Housing First

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Housing First, which is distinct and separate from "rapid re-housing", is a relatively recent innovation in human service programs and social policy regarding treatment of the homeless and is an alternative to a system of emergency shelter/transitional housing progressions. Rather than moving homeless individuals through different "levels" of housing, known as the Continuum of Care, whereby each level moves them closer to "independent housing" (for example: from the streets to a public shelter, and from a public shelter to a transitional housing program, and from there to their own apartment in the community) Housing First moves the homeless individual or household immediately from the streets or homeless shelters into their own apartments.

Housing First approaches are based on the concept that a homeless individual or household's first and primary need is to obtain stable housing, and that other issues that may affect the household can and should be addressed once housing is obtained. In contrast, many other programs operate from a model of "housing readiness" — that is, that an individual or household must address other issues that may have led to the episode of homelessness prior to entering housing.

General principles[edit]

In Los Angeles, California in 1988, the "Housing First" Program at PATH Beyond Shelter was launched by Tanya Tull in response to a sharp increase in the number of homeless families with children.[1] In 1992 Dr. Sam Tsemberis, a faculty member of the Department of Psychiatry of the New York University School of Medicine, founded Pathways to Housing in New York City. Housing First for the chronically homeless is premised on the notion that housing is a basic human right, and so should not be denied to anyone, even if they are abusing alcohol or other substances. The Housing First model, thus, is philosophically in contrast to models that require the homeless to abjure substance-abuse and seek treatment in exchange for housing.[2]

Housing First, when supported by the United States Department of Housing and Urban Development, does not only provide housing. The model, used by nonprofit agencies throughout America, also provides wraparound case management services to the tenants. This case management provides stability for homeless individuals, which increases their success. It allows for accountability and promotes self-sufficiency. The housing provided through government supported Housing First programs is permanent and "affordable," meaning that tenants pay 30% of their income towards rent. Housing First, as pioneered by Pathways to Housing, targets individuals with disabilities.[3] This housing is supported through two HUD programs. They are the Supportive Housing Program and the Shelter Plus Care Program.[4] Pathways' Housing First model has been recognized by the Substance Abuse and Mental Health Services Administration as an Evidence-based practice.[5]

Principles of Housing First are: 1) Move people into housing directly from streets and shelters without preconditions of treatment acceptance or compliance; 2) The provider is obligated to bring robust support services to the housing. These services are predicated on assertive engagement, not coercion; 3) Continued tenancy is not dependent on participation in services; 4) Units targeted to most disabled and vulnerable homeless members of the community; 5) Embraces harm-reduction approach to addictions rather than mandating abstinence. At the same time, the provider must be prepared to support resident commitment to recovery; 6) Residents must have leases and tenant protections under the law; 7) Can be implemented as either a project-based or scattered site model.[6]

Housing First is currently endorsed by the United States Interagency Council on Homelessness (USICH) as a "best practice" for governments and service-agencies to use in their fight to end chronic homelessness in America.[7]

Housing First programs currently operate throughout the United States in cities such as Plattsburgh, New York; Anchorage, Alaska; Minneapolis, Minnesota; New York City; District of Columbia; Denver, Colorado; San Francisco, California; Atlanta, Georgia; Chicago, Illinois; Quincy, Massachusetts; Philadelphia, Pennsylvania; Salt Lake City, Utah;[8] Seattle, Washington;Los Angeles and Cleveland, Ohio among many others, and are intended to be crucial aspects of communities' so-called 10-Year Plans To End Chronic Homelessness also advocated by USICH.

Evidence and outcomes[edit]

In Massachusetts, the Home & Healthy for Good program reported some significant outcomes that were favorable especially in the area of cost savings.[9]

The Denver Housing First Collaborative, operated by the Colorado Coalition for the Homeless, provides housing through a Housing First approach to more than 200 chronically homeless individuals. A 2006 cost study documented a significant reduction in the use and cost of emergency services by program participants as well as increased health status. Emergency room visits and costs were reduced by an average of 34.3 percent. Hospital inpatient costs were reduced by 66 percent. Detox visits were reduced by 82 percent. Incarceration days and costs were reduced by 76 percent. 77 percent of those entering the program continued to be housed in the program after two years.

