Housing First in International Contexts: What We’ve Learned

IGH Community of Impact Webinar Series

29 July 2021

Housing First is a model of homelessness intervention that is targeted towards people experiencing chronic homelessness. As opposed to ‘staircase’ models that generally require program participants to meet certain requirements before attaining standard housing, the Housing First model is a housing-led intervention that addresses homelessness by first providing secure accommodations to program participants and then working to address their needs through providing case management and access to services and support as needed.

As the evidence base for Housing First’s effectiveness has grown, the model has proliferated throughout the world. As it has been implemented in new and diverse socioeconomic and cultural contexts, Housing First has been adapted to suit new environments. This IGH Community of Impact webinar brought together Housing First experts to discuss the successes, prospects, and challenges related to Housing First’s development in an international context. Webinar speakers included:

  • Sam Tsemberis – Founder of Pathways Housing First
  • Karinna Soto – Jefa Oficina Nacional de Calle, Ministerio de Desarrollo Social y Familia, Gobierno de Chile
  • Susan McGee – CEO of Homeward Trust Edmonton (Canada)
  • Margaret Ann Brünjes – Chief Executive of Homelessness Network Scotland

Housing First v. Other Approaches

Sam Tsemberis, who developed the Housing First model in New York City in the 1990s, spoke first, contrasting the Housing First model with other models of homelessness responses. Tsemberis suggested conceptualizing homelessness programs as belonging to two broad categories: those that keep people homeless and those that end or prevent homelessness directly. Programs that focus on only temporarily sheltering people or providing treatment services often fail to adequately address the problem of homelessness. Conversely, programs that keep people housed, prevent them from becoming homeless, or provide housing without preconditions can be seen as a solution to the problem of homelessness directly by ensuring that people have access to housing.

Housing First falls into this latter category of housing programs, providing housing without other preconditions and emphasizing principles related to consumer choice; separation of housing and services; needs-based services; recovery-focused practice; and community integration and social inclusion. Tsemberis noted that this principled approach to addressing homelessness has now been tested through several random control trials and found to have double the success rate of the traditional ‘staircase’ model (~80% vs. ~40%). Tsemberis also cautioned that as Housing First is adapted to new contexts, it is essential that those implementing the model stay true to the core principles since fidelity to these principles is critical to the success of any Housing First program.

Adaptation & Success in Chile, Edmonton, and Scotland

Each of the speakers discussed the successes achieved through their Housing First programs. Karinna Sota reported that Chile’s program, which focuses primarily on homeless people 50 years and older who have been living on the street for over five years, has a housing success rate of 90%. Susan McGee, whose organization Homeward Trust Edmonton focuses heavily on indigenous homelessness, reported that their Housing First program had housed nearly 13,000 people since 2009, with 85% of people remaining housed after one year in the program. Margaret Ann Brünjes reported similarly high rates of housing success in Scotland, with the country as a whole having an average of 85%.

The rates of housing stability reported by the speakers are largely in line with those recounted by Tsemberis in regards to Housing First programs that have been effectively implemented. These outcomes suggest that the model can achieve similar levels of success in housing stability for the chronically homeless in varied contexts.

For Chile, Soto shared that the program has focused on community integration with Housing First being one of the programs in their Barrios Calle Cero program, an intersectoral strategy with the goal to reduce rough sleeping and advance in the goal committed as part of IGH’s Vanguard City program. The strategy is led by the Ministry of Social Development and Family, in alliance with different organizations public and private providing an installation of a network of integrated services.

McGee shared how Edmonton’s Housing First program is part of a robust system of housing with a coordinated access program to road map matching people to the right housing solution. Edmonton has also focused on providing indigenous-led housing first programs. With 60 percent of people experiencing homelessness identifying as indigenous, providing training to staff and programs with cultural supports has been critically important.

In Scotland, Homeless Network Scotland along with their partners developed Branching Out- A National Framework to start-up and scale-up Housing First. Brünjes spoke about the document which is both a route map and reference material for Scottish communities to scale up Housing First.

Housing First & COVID-19

The speakers also spoke of the challenges and opportunities brought about by the COVID-19 pandemic. Despite launching their Housing First program during the pandemic, Soto mentioned that the program had been implemented successfully in Chile and likely resulted in cost savings overall. McGee noted that the pandemic has unfortunately had led to an increase of the inflow into homelessness in Edmonton and further argued that the sense of urgency created by the pandemic has served to refocus their efforts to address homelessness as the crisis that it is. Brünjes reported that homelessness was at record lows due to the pandemic, with fewer than ten people currently experiencing street homelessness in Glasgow. The pandemic also coincided with a shift in Scotland’s national framework for addressing homelessness.

Tsemberis pointed out that the pandemic had led to an unprecedented response to homelessness in many cities, such as in Los Angeles where people experiencing homeless were moved into hotels without having to meet restrictive requirements. The success and progress made by the three Housing First programs represented on the webinar, even in times of adversity, demonstrates that with adequate resources, commitment, and political will, Housing First can be an effective intervention for addressing chronic homelessness in various international contexts.

You can access resources and additional information from the webinar on IGH’s Community of Impact website. To learn more about international Housing First strategies, visit IGH’s Hub. You can watch the full webinar video on Youtube.

Homeless Prevention Strategies: What We’ve Learned

IGH Community of Impact Webinar Series

25 March 2021

How do communities work upstream to prevent homelessness? How does data and evidence inform targeted prevention strategies?

In our recent Community of Impact Webinar, we investigated these questions by featuring homeless prevention experts and strategies from around the globe. Homelessness prevention works to address the causes of homelessness before it occurs. Traditionally, homeless services and systems focus on serving people after they become homeless. Growing evidence indicates that prevention strategies help communities reduce the number of people entering the homeless system. People who experience homelessness are not homeless due to some innate characteristic that they possess; homelessness results after a failure of multiple systems. It is important to understand the gaps that exist in systems in order to disrupt the inflow of people becoming homeless and drive change. 

