight' of evidence from HFE (and other studies) is utterly convincing Most homeless people, even with very complex support needs, can sustain ordinary housing if given the right support There will always be a need for other approaches for a minority, but there is an increasing view that the default should be HF (or housing-led) Scattered-Site Housing is Best HFE adds to large body of evidence that scatteredsite housing is: a) what most homeless people want; and b) what works best for most homeless people The negative impacts and institutionalising tendencies of congregate settings are now well evidenced, e.g. hostel closure evaluations, problems with Common Ground in Australia, etc. There will, of course, be a need for (usually small) group settings for a minority of homeless people, but the evidence indicates that the default should be scattered-site Going Forward Basic case for HF, using scattered-site housing, is now made. But there are important areas which would benefit from future development/research: long-term sustainability cost-effectiveness Assertive Community Treatment – when required/useful resolving neighbour disputes whether HF or transitional model most appropriate for young people HFE Study www.socialstyrelsen.dk/housingfirsteurope