Researchers in Seattle Washington, partnering with the Downtown Emergency Service Center, found that providing housing and support services for homeless alcoholics costs taxpayers less than leaving them on the street, where taxpayer money goes towards police and emergency health care. Results of the study funded by the Substance Abuse Policy Research Program (SAPRP) of the Robert Wood Johnson Foundation[10] appeared in the Journal of the American Medical Association April, 2009.[2] This first US controlled assessment of the effectiveness of Housing First specifically targeting chronically homeless alcoholics showed that the program saved taxpayers more than $4 million over the first year of operation. During the first six months, even after considering the cost of administering the housing, 95 residents in a Housing First program in downtown Seattle, the study reported an average cost-savings of 53 percent—nearly US $2,500 per month per person in health and social services, compared to the per month costs of a wait-list control group of 39 homeless people. Further, stable housing also results in reduced drinking among homeless alcoholics.

In Utah, a decrease of 42 percent in chronic homelessness from 2009 to 2010 "can be attributed to the State’s Housing First Initiative," according to the Utah Division of Housing and Community Development.[11]

In August 2007, the US Department of Housing and Urban Development reported that the number of chronically homeless individuals living on the streets or in shelters dropped by an unprecedented 30 percent, from 175,914 people in 2005 to 123,833 in 2007. This was credited in part to the "housing first" approach; Congress in 1999 directed that HUD spend 30% of its funding on the method.[12]

In September 2010, it was reported that the Housing First Initiative had significantly reduced the chronic homeless single person population in Boston, Massachusetts, although homeless families were still increasing in number. Some shelters were reducing the number of beds due to lowered numbers of homeless, and some emergency shelter facilities were closing, especially the emergency Boston Night Center.[13]

Independent Research[edit]

> Perhaps the best concise summary of independent Housing First research is found in the article: 'Doing it already'?: stakeholder perceptions of Housing First in the UK[14]

