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Housing First: tackling homelessness for those with complex needs

Published Tuesday, July 17, 2018

Housing First (HF) is an alternative homelessness intervention strategy, aimed at people with complex needs, particularly rough sleepers. This House of Commons Library paper describes the principles behind Housing First and outlines some of the evidence behind it. The paper also sets out how Housing First has developed in the UK, and what support that it has been offered by the governments of the UK, Scotland, Wales and Northern Ireland.

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Traditional homeless interventions for people with complex needs usually require them to complete a series of steps to make them ‘housing ready’ before moving into their own accommodation. Proponents of HF argue that there is a high drop-out rate from these schemes; users can struggle to meet their strict requirements and thus risk becoming chronically homeless.

Advocates of HF support the early provision of permanent housing which provides a stable home from which it is easier to deal with other underlying issues, such as substance abuse. Unlike most traditional approaches, HF commits to support individuals for as long as they require, even if a person leaves HF accommodation. Proponents of the HF model do not argue that all current strategies should be replaced by Housing First; it is seen as a programme particularly for those with multiple needs and as a complement to a wide range of rough sleeping interventions.

The principles of HF were first developed in the USA, particularly by the Pathways to Housing project established in New York City in 1992. Since then, HF has been used by organisations in Europe and adopted by several European governments as part of their homelessness strategies. Studies have suggested that these projects result in better housing retention rates amongst users with complex needs.

The Scottish, Welsh, Northern Ireland and UK Governments have all committed to exploring the model. In England, what is now the Ministry of Housing, Communities and Local Government (MHCLG) funded a Housing First feasibility study in the Liverpool region, the results of which were published July 2017. The Autumn Budget 2017 committed £28 million to support three Government-sponsored pilots in the West Midlands, Liverpool City Region and Greater Manchester. Funding allocations for the pilots were announced on 9 May 2018.

Increased interest in HF in England is taking place within the context of a growth in rough sleeping. Overall, the number of rough sleepers has increased by 169% from 1,768 in 2010 to 4,751 in 2017. The Government has a target of halving rough sleeping by 2022 and eliminating it by 2027; it is recognised that some innovative approaches to helping people with complex needs off the streets will need to be adopted. 

The evidence base for the successes claimed by the HF approach has been subject to a certain amount of challenge. Questions have been asked about the quality of the evidence; there is also debate about several aspects of the HF model including:

  • Unfair depictions of traditional approaches which use, especially in the UK, many of the ideas behind Housing First.
  • Questions about the cost-effectiveness of a Housing First programme when compared to other models.
  • Difficulties in providing open-ended funding, finding accommodation and employing sufficient support staff.
  • Housing First’s ability to improve other outcomes, such as health, offending rates, substance abuse and so forth.

Commons Briefing papers CBP-8368

Authors: Alexander Bellis; Wendy Wilson

Topics: Homelessness, Housing, Supported housing

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