Housing First:
Effective Solution
What is Housing First?
 Significant departure from traditional ‘linear’ models of
provision for homeless people with complex needs
 ‘Housing’ First as opposed to ‘Treatment’ First
 Platform for Recovery
Essential Elements of the approach:
Aim: To reduce re-occurring homelessness by supporting
individuals with poor mental health or addiction issues
Underlying principles:
Independent accommodation in scattered site housing
No requirement for housing readiness
Harm reduction approach
Provision of permanent housing and holistic support
Respect for service user choice re: apartment, levels of engagement,
location and times of support
24/7 support from multidisciplinary team
Targets most vulnerable – those that have difficulty coping with
traditional services, resistant to service engagement
Platform for Recovery:
Making a Home
• Independent living skills,
development of social
network, engagement in
employability
Getting a tenancy
• Gaining a tenancy, benefit
maximisation, furniture,
harm reduction, community
integration
Assessment
• Develop a relationship.
Gather relevant
information, Support
Planning/ Risk Assessment.
Ongoing Recovery
Self
Actualisation
Self Esteem
Love/ Belonging
Safety/ Security
Physiological Needs
Housing First - Glasgow
Motivational
Interviewing/
Assertive Outreach
Supporting Service
Users in active
addiction
Full tenancy rights,
scatter site
housing
Harm Reduction
approach
Peer support
workers
No need to be
‘Housing Ready’
No time limits –
support or tenancy
Partnership
working
Flexible, 24/7
support available
Tenancy Sustainment Outcomes:
Length of Tenancy
Sustainment
Number of Service Users
< 6 months
4
> 6 months
3
> 1 year
4
> 2 years
10
Total Number of Service Users
Supported to gain a tenancy by
Housing First
21
Tenancy Sustainment Outcomes
No Evictions!
 2 x supported to give up tenancy
due to prison sentences over 13
weeks
 1 x supported to move from
tenancy due to harassment in local
area
Service User Achievements to date:
Supporting individuals who have never engaged
with any service
 7 service users involved in education and training –
including a university course
 5 service users regularly attending day services
(including community based addiction programmes)
 2 service users involved in voluntary work
 1 service user gained full time employment since
engaging with Housing First
Substance Misuse Outcomes:
Number of individuals now abstinent from their
problematic substance of choice
Substance
Number of Service Users
Alcohol
2
Illicit Substances
10
Housing First Europe
Housing First in Europe
Housing First Europe – test sites
 5 different test sites and 5 different welfare regimes
 Relatively high staff- client ratios 1:3-5 to 1:11
 Mix of congregate housing and scattered housing in
Copenhagen, all others used scatter site housing
 Use of social housing in 3 cities, using allocation rights
with priority for homeless people in social housing. (UK
and Denmark)
 Budapest is a special case
Each service reflects the city and culture that
it resources:
Copenhagen
Marseille/
Lisbon
Amsterdam
Budapest
• Individuals from Greenland
• Group tenancies
• Supports those with mental health issues
• True to original Pathways model
• Supports individuals with a ranges of
need
• ACT
• Clear forest of rough sleeper/ homeless
people
• Negative regime – homelessness illegal
Helsinki
Dublin
• There are differing views regarding whether
or not these are Housing First models
• Focus upon long term rough sleepers –
(alcohol use)
London/
Midlands
• Housing First now developing in England
• London 5 sites aimed at rough sleeping
• Midlands – homeless/ rough sleepers
Vienna
• Includes Housing First support to families
Housing retention rates in Housing First
Europe
Amsterdam
Copenhagen
Glasgow
Lisbon
Budapest
Total number of
service users
165
80
16
74
90
Positive
Outcome
138
(97.2%)
60
(93.8%)
13
(92.9%)
54
(79.4%)
29
(<50%)
Unclear Cases
23
16
2
6
N/A
Negative
Outcome
4
(2.8%)
4
(6.3%)
1
(7.1%)
14
(20.6%)
N/A
Housing First United States of America: In the
beginning --------- Impact on Homelessness from Reagan recession
1979/80s
 Development of warehouse type shelters by Federal
and local Governments to increase provision
 Those with mental health and/or addiction issues lost in
the multiple systems
 Creation of institutionalisation of mental health services
in hospitals
 Reagan cut-backs from 1981 on public housing only
response accommodation
Creation of Pathways and Housing First in
USA
• Concern about the volume of single homeless whose mental illness
needs not being responded to
• Individuals caught in trap created by inadequacies and gaps in
services
• Creation of services to support individuals with their mental health by
multidisciplinary team
• Create support to assist acquiring property to provide them with
‘home’ security
Pathways - Assertive Community Treatment
Team
 First created in New York
 Respond to mental health issues but equally support the
individual in their tenancy
 ACT teams are likely to include: psychiatrists, nurse
practitioners, outreach nurses, occupational therapists
and support workers, employment and education
support worker and peer support workers
Canada’s positive response:
 In USA, Pathways Housing First tackles homelessness
for those suffering with mental illness
 2008 – Canada invited 5 cities to develop ‘At Home’
(Chez Soi) programmes
 Visited Calgary and Vancouver and spent time with an
ACT team in each city.
 Sustained funding recently agreed by Canadian
government although staff funding moving to funding via
health services.
Churchill visits and learning:
 Visited services in Toronto, Calgary, Vancouver,
Minneapolis, Washington/ Philadelphia and New York
 Application of Pathways model within our services
 Responses to homelessness in general and not just
‘single’ homelessness - family responses (as per
Minneapolis)
 Housing First support to Veterans
 Sustained growth of the Recovery Network/ WRAP
models
For more information:
Contact:
Ian Irvine (Operations Manager)
T: 0141 427 8200
E: ianirvine@turningpointscotland.com
Emma Hamilton (Development Manager)
T: 0141 427 8200
E: emmahamilton@turningpointscotland.com
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