What is Housing First and how can it solve homelessness in the UK?

If you heard anything about efforts to end rough sleeping in the UK over the last few years, chances are you will have heard Housing First mentioned.

It has been billed as one of the most effective ways of helping people out of street homelessness.

The model’s success abroad has seen politicians, both local and national, heading to Finland to learn more about how it has been introduced in the Scandinavian country.

All left these shores in search of an ever-elusive solution to homelessness. With governments vowing to end rough sleeping once and for all, The Big Issue lays out how Housing First works and why it is held up by many experts as the model to follow to help people into a secure home for good. 

What is the Housing First approach?

Housing First in many ways is self-explanatory.

Rather than making rough sleepers jump through hoops to prove their ability to hold down a home in order to access accommodation, they are simply given a home.

But the cornerstone of the model is the support that comes alongside the property. That support helps people keep their homes, battle their demons and adapt to independent living so they can get back on their feet.

There is no time limit to this support, it’s there for as long as someone needs it and housing and support are separate too. If someone no longer needs support they do not have to give up their home.

The idea is to give people who have experienced homelessness control and choice over how they are treated give them the best chance of making the transition from the streets.

This differs from traditional methods used in the past, where a lack of support after someone has been housed can see them lose their tenancy and return to homelessness.

All Housing First models adhere to a set of principles. England, Wales and Scotland all have separate principles which, while broadly the same, do differ in slight ways. All of them recognise that people have a right to a home and are entitled to support in the way described above.

Who started Housing First?

The approach is the brainchild of Sam Tsemberis, a clinical psychologist who took a fresh perspective on solving spiralling homelessness in early-Nineties New York City.

Tsemberis, now 73, could see that full communal shelters were not translating into more people being housed. So he developed the Housing First model and started tracking its success, initially housing one person a week and seeing higher housing retention rates than people moved on from shelters without support.

It has become a blueprint for tackling homelessness all over the world and Tsemberis has proven to be a charismatic advocate for the model as well as an advisor and sounding board for countries wanting to adopt it.

He recently told The Big Issue: “With our model we quickly understood that we were on to something here, it was extraordinary. But it became a matter of why aren’t people doing more of this? We’re in Covid right now and Housing First felt like we had discovered a vaccine for chronic homelessness and I’m trying to tell people: use the vaccine!”

Does Housing First really work?

There is plenty of evidence that Housing First works internationally and the proof of its merits is growing in the UK too.

After initial success in New York, Tsemberis saw Housing First start to pick up internationally. Finland is perhaps the shining example of the model making a huge impact on rough sleeping.

While it is not true that Finland has completely solved homelessness, despite how the country is often hailed, Housing First has virtually eradicated street homelessness. 

At the end of the 1980s, around 20,000 people were homeless in Finland, which has a population of around 5.5 million people. Now that figure sits at around 4,600 and the majority of people without a home of their own live with family and friends.

By comparison, 268,560 households needed council help with homelessness in England alone in 2020/21, out of a 56.5 million population while 2,440 people were counted as sleeping rough in autumn 2021.

Since 1987 about 12,000 people have received a home through the Housing First model.

It’s a remarkable success achieved by wide-spread embracing of the ideology behind Housing First.

There is evidence that Housing First is also proving successful in Scotland (see below) and there is a commitment to make Housing First the default response to rough sleeping in the long term.

How much does Housing First cost?

Initially, the approach can be costly. You can’t have Housing First without housing first, as Juha Kaakinen, CEO of Finnish non-profit Y-Foundation puts it.

Sourcing homes can be expensive, especially in a housing crisis like the one the UK has been mired in for years, and the cost of providing support is not cheap either.

However, Housing First is not considered to be an overnight quick fix or a magic bullet to end homelessness for good. It’s a long-term commitment that brings financial savings over future years as well as the obvious social benefits in our communities.

Analysis in Finland reported that the supported housing unit in Härmälä in the Finnish city of Tampere made almost 250,000 euros (£221,000) in savings in one year thanks to Housing First.

On an individual level, Housing First can save up to 9,600 euros (£8,500) a year when compared to the costs that would result from a person being homeless while housing someone over the long-term can save up to 15,000 euros (£13,300) of taxpayer’s cash per year.

England

Housing First has continued to scale up in England and, as of 2020, there were 105 active projects supporting more than 2,000 people, according to Homeless Link.

