Housing First and the Fight Against Homelessness

Ahead of this year’s Homeless World Cup in Tampere, we take a look at the programme of Housing First and the fight against homelessness in Finland.

What is Housing First?

Housing First is a policy that provides homes to people suffering from homelessness, immediately and unconditionally.

Where other policies focus on preparing people to be housed, Housing First ensures people have a roof over their heads first, which then provides a safe base to work on issues.

The ideology of the policy can be traced back to New York, 1992, through the Pathway of Housing concept by Dr Sam Tsemberis.

It focused on housing as a human right – that it should not be denied or dependent on treatment-seeking, as was the case with many homeless policies at the time.

According to the Housing First Europe Guide, the policy was first developed to help people with mental health problems who were living on the streets. It later expanded to include people who were staying in homeless shelters long-term. In North America, Housing First services are now also open to families and young people who are homeless.

Prior to this, the most common approach to housing people with support was called the “staircase approach” – where housing was only offered once a service user completed several steps to ready them for living independently.

That approach had three goals; train people to live in their own homes, ensure the service user was receiving treatment for any mental health issues, and make sure the user doesn’t engage in behaviour that would put them at risk, that is, by using drugs or alcohol.

There were problems with this approach. Some service users became ‘stuck’ on a step due to being unable to complete the necessary tasks to move onto the next step.

The strict rules meant some people abandoned the service, as they were sometimes held to a higher standard than the general population.

Ethical issues were also raised. There were concerns about “a tendency to view homelessness as the result of someone’s character flaws”. Add to this the harsh environments service users were often exposed to in staircase services and high costs with limited effectiveness. (HF Europe guide, p15)

Core Principles

There are several core principles to the successful implementation of Housing First. They are;

  • Housing is a human right
  • Housing and support/treatment are separated
  • Harm reduction
  • Flexible support for as long as needed
  • Active engagement approach
  • Service users have choice and control
  • Person-centred approach

More info on the principles can be found here.

Housing First in Finland

Prior to 2008, tented villages in city parks were a common sight in Finland. The country had a substantial housing problem. Besides there not being enough shelters, getting out of homelessness was also a challenge. To find a job, a person needed to have an address. To rent a flat, a person needed a job. It was a catch-22.

In 2008, Finland chose to make a change – it began the policy of Housing First.

And it’s working.

According to Kontrast.at (available in English here) and Finland’s Y-Foundation, Finland is the only EU country where the number of homeless is in decline.

The last ten years have seen Finland provide 4,600 homes to those in need. In 2018 there were around 1,900 people living on the streets but there was enough room for them in emergency shelters.

Graph of homeless levels in Finland dropping from over 18,000 in 1987, to approximately 7,000 in 2016.

(Graph courtesy of Y-Foundation)

Why does it work?

It works because as well as being given a home, those in the programme are also given individually tailored support. They are able to meet with advisors and get advice on things such as problems paying the rent, or applying for government benefits.

Tenants also given financial and debt management training. What is key here, is that much of this support can be provided in their own home.

But what about the cost?

In Finland, according to scoop.me, 270 million euros has been spent in the last ten years on the construction, purchase and renovation of housing for the programme.

The Y-Foundation argues that this is saving money:

“In Tampere the supported housing unit in Härmälä reached almost 250,000 euros in savings in one year thanks to the model. The savings in terms of the services needed by one person can be up to 9,600 euros a year when compared to the costs that would result from that person being homeless.”

They also say that housing one long-term homeless person saves the taxpayer roughly 15,000 euros a year.

Housing First elsewhere

The programme has been implemented in a number of countries, each differing slightly from one another, with differing levels of success. It is operational in parts of the USA, and most Western European nations have also adopted Housing First, as well as Scandinavia, Italy and Austria.

Challenges

There are several challenges that may hinder the effectiveness of the programme. First, there is a need for steady, reliable funding. Next, the sourcing of housing. Besides the need by service providers to find suitable accommodation, in some wealthier countries the private rental sector is often overpriced and uncertain, leading to a need for purpose-built housing.

In Finland, this is helped by the fact that the Y-Foundation have over 17,000 apartments in over 50 cities and towns, offering affordable rental housing.

There is also the issue of the NIMBY, that is, the Not In My Back Yard attitude. While most people agree we need to house those in need, they can be apprehensive about that kind of housing being in their neighbourhood.

A further challenge may be they type of housing made available. In the US the argument is whether to employ the use of scattered housing (to avoid NIMBY issues and promote integration in the community) or single-site housing for ease of service provision. Research suggests the success of either approach is dependent on each city or town’s capabilities. In Finland the mix of scattered and purpose-built housing blocks are both proving effective.

Despite the challenges, it is working

Housing First does not work as a stand-alone policy. It requires an integrated approach involving healthcare, advice, and prevention.

But yes, it is helping to eradicate homelessness.

Professor Suzanna Fitzpatrick – an expert on homelessness in the UK, recently told the BBC that wherever it has been tried around the world it is found to be better than the alternative model.

“The evidence base for Housing First is absolutely overwhelming,” she says. “Out of all the initiatives in the homelessness world it is the one by far with the strongest evidence base.”

Juha Kaakinen, head of the Y-Foundation, told The Guardian: “The Housing First model can be replicated even though housing conditions may vary from country to country in Europe. Providing permanent homes for the homeless should be a target instead of temporary solutions.

“There is no quick fix to all life situations, but a solid base provides the foundations upon which to improve the welfare of the homeless. The first step in change is the change in attitudes.”

 

Featured image: Tampere, Finland, by Laura Vanzo