However, Kertesz et al. (2009) note that present knowledge regarding the effectiveness of Housing First for people with severe and active addiction is incomplete, and call for assertions that the model can ‘solve’ homelessness to be tempered on these grounds. After conducting secondary analysis of Pathways data they concluded that the addiction severity of PHF clients at point of recruitment was ‘lower than that normally seen in homeless persons’ in the US (Kertesz et al., 2009, p. 519), as fewer than 20 per cent of the intervention sample had more than four days of drug use (or 28 days of alcohol use) in any six-month period, including at baseline (Padgett et al., 2006). More recently, while all participants involved in a study of substance use outcomes had a history of drug or alcohol misuse (a prerequisite for study inclusion), only 7 per cent of PHF clients (and 17 per cent of treatment first participants) were actively using at the point of enrolment (Padgett et al., 2011).
On a related note, with a few notable exceptions (e.g. Larimer et al., 2009; Edens et al., 2011), the Housing First literature tends to be light on detail about the severity and nature of substance misuse, and the thresholds utilised are often low. Many reports note rather vaguely that dually diagnosed PHF clients have ‘a diagnosis or history of’ alcohol or substance misuse yet fail to specify: (a) whether these issues continue to affect them at point of recruitment; and (b) if so, how severe such problems are (see, for example, Tsemberis et al., 2004). Padgett et al. (2011, p. 229) provide greater detail, but nevertheless acknowledge that their definition of ‘substance use’ over the course of 12 months: ‘ranged from a single episode of crack cocaine smoking to sporadic use of drugs and/or alcohol to complete relapse into addiction and heavy use’.
That said, recent findings as regards the potential effectiveness of Housing First for people misusing substances are promising. For example, of the eight (of total 27) of Padgett et al.’s (2011) Housing First participants who reported using substances during the year after enrolment, all remained enrolled in the programme, including the two individuals who relapsed into addiction; whereas of the 31 (of 48) treatment first clients who reported using drugs or abusing alcohol during the study, 26 ‘went AWOL’ (that is, left the programme prematurely). Further, when comparing outcomes for ‘high-frequency substance users’ and ‘abstainers’ housed under the Collaborative Initiative on Chronic Homelessness (see below), Edens et al. (2011) discovered that the number of days housed increased dramatically for both groups (with no significant differences between them), but also that mental health and subjective quality of life outcomes were poorer for high frequency users.
Few Housing First studies have explicitly considered issues such as financial wellbeing, the strength of social support networks and/or participation in meaningful activity, but those that do conclude that these areas remain problematic for many clients (Padgett, 2007; Toronto Shelter Support and Housing Administration, 2007; Yanos et al., 2007). Padgett (2007, p. 1934), for example, reported that while Housing First offered consumers ontological security, that is, a sense of wellbeing arising from constancy in one’s social and material environment, other core elements of recovery such as ‘hope for the future, having a job, enjoying the company and support of others, and being involved in society’ had only been partially attained by service users.
McNaughton Nicholls and Atherton (2011) thus argue that, impressive housing retention statistics aside, the non-housing outcomes of Housing First are ‘under-whelming’. A similar conclusion is drawn by Johnson et al. (2012) who note that existing evidence on non-housing outcomes highlights limits to Housing First that rarely feature in public and policy discourses (see also Pleace, 2011, on this issue). They argue that while the evidence base on Housing First is impressive, to date ‘the tendency has been to over simplify or ignore some of the complexities and prob- lems identified in the literature’ (Johnson et al., 2012, pp. 11–12), and thus urge policy-makers and practitioners to not lose sight of goals around recovery and social inclusion when searching for ‘new’, ‘bold’ and ‘evidence-based’ solutions.[15]

> Additional articles include: Housing First for homeless persons with active addiction: are we overreaching?

This article closes with:
Researchers and other stakeholders should acknowledge the limitations of what has been shown to date through research and consider the risks of overreach when extending either linear or Housing First approaches to populations for which the data are, at present, insufficient. Not to do so risks long-term disappointment should a program’s results fail to match the public’s expectations.[16]

> The Ambiguities, Limits and Risks of Housing First from a European Perspective[17]

Six leading researchers from around the globe have responded to this article creating perhaps the best pool of global knowledge on the topic.[18]

> Housing first - Where is the evidence?:

Remarkably, in this article, the former Director of Research for Pathways to Housing, the organization that pioneered the Housing First model, Jeannette Waegemakers Schiff, now with the University of Calgary, surveyed all the available literature in 2012 and concluded with the following comments:
  • Given the paucity of highly controlled outcome studies, we examined the process whereby Housing First had so rapidly become accepted as a 'best practice'. Declaring the Housing First model a best practice appears to be a political decision rather than a scientific research decision.
  • With relatively sparse external scientific evidence or research on the model, [Housing First] is nonetheless supported by the US department of Housing and Urban Affairs (HUD) and had been declared a "best practice" by the United states Interagency Council on Homelessness.
  • We can safely conclude that Housing First has been shown to be effective in housing and maintaining housing for single adults with mental illness and substance use issues in urban locations where there is ample rental housing stock. There is no ‘best practice’ evidence in the form of randomly assigned, longitudinal studies on families, youth, those with primary addictions, those coming from incarceration, and those with diverse ethnic and indigenous backgrounds.[19]

> In August 2011 researchers from Loyola University and The University of Chicago, in research sponsored by the Chicago Alliance to End Homelessness found the following:[20]

