There is a growing consensus that Housing First is the way to go in combatting homelessness. Housing First is defined as “an approach that offers permanent, affordable housing as quickly as possible for individuals and families experiencing homelessness, and then provides the supportive services and connections to the community-based supports people need to keep their housing and avoid returning to homelessness”.
The concept of Housing First has been around since 1988 but in recent years it has been championed by Homeless Link and, as a result, has attracted more interest and support.
The concept, as applied in the U.K., is that street homeless people, usually with addictions and chaotic lifestyles, get housing and open-ended support in order to avoid further periods of homelessness. This is not conditional on any change of behaviour or the need to engage with support services.
There is very informative research carried out by Joanne Bretherton and Nicholas Pleace from the Centre for Housing Policy at the University of York that is very positive about the nine pilots that have been run around England, including one in Brighton run by CGL (Change, Grow, Live, formerly CRI – Crime Reduction Initiatives).
I can see the positive aspects and achievements of Housing First, but I don’t think it is the panacea it is sometimes presented, and I think it has some fundamental flaws in principle.
The research found many positive outcomes had been achieved, for example:
- 74% remained housed for over a year;
- Bad or very bad health fell from 43% to 28%; and
- Bad or very bad mental health fell from 52% to 18%.
But while there have been improvements in other areas, the situation remains depressingly poor:
- Drug use fell only from 66% to 53%;
- Those who “drank until they felt drunk” reduced only from 71% to 56%; and
- Anti-social behaviour, compared to the year before entering Housing First, remained at 53% compared to 78%.
I am not sure whether we can regard a scheme as a success when the majority continue to use drugs, drink until they are drunk, and continue to commit anti-social behaviour.
In other areas of their lives, the improvements, while welcome, are not very encouraging. Begging dropped from 71% to 51%. Why, we should ask, are people who are housed, and getting support to claim benefits, still begging? 36% of those housed had been arrested, compared to 53% before they were housed.
For most of us, when we meet someone for the first time, the first two bits of information we share about ourselves are our names and what we do, be it paid or unpaid, work or hobbies. In the Housing First research, there was absolutely no change in the number of clients entering work, remaining stubbornly low at just 3%. Those in Housing First schemes are at risk of continuing to be defined by what they do: drinking until they are drunk, using drug, begging, perpetrating anti-social behaviour. Housing First hardly helps people to achieve their aspirations and their full potential.
My doubts about Housing First are those very principles that its advocates regard as its strengths:
- It is based on a harm reduction model;
- It offers open-ended support;
- It is not conditional on engagement: and
- Retention is not based on behaviour modification.
At its heart, Housing First lacks ambition, that change is possible, that people can achieve their aspirations and full potential. It embeds dependency, on welfare benefits and support. As one interviewee put it: he gets “help with everything”. At BHT, part of our ethos has seen a move away from staff always doing things for clients, helping with everything, to promoting change so that people can take advantage of the opportunities available to them so that they can combat their homelessness, poverty, mental ill health and addictions.
Economically, can the modest savings be regarded as adequate? The report found that savings were £15,000 per person per annum. While that is not to be dismissed, by being more ambitious, greater savings can be made. Our Addiction Services, for example, will see 60 individuals each year with a history of homelessness and addiction becoming abstinent and housed. Most go on to training and employment. Relationships strengthen, they don’t beg or steal, and their health improves. As a result, crime rates plummet and there are no demands on the police and criminal justice, there are fewer ambulance call outs, fewer attendances at A&E, welfare dependency reduces, people begin paying taxes.
For how long should landlords tolerate rent arrears and damage to property, disturbance to neighbours and the community excused, high levels of public funds be expended?
Housing First is an open-ended commitment. It would be great if we had open-ended resources, if we had plentiful housing, if we had homes with no neighbours being impacted by anti-social behaviour. But even then, I don’t find it acceptable, morally or economically, to leave people in action addiction, committing anti-social behaviour, begging and offending, when better outcomes are possible. Surely we can do better.