THE EVIDENCE
The solution is a simple idea: give someone their own place to live – their own tenancy – and work with them to build the bespoke package of support, care and treatment that they need to keep it. THE SOLUTION
STUDIES IN THE UK AND OVERSEAS SHOW THE EFFECTIVENESS OF HOUSING FIRST
We have a proven model for this transformative offer: Opportunity Nottingham is a service for people in Nottingham with multiple and complex needs. It has an emphasis on systems change – using experience, evidence and outcomes data to influence the way in which services are designed and commissioned: over nearly eight years beneficiaries themselves have played an important part in improving the design and delivery of these services by pointing out shortcomings and ways to overcome them. The most significant example of systems change by Opportunity Nottingham is piloting the principles of Housing First – an innovative approach providing housing ‘first’ rather than ‘last’. There are no conditions around ‘housing readiness’ before giving a rough sleeper a tenancy; instead, secure housing provides a stable platform from which other issues can be addressed: according to Opportunity Nottingham’s research
at least 66% of rough sleepers in the city present with two or more health conditions related to substance misuse, alcohol, and mental health. This safe place to call home, and the intensive person-centred support that goes with it, gives people with the most complex needs the best chance to sustain accommodation, re-integrate into society and ultimately thrive. It is an approach which is kind, compassionate, and transformational. Each person has their own dedicated worker who visits on a frequent and often daily basis: this worker is there whenever the person needs them – for years if necessary: this is very different from the time-bound approach of commissioned services. Based on the success of the Opportunity Nottingham pilot we want to extend our Housing First provision by developing 200 dedicated units in the next five years across Lincolnshire, North Lincolnshire, Nottinghamshire and Sheffield.
There has been extensive analysis of Housing First’s impact in changing lives, and its effectiveness as a contributory strategy in ending homelessness. The evidence is in and the literature is considerable. Below are two indications. In 2008 Finland began building its homelessness policies around the Housing First ethos – transforming short- term accommodation into individual flats. The number of long-term homeless people in Finland has fallen by more than 35% and rough sleeping in Helsinki, where more than 50% of the homeless population live, has been practically eradicated. Housing First requires significant investment: Finland spent €250m creating new homes and hiring 300 extra support workers, however a study showed the savings in emergency healthcare, social services and the justice system totalled as much as €15,000 a year for every homeless person in properly supported housing 1 . In 2015 an observational study by the University of York 2 evaluated nine Housing First pilots across England and showed high levels of success in reducing long-term and repeated homelessness associated with very high support needs. Sixty service users reported that they had been homeless for an estimated average of 14 years; 80% of the group had lived in hostels
or temporary supported housing for two years or more, prior to using Housing First. Key findings from these Housing First beneficiaries included: • 78% were successfully housed for one year or more • Positive physical health outcomes increased by 35% • Positive mental health outcomes increased by 65% • Alcohol use was reduced by 21% • Drug use was reduced by 20% • Social integration with neighbours and re-establishing links with families improved by 100% • Anti-social behaviour was reduced by 32%. In Opportunity Nottingham’s pilot, 80% of the former rough sleepers were still in their tenancy a year later - an outcome which is consistent with national data. 1 ‘It’s a miracle’: Helsinki’s radical solution to homelessness. Jon Henley, The Guardian, 3 June 2019. 2 Housing First in England: An Evaluation of Nine Services. Joanne Bretherton and Nicholas Pleace. Centre for Housing Policy, University of York, 2015.
HOUSING FIRST PATHWAY Housing First offers a person-centred approach; it provides long-term accommodation with intensive support tailored to the needs of the individual and is not time-limited.
ROUGH SLEEPING / PRISON
SUBSTANCE MISUSE | MENTAL HEALTH DIFFICULTIES | HEALTH ISSUES | CHILDHOOD TRAUMA
HOUSING FIRST
TAILORED SUPPORT | NO TIME RESTRICTIONS | SUITABLE ACCOMMODATION
04 Building Better Futures
Building Better Futures 05
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