• All in all, there is very little evidence supporting the suggestion that Housing First services give clients the room needed to improve on outcomes other than homelessness. In general, the improvements in relative housing security are not, at the aggregate level, translated into improvements in health or mental health.
• However, there only is very limited evidence that improvements in housing lead to improvement in health, mental health, drug use, and alcohol use, or even that clients improve after receiving treatment for personal problems. The aspect of the Housing First model suggesting that stability leads to various personal improvements cannot be confirmed with the data at hand.
• The multivariate analyses continue to suggest that interim [Transitional/Interim] housing programs are better than shelters at helping individuals escape homelessness. In other words, our findings tend to discount that the differences described above occur because of the personal traits of the clients. Our results hold up when controlling for a large group of such traits, including family status, the existence of alcohol and drug problems, education, mental health problems, and demographic characteristics. Results even hold up when separately analyzing the sample of single individuals. This is accomplished because few family heads reside in emergency shelters.
• Multivariate analyses also suggest several reasons for the central difference. Evidence, while imperfect, suggests that the receipt of the three types of services taken together – professional, advocacy, and employment-related – contribute to the decline in homelessness, that employment-related services are particularly efficacious, and that interim housing programs are particularly successful when their clients first move to permanent housing or to market housing. Further, those clients leaving interim housing programs in order to move to market housing are found to have reasonable resources, including either jobs or some sort of welfare benefits.[20]

> Perhaps the strongest survey of the Housing First research appears in "Policy Shift or Program Drift? Implementing Housing First in Australia"[21] Section Three of this document summarizes the state of the data with statements such as:

