Housing First is not the only solution to homelessness

Housing First has often been hailed as the solution to ending rough sleeping.

Too often stories appear in the media which portray other types of supported accommodation in a more negative light in comparison.

Some have even called for the closure of all other forms of supported housing, replacing them with Housing First.

But is Housing First really the only solution for everyone?

While Riverside supports Housing First and has strong experience in delivering successful Housing First pilots, it is most effective for people who have very complex needs, or who have been excluded from traditional transitional supported accommodation, predominantly for issues around ‘non-engagement’ or behaviour.

A very high percentage of people already achieve a successful outcome in more traditional forms of short-term supported housing.

In Riverside’s case more than four-fifths of people (83%) moved on from homelessness in 2021/22 after staying in hostels and shelters for a maximum of 24 months.

Housing First – by virtue of the fact it involves caring for people in an individual home – involves more support staff per customer and has a much higher cost per person supported. It is therefore more expensive than more traditional models, when hostels are cheaper to run, can reach more people for the money invested, and are effective for the vast majority of people.

For the four-fifths of people who are able to succeed in more traditional forms of services, Housing First does not represent value for public money.

However, the problem with widely expanding Housing First at the expense of other forms of help goes much further than that.

Closing good quality, short-term supported housing in favour of Housing First would reduce significantly the number of people local authorities could support with their often limited and overstretched funding for tackling homelessness.

There is also the practicality of finding suitable accommodation in a housing market that is both expensive and lacks the numbers of suitable one-bed units to meet the level of need.

One thing Riverside has learnt from our active involvement in the three large-scale Housing First pilots, both as a care and support provider and a provider of social housing, is that scarcity of housing accommodation is a significant barrier.

Countries like Finland and the United States are often referred to as evidence of the success of Housing First, where it has been used to good effect. However, while each US city approaches Housing First with their own interpretation, in the majority of cases it has not replaced more traditional types of transitional supported housing.

My own experience in the States showed that the traditional transitional forms of supported accommodation were retained, and some of the key principles of Housing First applied to those transitional settings such as the removal of conditionality – where someone has to accept support to keep the accommodation – and dictating to people that they can only have a fixed length of stay.

Housing First was set up in addition to traditional forms of supported housing, not instead of. As a result, traditional accommodation was more effective, and the cohort for whom traditional supported housing was never a viable option gained access to Housing First. Though this should be caveated with the fact that the US Dept of Housing and Urban Development (HUD) heavily incentivises landlords bringing unoccupied units back into use for Housing First.

Housing First cannot replace more traditional forms of supported housing, it needs to be as well as. We need a viable route off the streets for every person who finds themselves sleeping on them. That means a range of accommodation-led options.

But there is a lot that Riverside has learnt from Housing First that can be applied to traditional supported housing. This means accentuating the benefits of asset/strength-based approaches, such as sustainable positive change, and mitigating the negative impacts of arbitrary lengths of stay and conditionality, such as coercing people to change.

The traditional supported housing model, often structurally built into services through contractual obligation, relies on someone being able to engage in change at the point that they are in emergency housing need. This creates an environment where staff can feel the need to coerce people into change, and design programmes of support, and the pace at which it moves, to meet the needs of the contract and not the customer.

So, let’s learn from the success of Housing First, use some of that learning to further improve more traditional supported housing, and provide high fidelity Housing First for the minority of people who would still struggle to succeed without it.

Diverting funding from traditional models of service delivery for tackling homelessness to Housing First will either result in:

1) unaffordable contracts for local authorities and poor value for money for the sector, (if the level of housing supply were to meet the level of demand)

2) the levels of homelessness and rough sleeping increasing as funding can’t stretch to care for as many people.

Let’s invest in Housing First and make it a huge success for the 20% or so of people affected by homelessness who need it.

However, let’s not make Housing First the panacea of national homelessness policy and the surrounding debate. Let’s invest in Housing First alongside investment in homelessness prevention and traditional forms of supported housing where they are successful.

This would be the best way to make use of Government’s and council’s limited homelessness funds to help most people.

Lee Buss-Blair is Director of Operations at Riverside