The government-backed pilot schemes in Greater Manchester, Liverpool City Region and the West Midlands launched in 2018 and have been the main testing ground to determine whether Housing First provision will be rolled out further in England.

As of 2021, the three pilots made up 1,100 of the spaces across the country and saw 750 people offered permanent accommodation while 450 people were housed with 88 per cent maintaining their tenancies.

The All-Party Parliamentary Group for Ending Homelessness ran a Housing First inquiry throughout 2020 and 2021 to discuss how the model can provide a sustainable solution to rough sleeping in England.

The group published their findings in July 2021, calling for the UK government to “scale up” Housing First across England, starting with a commitment to fund the three pilots beyond 2022. 

The government has conducted several reports evaluating the pilots with the final report due at the end of 2023.

Housing minister Marcus Jones said: “We recognise that rough sleeping is a nationwide challenge, and that is why it is important that we consider the findings of our evaluation, together with our experiences from the three pilots, to ensure that we know how it could work best on a larger scale.”

The rollout of Housing First has been too slow for some, with the government’s 2024 target of ending rough sleeping in England fast approaching. Crisis chief executive Matt Downie told The Big Issue: “The take up of Housing First, particularly in England, is far too slow. There is no service in homelessness with a better evidence base and so there is no reason not to go faster.

He added: “I want Crisis to be agitating for and showing how that’s the way to end homelessness, moving away from quite traditional old ways of doing it, which haven’t haven’t shown anyone that they’re the way to to end homelessness at all.”

Wales

Housing First pilots have been running across 15 local authorities in Wales since 2018 in a bid to demonstrate that the model can be effective at reducing street homelessness.

The first statistics quantifying the model’s impact were released in July 2021. Overall 521 people were supported through the projects between February 2018 and September 2021, receiving outreach support to help them prepare for moving into a tenancy.

Of the 245 people who started Housing First tenancies, 90 per cent are still in their home and have sustained the tenancy – a broadly similar rate to other Housing First projects internationally.

“Housing First is an internationally proven model but it is fantastic to see it working so effectively here in Wales,” said Katie Dalton, the director of charity Cymorth Cymru which coordinates the Housing First Wales Network. “Huge credit must be given to the support providers, local authorities, landlords and public services who have embraced this model and work incredibly hard to deliver Housing First in line with the principles.

“It is clear that Housing First has a significant impact on homelessness and will have numerous benefits to other public services..”

The Housing First model has become a key part of the response to street homelessness in Wales after the Covid pandemic signalled a renewed drive to tackle the issue.

Wales’ Housing First principles contain a particular focus on mental trauma as well as an explicit mention of the UN charter that outlines housing as a human right.

Julie James, Welsh minister for climate change, said: “The Welsh Government has been clear that there will be no going back to the pre-pandemic approach to homelessness. Housing First is a key component of our ambition to ensure homelessness becomes rare, brief and unrepeated in Wales.”

Scotland

Housing First has progressed quickly in Scotland in becoming central to leaders’ plans to tackle homelessness.

Housing First has been given government backing in the Ending Homelessness Together Action Plan, and a national framework to share good practice is under consultation. And the Everyone Home Collective – a group of 30 charities, experts and academics – have set out road maps to tackle homelessness during the next two parliamentary terms with Housing First at their centre.

The country has also launched a national framework to ensure the model is at the centre of tackling homelessness for the next decade.

Housing First Scotland research published alongside the national framework in March 2021 estimated around 3,560 people could be helped into permanent accommodation through Housing First every year. The greatest demand is reportedly in Glasgow where 538 people could benefit.

Maggie Brünjes, chief executive of Homeless Network Scotland, said the framework covers the next ten years because “we know it’s going to take that long to do this properly”.

The Housing First Pathfinder programme, a project part-funded by the Scottish government and social enterprise Social Bite, helped around 500 people into Housing First tenancies with the model becoming the go-to method for supporting rough sleepers.

In total, 24 of Scotland’s 32 local authorities operate a Housing First programme with an estimated 1,224 tenancies under the model as of June 30 2022.

Housing First has also been identified as a way to tackle Scotland’s drug deaths crisis. The Scottish government’s Drug Deaths Taskforce recently said the holistic approach used in Housing First could help people battling addiction.

The taskforce called for Housing First to be scaled up across Scotland as well as bringing across some of the lessons learned from the model. 

Brunjes said: “People’s lives have more moving parts than can be adequately met by support services operating in silos that too often respond to single issues rather than whole lives.”