"Cost-Effective?": While it is true that many jurisdictions in the US have conducted costs analysis of Housing First, what is not mentioned is that few of these ‘studies’ have been subject to peer review and most lack rigour. Sam Tsemberis [founder of Housing First] concluded that cost studies of Housing First:
... seldom involve random assignment and seldom include comparison or control groups. Moreover, study populations are selected through convenience sampling and frequently are chosen based on their presumed heavy use of services. Thus, these studies are likely to overestimate cost reductions and should be interpreted with caution. (Tsemberis 2010, p.52)
Given that Housing First is promoted as a cost-effective approach it is surprising that a full cost-effectiveness analysis that includes the costs of the Housing First intervention itself has yet to be published (Rosenheck 2010, p.24). Perhaps even more astonishing is that while supportive housing generally and Housing First specifically are linked to important costs offsets as a result of reduced hospitalisation, acute treatment and involvement with criminal justice system, cost savings do not equal the cost of providing supportive housing (Culhane et al. 2002; Rosenheck et al. 2003; Culhane & Metraux 2008). This is an important finding, but one that is often overlooked in the Australian literature.
"Recovery?": [I]t is important to critically consider whether housing retention rates reported by Pathways to Housing are bolstered by the exclusion of people with serious addictions. While other Housing First programs in the US are tackling the issue of addiction, the assertion that the existing data on Housing First and addiction remain ‘mixed and unsettled’ represented a cautionary warning (Kertesz et al. 2009, p.519).
Assisting chronically homeless people into housing and keeping them housed is important but the literature shows that the problems faced by chronically homeless people do not magically disappear once they are housed. As Tsemberis (2010, p.52) notes:
Housing First and other supportive housing interventions may end homelessness but do not cure psychiatric disability, addiction, or poverty. These programs, it might be said, help individuals graduate from the trauma of homelessness into the normal everyday misery of extreme poverty, stigma, and unemployment.
A number of qualitative studies have found issues of social isolation and loneliness among Housing First consumers both of which are associated with depression, a reduced sense of control and pessimistic social expectations (Schutt & Goldfinger 2011, p.31). Padgett (2007) and Yanos, Felton, Tsemberis and Frye (2007) found that despite being in stable accommodation, Housing First consumers often lacked a sense of involvement with the broader community, a sense of purpose or any meaningful pursuits. In her study of 39 chronically homeless people in New York who were provided with ‘immediate access to housing’ Padgett notes that ‘other elements of psychiatric recovery such as hope for the future, having a job, enjoying company and the support of others, and being involved in society ... have only been partially obtained’ (2007, p.1935).
The point to bear in mind is that while a Housing First approach can be successful at getting people into housing and keeping them housed, it is purportedly less successful in addressing social and economic exclusion. As McNaughton Nichols & Atherton (2011, p.775) note:
... the evidence as to further benefits from Housing First beyond that of maintaining housing (albeit an important outcome) remains underwhelming.
Addressing social and economic exclusion remains a complex and challenging task and the point here is not so much a criticism of Housing First per se but rather to highlight the limits of Housing First—limits that are rarely mentioned in the public or policy discourse.
Higher Goals, Less Funding?: One final point about the Housing First evidence base needs to be made. Housing First studies often use continuum models as the point of comparison (Tsemberis 1999; Tsemberis & Eisenberg 2000; Gulcur et al. 2003; Stefanic et al. 2004; Tsemberis et al. 2004; Padgett et al. 2006; Kertesz et al. 2009; O'Connell et al. 2009; Pearson et al. 2009; Tsai et al. 2010). While many studies suggest that Housing First is more effective than existing models, some researchers argue the reason for this can be traced back to the resources available to each approach. For instance, Kertesz and his colleagues (2009) argue that many continuum interventions are under-funded and have a limited capacity to achieve what they are meant to. This observation suggests that while studies show that Housing First interventions achieve better outcomes than traditional interventions, it cannot necessarily be assumed that the Housing First model is better. Rather, the identified differences between the two interventions may be more a result of traditional services not having the resources and capacity to do what they are supposed to (see also O'Connell et al. 2009 who make a similar point). In short, the problems may not be with the continuum model at all, but rather that continuum models have no control over the housing they refer service users to—thus contributing to uncertainty about what housing outcomes are achieved or can be attributed to the service (Kertesz et al. 2009, p.510).
Further, housing retention rates are lower in continuum models, in part because its goals are more ambitious—continuum models aim to address mental health and substance misuse problems. In short, a simple:
... like-with-like comparison between Housing First and continuum models might be viewed as unfair, because these services have different operational goals. (Pleace 2010, p.5)
Summary: The Housing First evidence base is impressive and certainly warrants close attention from policy-makers. However, it requires close scrutiny and to date the tendency has been to over simplify or ignore some of the complexities and problems identified in the literature. The evidence certainly highlights strengths in the Housing First approach but it also identifies some limits—in as much as policy-makers need to know what works, it is equally crucial that they have a clear understanding of what does not work and for whom.
Housing First represents an important development in the way services are delivered to the homeless but it is not an antidote to the structural contexts in which homelessness is embedded. Similarly, while Housing First can assist people to make immediate exits from long term homelessness, it has been demonstrated that formerly homeless people often continue to experience a range of health, social and economic problems, all of which can pose a threat to their housing stability. Thus we do not see Housing First as the ultimate panacea to the problem of homelessness. The limitations of Housing First are similar to those of every program designed to work with people who are already homeless. Housing First supporters would do well to recognize it.[21]

Recent US policy and legislation[edit]

The United States Congress appropriated $25 million in the McKinney-Vento Homeless Assistance Grants for 2008 to show the effectiveness of Rapid Re-housing programs in reducing family homelessness.[22][23][24]

In February 2009, President Obama signed the American Recovery and Reinvestment Act of 2009 part of which addressed homelessness prevention, allocating $1.5 billion for a Homeless Prevention Fund. The funding for it was called the "Homelessness Prevention and Rapid Re-Housing Program" (HPRP), and was distributed using the formula for the Emergency Shelter Grants (ESG) program.[25]

On May 20, 2009, President Obama signed the Homeless Emergency Assistance and Rapid Transition to Housing (HEARTH) Act into Public Law (Public Law 111-22 or "PL 111-22"), reauthorizing HUD's Homeless Assistance programs. It was part of the Helping Families Save Their Homes Act of 2009. The HEARTH act allows for the prevention of homelessness, rapid re-housing, consolidation of housing programs, and new homeless categories. In the eighteen months after the bill's signing, HUD must make regulations implementing this new McKinney program. [26][27]

