Housing-led solutions to rough sleeping and homelessness

A new report from the Conservative think tank the Centre for Social Justice (founded by Iain Duncan Smith in 2004) entitled Housing First: housing-led solutions to rough sleepers has received a favourable response from the Government.

Housing First is an increasingly common international model which prioritises finding rough sleepers a stable home first before encouraging them to engage with mental health services, drug and alcohol support, and training to find employment. In the UK rough sleepers are often only able to obtain accommodation if they agree to receive treatment for drug and alcohol misuse.

Rough sleepers

The number of rough sleepers has soared by over 130 per cent from 1,800 in 2010 to over 4,000 in 2016 on any given night. Each year around 34,500 people sleep rough in England. [See here for latest figures.]

The Centre for Social Justice calculates that rough sleeping costs the Government £1bn every year in health, drug rehabilitation and criminal justice spending. It argues that the plan to introduce Housing First in the UK would cost the Government £110 million a year, but would pay for itself within three years.

The Housing First model

The Housing First model was developed in New York in the early 1990s by the not-forprofit organisation Pathways to Housing. The aim was to help people who were chronically homeless with severe mental health problems access permanent accommodation. Its key principles are:

• Provision of independent permanent accommodation across scattered sites in the private rented sector. The Housing First provider leases accommodation from private landlords. Permanent accommodation is provided alongside wrap-around support. Participants are given far more choice over the location and type of accommodation they move into.
• No requirement to prove ‘housing readiness’ or that they have undertaken work to reduce their drug and alcohol intake to access permanent housing.
• A harm reduction approach separates clinical issues from housing issues. There is no requirement for people to be sober or access treatment to sustain their housing.
• Provision of integrated and comprehensive community support is delivered to participants through multidisciplinary Assertive Community Treatment (ACT) teams. ACT teams are designed to provide treatment, rehabilitation and support services to individuals who are diagnosed with severe mental health problems and whose needs have not been well met by more traditional mental health services. The team will include specialist healthcare professionals.
• Targeting of the most vulnerable to give priority to people who have faced the greatest difficulties accessing mainstream services.

International evidence demonstrates the success of Housing First in achieving high levels of tenancy sustainment rates from 70% to over 90%. One study in New York reported that 88% of chronically homeless people using Pathways to Housing’s model were stably housed after five years. This compares to only 30% to 50% of people who used the staircase model in America, which required them to demonstrate that they were ‘housing ready’ before moving into permanent accommodation.

Housing First has been piloted in parts of the UK including Manchester, Glasgow and Camden.

Reaction

The reaction to the report from homelessness charities has generally been positive with the caveat that housing first mustn’t mean housing only and concerns about whether there is sufficient available accommodation for rough sleepers to access.

Recommendations

The CSJ report makes 7 key recommendations:

1. The Government should create a new funding pot of at least £110 million per year to deliver a National Housing First Programme to end rough sleeping and chronic homelessness for people with the most complex needs. This programme will be cost neutral over the course of a parliament.
2. The Government should amend the homelessness legislation to place a greater focus on prevention work.
3. The Government should set up a Prime Ministerial Taskforce to embed housing and homelessness strategies across government departments to better prevent and end homelessness.
4. DCLG should support and help facilitate the expansion of a CHAIN style database (currently used in London) to other parts of England.
5. The Government should boost investment in low cost rental accommodation.
6. Welfare benefits chances should be made to help improve and increase the supply of housing for people who are homeless.
7. The Government should support social lettings agencies to improve access into the private rented sector and ensure that people can be rapidly rehoused if they face homelessness.

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