Housing First
[1] There is a substantial base of evidence showing that Housing First is both an effective solution to homelessness and a form of cost savings, as it also reduces the use of public services like hospitals, jails, and emergency shelters.
The Housing First strategy is a comprehensive solution incorporating support for homeless people in all aspects of their personal and social life.
[11][12][13][14] The Housing First philosophy is a paradigm shift, where quick provision of stable accommodations is a precondition for any other treatment to reduce homelessness.
Meanwhile, this approach relies on layers of collaborative support networks that promote stability and eliminate factors that cause or prolong homelessness.
The support system addresses issues such as healthcare, education, family, children, employment, and social welfare.
For many years, the conventional action taken in regard to people experiencing homelessness was that of psychiatric hospitalization, where doctors considered individuals diagnosed with severe mental illness incapable of functioning in all areas of life and that they required around-the-clock supervision and support.
This also reflected the idea prevalent at the time that all or a vast majority of people experiencing homelessness were suffering from mental illnesses.
The staircase approach for people experiencing homelessness had three goals: training people to live in their own homes after being on the streets or in and out of hospitals; making sure someone was receiving treatment and medication for any ongoing mental health problems; and making sure someone was not involved in behavior that might put their health, well-being, and housing stability at risk, particularly that they were not utilizing drugs or alcohol.
Participants were often evicted from housing due to failure to abstain from drugs and alcohol and refusing to undergo psychiatric treatment.
In contrast to the staircase approach, former psychiatric patients were very quickly provided with ordinary housing and received flexible help and treatment from mobile support teams.
[30] In both the scattered-site and project-based Housing First programs, residents are given access to a wide variety of supportive health and rehabilitation services which they have the option, although not mandatory, to participate in and receive treatment.
[35] Dr. Deborah K. Padgett was among the experts who advised the country’s Ministry of Human Rights[36] at a summit in late 2023 launching the government’s multi-year plan to phase in Housing First nationally.
Thus, private or public organizations across Canada are eligible to receive HPS subsidies to implement Housing First programs.
[38] In 2008, the Federal Government of Canada funded a five-year demonstration program, the At Home/Chez Soi project, aimed at providing evidence about what services and systems best help people experiencing serious mental illness and homelessness.
This time the target people group was long term homeless singles and the project is run by the municipality.
However, it has been shown that this intervention strategy is serving only a small number of people recorded to be homeless which is most likely due to barriers like shortage of affordable housing.
[47] In 2007 the centre-right government of Matti Vanhanen began a special program of four wise men to eliminate homelessness in Finland by 2015.
The programme's objectives are:[needs update] Analysis of Housing First in Tampere, Finland found that it saved €250,000 in one year.
[51] The French government launched a Housing First-like program in 2010 in four major cities — Toulouse, Marseille, Lille and Paris — called "Un chez-Soi d'abord", focused on homeless people with mental illness or addictions.
[56] Some renovate discarded or empty homes and they rent the rooms to single mothers with financial and occupational support.
[57] In 2017, the U.K. government announced plans for a Housing First pilot programme in the West Midlands, Liverpool, and Manchester, along with funding of £28m.
[59] In August 2007, the US Department of Housing and Urban Development reported that the number of chronically homeless individuals living on the streets or in shelters dropped by an unprecedented 30 percent, from 175,914 people in 2005 to 123,833 in 2007.
[24][62][63] This first US controlled assessment of the effectiveness of Housing First specifically targeting chronically homeless alcoholics showed that the program saved taxpayers more than $4 million over the first year of operation.
[67][68] A research study from the University of North Carolina at Charlotte also reported that a housing project for the chronically homeless called Moore Place had saved the county $2.4 million.
[69] When comparing the effects of Housing First on older and younger homeless adults, older homeless adults have shown significantly higher rates of improvement in areas like mental component summary scores, condition specific quality of life, mental health symptom severity, and percentage of days stably housed.
In San Francisco, home to over 4,000 people experiencing homelessness and mental illness or drug addiction,[71] a 2015 study found that 91% of those approached by the San Francisco homeless outreach team during sweeps refused the shelter offered to them,[72] often due to underlying drug addiction or mental illness.
[80] On June 11, 2014, the 100,000 Homes Campaign in the United States, launched in 2010 to "help communities around the country place 100,000 chronically homeless people into permanent supportive housing", announced that it reached its four-year goal of housing 100,000 chronically homeless people nearly two months before its July 29 deadline.
[81] This included learning individual homeless people's "name and need" by mobilizing volunteers to go very early in the morning to check on them, establishing a "vulnerability index" so they could prioritize certain homeless people and "bring housing advocates and agency representatives together to streamline the placement processes, and share ideas about how to cut through red tape.
[83] These criticisms have been rebutted on the grounds that Housing First is a program to end homelessness not to reduce substance abuse, though more recent research indicates it is more effective than traditional approaches in this regard as well.
Embedded in that mantra are a priori decisions about what constitutes working and for whom; in this case it was stable housing for the chronic homeless.