In late 2009, some homeless advocacy organizations, such as the National Coalition for the Homeless, reported and published perceived problems with the HEARTH Act of 2009 as a HUD McKinney-Vento Reauthorization bill, especially with regard to privacy, definitional ineligibility, community roles, and restrictions on eligibile activities.[28]

On June 22, 2010, the United States Interagency Council on Homelessness presented Opening Doors: Federal Strategic Plan to Prevent and End Homelessness to the Obama Administration and Congress.[29] This is the nation's first comprehensive strategy as mandated by the HEARTH Act and includes Housing First as a best practice for reaching the goal of ending chronic homelessness by 2015.

Application to family homelessness[edit]

The Housing First methodology is also being adapted to decreasing the larger segment of the homeless population, family homelessness, such as in the Los Angeles based program Housing First for Homeless Families which had been established in 1988.[30] Dennis Culhane, University of Pennsylvania homelessness researcher, states: “There’s a lot of policy innovation going on around family homelessness, and it’s borrowing a page from the chronic handbook — the focus is on permanent housing and housing-first strategies.”[31]

Outside the United States[edit]

Australia[edit]

In South Australia, the State Government of Premier Mike Rann (2002 to 2011) committed substantial funding to a series of initiatives designed to combat homelessness. Advised by Social Inclusion Commissioner David Cappo and the founder of New York's Common Ground program, Rosanne Haggerty, the Rann Government established Common Ground Adelaide [32] building high quality inner city apartments (combined with intensive support) for "rough sleeping" homeless people. The government also funded the Street to Home program and a hospital liaison service designed to assist homeless people who are admitted to the Emergency Departments of Adelaide's major public hospitals. Rather than being released back into homelessness, patients identified as rough sleepers are found accommodation backed by professional support. Common Ground and Street to Home now operate across Australia in other States.

Canada[edit]

In its Economic Action Plan 2013, the Federal Government of Canada proposed $119 million annually from March 2014 until March 2019—with $600 million in new funding—to renew its Homelessness Partnering Strategy (HPS). In dealing with homelessness in Canada, the focus is on the Housing First model. Thus, private or public organizations across Canada are eligible to receive HPS subsidies to implement Housing First programs.[33] In 2008, the Federal Government of Canada funded a five year demonstration program, the At Home/Chez Soi project, aimed at providing evidence about what services and systems best help people experiencing serious mental illness and homelessness. Launched in November 2009 and ending in March 2013, the At Home/Chez Soi project was actively addressing the housing need by offering Housing First programs to people with mental illness who were experiencing homelessness in five cities: Vancouver, Winnipeg, Toronto, Montréal and Moncton. In total, At Home/Chez Soi has provided more than 1,000 Canadians with housing.[34]

Housing First has grown in popularity in Canada and used in many Canadian ten-year plans to end homelessness, such as those in Edmonton and Calgary, Alberta. Housing First: A Canadian Perspective (TM) is spearheaded by Pathways to Housing Calgary and director Sue Fortune. Canadian adaptations to Housing First have demonstrated positive outcomes as documented on the website: www.thealex.ca (Housing Programs; Pathways to Housing). Canadian implementations of Housing First must be tailored to Canadian homelessness, resources, politics and philosophy.

