Housing First: what can we learn from evaluation in England?
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Housing First
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Housing First What defines Housing First?
o For people with high support needs o Response to long term and repeat homelessness o Open-ended provision of housing and support o Housing not conditional on treatment, abstinence or being ‘housing ready’ o Client-led
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Housing First What are the core principles? • • • • •
a separation of housing and support services support is open ended and flexible people accessing the service are chronically homeless a harm reduction approach is used people are given choice and this is respected.
Why is it different? • Departure from the ‘staircase’ model which requires people to be ‘housing-ready’ • No ‘requirement’ for compliance as a condition of tenancy - relapse or dis-engagement does not affect accommodation • Aims to offer a permanent housing solution for an individual www.homeless.org.uk
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Housing First How common is Housing First?
• Currently a third (34%) of homeless accommodation providers are using or exploring Housing First in England • Scoping research suggests Housing First would be targeted at between 10-20% of people currently in contact with homelessness services • Widely used across Europe, Canada and the US
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Housing First What do we know about the outcomes? • Strong evidence base from US, Canada and Europe • Evaluation of nine pilots provides recent data for England [conducted by York University] • • • • • • • •
Changing Lives Brighter Futures Bench Outreach CRI SHP St Mungo’s Broadway Thames Reach Stonepillow
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Housing First What were the housing outcomes?
Successful engagement with long-term and repeatedly homeless people, with high rates of support needs
People had history of sustained contact with services without homelessness being resolved
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78%
December 2014, 78% of people were housed. 5 services housed 74% of current users for 1+ year
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Housing First What were the health outcomes? Proportion of users reporting the following:
Bad or very bad physical health
Bad or very bad mental health
43%
one year prior to working with service
52%
28%
currently reported
18%
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Drug and alcohol use
one year prior to working with service
currently reported
Outcomes uneven…
…but some evidence of reduction Let’s end homelessness together
Housing First What were the social integration outcomes?
Daily, weekly or monthly contact with family
25%
one year prior to working with service
75%
currently reported
78%
one year prior to working with service
53%
currently reported
!?$£! Involvement in anti-social behaviour
…but again, positive effects were not uniform www.homeless.org.uk
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Housing First The Key Findings (summary)
• Average client had been homeless for 14 years • Improvements in mental and physical health • Reductions in drug and alcohol use • Evidence of re-establishing links with family • Fall in anti-social behaviour
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Housing First England Cost savings o Services costs approx £26 - £40 per hour o Savings in support costs approx £3,048 - £4,794pa o Additional savings for healthcare, criminal justice o Potential savings in public expenditure £15,000pa
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Housing First What are the issues for England?
• Inconsistent definition of Housing First –local variations with some projects referring to floating support models as Housing First • Lack of affordable and accessible units to use – raising issues of tenancy sustainment, affordability and quality • Getting the right partnerships - inconsistent buy-in from adult social care, health, criminal justice and substance misuse agencies across local authority areas • Lack of co-commissioning arrangements and short term funding – heavy reliance on housing related support with most projects funded between 1 to 3 years
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Housing First England Recommendations o Housing First works for particular client groups but should be one of a range of housing options o Potential to adapt the model for women, young people, those leaving substance treatment o Homeless Link hoping to establish Housing First England project to: •
Lead an alliance of cross-sector partners with the vision and confidence to make Housing First a reality for all who need it
•
Build the evidence base about Housing First, particularly long term outcomes
•
Engage local and national partners to deliver, review and replicate Housing First projects that are effective and sustainable
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Thank you - any questions?
http://www.homeless.org.uk/facts/ourresearch/housing-first-in-england-evaluationof-nine-services
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