Housing First - getting enthusiasm right
The last few months have seen Housing First breakthrough into the homelessness and political agenda in the UK. Crisis has enthusiastically promoted the potential contribution it can make because the evidence base for the outcomes it achieves is compelling. We have also seen increasing concern and some opposition amongst supported housing providers. There are some common themes of concern, which must be taken seriously, and below are some lessons learned.
Never allow Housing First to misrepresent the importance of emergency accommodation. The evidence base for Housing First is best when it is applied to homeless people with complex and multiple needs. This does mean that for a cohort of rough sleepers and people in hostels and night shelters that there is a better alternative, but it does not mean that emergency accommodation is not required - far from it! The Housing First feasibility study we completed for the Liverpool City Region made clear that the provision of Housing First, alongside a housing-led (rapid rehousing) approach for people with low or no support needs, will free up emergency accommodation for it’s stated purpose; short-term emergencies.
In the face of the current threat to supported housing funding we must tread very carefully. Housing First offers an evidence-based alternative people with complex and multiple needs. This includes some people who are sleeping rough, plus some in hostel and night shelter provision. Over time, and alongside robust prevention work and a rapid-rehousing approach for other groups, we can imagine a reduced role for congregate supported housing, as has been seen in other countries.
However, the current proposals for funding supported housing are a serious threat to vital provision up and down the country. This must be addressed in it’s own right and Ministers are being urged to reconsider their plans. In this context, proponents of Housing First must avoid giving the impression that it is somehow a wholesale replacement for the hostel system. It is not, and any immediate reductions of supported accommodation will only serve to increase rough sleeping.
Housing First is a defined model that must be protected. The model has clear principles, the application of which has consistently led to an evidence base of successful outcomes. Provision that veers from the model must not be called Housing First, and we should all be bold enough to call out false claims. Large-scale evaluations of Housing First in Canada and France showed the closer to the fidelity of the model, the better the outcomes were for homeless people. My view is that any future Government funding for Housing First should be accompanied by rigorous and nationally consistent fidelity measures.
There are still unanswered questions. And that’s ok. Tenancy sustainment rates for Housing First schemes are consistently 85% and above. This is compelling, however there are clearly some people for whom this is not the answer. Is the answer a different and congregate model of Housing First? Are there identifiable cohorts within that require registered care rather than homelessness solution? What is the potential of Housing First for youth? How does it fit into a prevention agenda? What does the Threshold model for homeless women who are ex-offenders teach us? All these questions and more should keep the Housing First debate live and push us to ever improve models of provision.
Much of these lessons learned are about framing the argument for Housing First in a better and more responsible way. This is not to somehow narrow the potential of it’s implementation in the UK, but to protect and inform the agenda as it rightly grows.
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