In Calgary, Alberta, the Alex[35] Pathways to Housing Calgary which opened in 2007, has 150 individuals in scatter site homes in 2013.[36] Client pay 30 percent of their income towards their rent: 85 percent of Pathways to Housing clients receive Assured Income for the Severely Handicapped (AISH) benefits and 15 percent receive Alberta Works. The Alex Pathways to Housing uses a Housing First model, but it also uses Assertive Community Treatment (ACT), an integrated approach to healthcare where clients access a team of "nurses, mental health specialists, justice specialists and substance abuse specialists." Director Sue Fortune is committed to the 10 Year Plan To End Homelessless in the Calgary Region. Fortune reported that the Housing First approach resulted in a 66 percent decline in days hospitalized (from one year prior to intake compared to one year in the program), a 38 percent decline in times in emergency room, a 41 percent decline in EMS events, a 79 percent decline in days in jail and a 30 percent decline in police interactions.[37] Sue Fortune, Director of Alex Pathways to Housing in Calgary in her 2013 presentation entitled "Canadian Adaptations using Housing First: A Canadian Perspective" argued that less than 1% of existing clients return to shelters or rough sleeping; clients spend 76% fewer days in jail; clients have 35% decline in police interactions.[37]

Pathways to Housing Canada describes the Housing First as a "client-driven strategy that provides immediate access to an apartment without requiring initial participation in psychiatric treatment or treatment for sobriety."[37]

Finland[edit]

In 2007 the centre-right government of Matti Vanhanen began a special program of four wise men to eliminate homelessness in Finland by 2015.[38][39]

The programme to reduce long-term homelessness targets just some homeless people. Assessed on the basis of social, health and financial circumstances, this is the hard core of homelessness. The programme to reduce long-term homelessness focuses on the 10 biggest urban growth centres, where also most of the homeless are to be found. The main priority, however, is the Helsinki Metropolitan Area, and especially Helsinki itself, where long-term homelessness is concentrated.

The programme is structured around the housing first principle. Solutions to social and health problems cannot be a condition for organising accommodation: on the contrary, accommodation is a requirement which also allows other problems of people who have been homeless to be solved. Having somewhere to live makes it possible to strengthen life management skills and is conducive to purposeful activity.

Because of all the reasons there are for long-term homelessness, if it is to be cut there need to be simultaneous measures at different levels, i.e. universal housing and social policy measures, the prevention of homelessness and targeted action to reduce long-term homelessness.

The programme’s objectives are:

  • To halve long-term homelessness by 2011
  • To eliminate homelessness entirely by 2015
  • More effective measures to prevent homelessness

France[edit]

French government launched a Housing First-like program in France on 2010 in 4 majors cities : Toulouse, Marseille, Lille and Paris called "Un chez-Soi d'abord". It follows the same principles as the Canadian and US programs : it is focused on the homeless people with mental illness or addicted to drugs or alcohol. The plan is on a 3 years basis for each individual, sheltered in an apartment lend by a NGO.[40]

They are given the needed help to reinsert and take medical care to the tenants, at home. The firsts housings are ready and working in 3 cities since 2011 and a hundred apartements will be available for the public in Paris starting on May 2012.[41]

Several NGOs are involved in this experiment, they are assuring the rental management as well as the social support for the housed people.[42]

Those NGOs are linked with scientists investigating the results of the experiment and serve as a relay for informations and status reports on the targeted public. The lead team of "Un chez-soi d'abord" is expecting results to be published around 2017.[43]

See also[edit]

References[edit]

