The election campaign was launched this week and the housing sector calls for the government to solve the housing crisis within a generation. This includes homelessness and rough sleeping where the Housing First model can be effective.
Housing and Homelessness have become the elephant in the rooms of government. In spite of Mark Carney, governor of the Bank of England, saying that problems with housing are the “biggest risk” to the UK economy and the CBI saying that “a perfect storm is brewing in the housing market”, building more homes at an affordable price and ending rough sleeping are not priorities in the grand political arena.
In their manifesto to end homelessness: “Together, Let’s make the difference”, Homeless Link call for the next government to “Provide leadership and resources to local authorities and the voluntary sector so they can develop new ways to invest in accommodation such as Housing First for people moving off the streets and shared housing options for young people”.
Housing First is based on a harm reduction philosophy where providers do not expect clients to shed their bad habits in order to be housed. Instead, these providers will find that by housing them first, clients are more likely to reduce their maladaptive behaviours. Research in the U.S. concur with this model and some significant improvements in reduced medical costs and police contacts have been achieved.
We say “it takes a village to raise a child”, equally, it takes a civic society working together to eradicate homelessness. The Housing First model has several features:
- all agencies recognise the signs of entrenched homelessness and report or refer to the local housing provider, they range from food banks, clothes banks, medics, the police and shop keepers.
- a belief that housing is a basic human need and not a reward for good behaviour and subject to the achievement of an imposed lifestyle change.
- meaningful activities for clients and creating a sense of belonging. Because they access long term housing first, clients feel a spirit of ownership and self-responsibility for their homes and environment. The activities are as simple as cooking and eating with friends – normal life stuff!
- a low expectation of giving up drugs or heavy drinking, but a dedicated, permanent, supportive facility aiming to educate once the person is housed. On this issue, evidence suggests that people have substantially reduced their consumption of substances as a result of Housing First’s harm reduction approach. Once housed people also report better physical and mental health (Baggett et al, Kertesz).
The low threshold for entry into housing might be a disincentive for people and not provide the necessary motivation found in the traditional housing approach. But I am curious…. how about having your basic needs met first and before you attempt addressing more personal mental health or lifestyle issues? Maslow would probably agree with the housing first model as a way to address homelessness.
Another attraction of Housing First is its financial benefits to society because of the investment upstream into prevention:
- no need for emergency accommodation or use of B&Bs, no staff time spent on providing advice, assessing eligibility for housing and priority status, making enquiries and dealing with appeals.
- fewer emergency hospital admissions due to severe mental health conditions – 20 to 25% of the homeless population suffer with mental health issues. Improved take up of screening programmes and lifestyle advice.
- fewer calls to the police due to street drinking, public disturbances and complaints.
Finally, the success of a Housing First model will need to be measured by its ability to engage with the most difficult people to serve. Safeguards need to be put in place against the possibility of “cherry picking” of clients that are easier to help – particularly in a Paid by Results environment. Rent levels need to be affordable for the poorest, 80% of market rate is unattainable for some.
For help on research and implementation of a Housing First model, contact me at ck@catherine-kevis.co.uk