  1. ^ "Profile for Tanya Tull, Ashoka Fellowship". 2009. Retrieved February 11, 2014. 
  2. ^ a b "Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons with Severe Alcohol Problems". Larimer, Malone, Garner, Atkins, Burlingham, Tanzer, Ginzler, Clifasefi, Hobson, & Marlatt in JAMA. April 2009. 
  3. ^ "The Applicability of Housing First Models to Homeless Persons with Serious Mental Illness". HUD. July 2007. 
  4. ^ "HUD Homeless Assistance Programs". HUD. December 21, 2007. 
  5. ^ "National Registry of Evidence-based Programs and Practices". SAMHSA. November 2007. 
  6. ^ "Housing First Principles". Downtown Emergency Service Center. July 2007. 
  7. ^ "Homeless Crisis Response," Opening Doors Objectives
  8. ^ "Homeless gain homes at manor," Deseret News, Feb. 29, 2008
  9. ^ "MHSA Submits Updated Home & Healthy for Good Report to Legislature: Statewide Housing First initiative reports dramatic cost savings to Commonwealth" — December 2007
  10. ^ "SAPRP Project: Housing First: Evaluation of Harm Reduction Housing for Chronic Public Inebriates". SAPRP. April 2009. 
  11. ^ Chronic Homelessness Significantly Drops in Utah
  12. ^ "U.S. Reports Drop in Homeless Population", New York Times, July 20, 2008.
  13. ^ Brady-Myerov, Monica, "Homelessness On The Decline In Boston", WBUR Radio, Boston, September 29, 2010
  14. ^ https://pureapps2.hw.ac.uk/portal/files/1202155/IJHP_DoingItAlready.pdf
  15. ^ https://pureapps2.hw.ac.uk/portal/files/1202155/IJHP_DoingItAlready.pdf
  16. ^ goo.gl/02i6Sn
  17. ^ http://www.feantsaresearch.org/IMG/pdf/think-piece-1-3.pdf
  18. ^ http://www.feantsaresearch.org/spip.php?article177&lang=en
  19. ^ goo.gl/8h8Pio
  20. ^ a b http://www.thechicagoalliance.org/research.aspx
  21. ^ a b http://www.ahuri.edu.au/publications/download/ahuri_30655_fr
  22. ^ National Alliance to End Homelessness, "Rapid Re-Housing", July 8, 2008.
  23. ^ United States Department of Housing and Urban Development, "Homeless Assistance Programs"
  24. ^ National Alliance to End Homelessness, "HUD and McKinney-Vento Appropriations", FY 2010
  25. ^ United States Department of Housing and Urban Development, "Homelessness Prevention and Rapid Re-Housing Program"
  26. ^ National Alliance to End Homelessness, "Summary of HEARTH Act", June 8, 2009
  27. ^ "The HEARTH Act — An Overview", National Law Center on Homelessness and Poverty, Washington, D.C.
  28. ^ National Coalition for the Homeless, "NCH Public Policy Recommendations: HUD McKinney-Vento Reauthorization", Washington, D.C., September 14, 2009
  29. ^ "Opening Doors"
  30. ^ "About the 'Housing First' Program for Homeless Families", Beyond Shelter agency, Los Angeles, California.
  31. ^ Strides in Fighting Homelessness, Christian Science Monitor, August 8, 2008.
  32. ^ http://www.commongroundadelaide.org.au
  33. ^ Government of Canada. nd.Action Plan: Homelessness Partnering Strategy
  34. ^ Mental Health Commission of Canada (MHCC). 2014. Housing and Homelessness: What is the issue? Calgary, Alberta.
  35. ^ "Pathways to Housing". The Alex. 2014. 
  36. ^ Fortune, Sue (April 1, 2013) (PDF).  (Report). Calgary, Alberta. http://www.thealex.ca/wp-content/uploads/2013/04/Annual-Report-2013-Final-P2H.pdf. Retrieved February 11, 2014.
  37. ^ a b c Fortune, Sue (October 2013). "Pathways to Housing Housing First Model adapted for use in the Canadian context" (PDF). Saskatchewan. Retrieved February 11, 2014. 
  38. ^ Finnish government's programme to reduce long-term homelessness 2008–2011
  39. ^ Reducing homelessness
  40. ^ 26 Janv 2010 Report
  41. ^ Housing first et le logement des personnes sans-abris
  42. ^ Intermediation Locative
  43. ^ Programme expérimental« Un chez-soi d’abord »
  44. ^ Ahearn, Victoria (5 June 2012). "NFB short web docs capture results of Canada's At Home/Chez Soi study". News1130 (Toronto: Canadian Press). Retrieved 13 November 2012. 

Bibliography[edit]

Further reading[edit]

Media[edit]

  • PBS, "Home at Last?, NOW series program, first aired on February 2, 2007. The topic was what will most help homeless people reenter the fabric of society and looks at the housing option.

External links[edit]