A comprehensive approach to homelessness prevention operates at different levels, addressing both direct causes of homelessness and working further ‘upstream’ to address issues contributing to the loss of housing. Certain prevention strategies involve targeting resources toward those who are at imminent risk of homelessness by providing services such as rental assistance or landlord-tenant mediation to those at risk of eviction. Other preventative approaches seek to identify risk factors – such as school absenteeism or contact with social services – well in advance and intervene prior to a point of crisis. Communities may also seek to address underlying structural issues such as housing stability, for example, by prioritizing affordable housing development or access to housing subsidies to combat homelessness. 

This IGH Community of Impact Webinar featured four experts on homelessness prevention, each bringing their own unique perspectives to the topic. 

  • Abe Oudshoorn, Ph.D., Assistant Professor at Western University in London, Ontario and the Managing Editor of the International Journal on Homelessness. 
  • Lynette Barnes, Manager of All Chicago’s Emergency Financial Assistance Program
  • Katie Shomacker and Melissa Matthews, Team Leaders for the Geelong Project

Below are key highlights from the webinar from each of our speakers:

Abe Oudshoorn, Ph.D: Prevention & Empowerment – A Review of International Prevention Strategies

Oudshoorn spoke on the importance of identifying the opportunities that exist for intervention and preventing an episode of homelessness. He discussed shelter intake practices in Canada that are targeted towards helping at-risk families access resources to stay in their current housing or move to accommodations other than a shelter. He also highlighted the importance of effective discharge planning and the need to ensure that people leaving institutions such healthcare facilities are not discharged into homelessness. These prevention tactics underscore the importance of thinking about how to address inflow into the homelessness system by identifying how people are entering into homelessness and addressing these gaps. 

Oudshoorn also discussed the concept of empowerment as it relates to helping people faced with homelessness have agency in their own lives, arguing that empowerment must be central to addressing homelessness, since the struggle against homelessness is intimately related to the larger struggle for human rights. Homelessness manifests differently depending on the social and cultural context. In one country homelessness may have a dimension related to security for housing for migrant workers, while in another it may have dimensions related to a patriarchal property rights regime. It is therefore essential to ensure that addressing homelessness entails also addressing underlying power imbalances that contribute to homelessness and housing insecurity in the first place. 

Lynette Barnes on All Chicago’s Emergency Financial Assistance

Barnes spoke about the work done through the All Chicago Emergency Financial Assistance Fund, which allocates financial assistance to people who are at risk of homelessness. The Fund traces its roots back to 1973 when it was established as a general emergency fund for those who could not obtain support through other social service agencies in Chicago. The fund evolved over the years into its current form, which Barnes explained as being geared toward providing “small amounts of assistance to prevent larger crises from happening.” By providing short-term financial support for rent, transportation, utilities, and other basic needs, the fund helps keep people housed and addresses some of the gaps in social services. 

Due to the economic hardships caused by the COVID-19 pandemic, the fund recently partnered with the Lawyers Committee for Better Housing in order to prevent evictions. This was necessary, Barnes pointed out, since an eviction filing against a tenant can cause future complications for securing housing. Additionally, the fund has started engaging with landlords to secure units for their rapid rehousing activities, which helps to accommodate people living in encampments. Barnes closed by noting that the fund has distributed nearly eight million dollars to over 3,000 households throughout the course of 2020. 

The Geelong Project’s Youth Homelessness Prevention

Schomacker and Matthews shared a video about the work being done by the Geelong Project to prevent youth homelessness in Geelong, Australia. Youth homelessness in some contexts is less visible than other forms of homelessness, often manifesting as couch surfing or living in a series of impermanent arrangements. The Geelong Project works within the school system, using a comprehensive survey to identify students who may be at risk. Then, the project provides case work and support services to students and families to help with the issues they are facing. An early evaluation of the Geelong Project’s work found that it had achieved a 40 percent reduction in students presenting at youth homeless entry points and a 20 percent reduction in students dropping out of school. 

Data & Prevention

Each of the webinar panelists stressed the importance of a nuanced, community-centered, and data-driven approach to homelessness prevention. Oudshoorn mentioned the importance of using what data is available in a community to understand the groups who are in need. The Geelong Project ‘s school surveys collect  information on risk factors among students, allowing them to target their prevention efforts towards at-risk students. Barnes discussed the importance of having data on the people who are contacting the All Chicago emergency assistance fund for help, noting that the main driver of fund applications over the past year has been job loss related to the pandemic. Having quality data allows for a better understanding of the population that needs services and a more efficient allocation of scarce resources to prevent homelessness. 

You can access resources and additional information from the webinar on IGH’s Community of Impact website. To learn more about international prevention strategies, visit IGH’s Hub. You can watch the full webinar video on Youtube.

Data and Collective Impact During COVID-19: What We’ve Learned

IGH launched our Community of Impact (CoI) to connect leaders and practitioners to a collaborative and dynamic global network of knowledge of what works in ending homelessness. COVID-19 has represented an enormous challenge as the pandemic has had a disproportionate impact on vulnerable populations especially people experiencing homelessness. In our first Community of Impact Webinar, we were honored to have three speakers who discussed how data and coordinated responses allowed their communities to adopt quickly and effectively to COVID-19 in order to protect and house people experiencing homelessness. The three speakers were:

  • Jeremy Swain, UK Advisor for the United Kingdom Ministry of Housing, Communities and Local Government
  • Dr. Surashree Shome, Senior Manager at Azim Premji Philanthropic Initiatives
  • Molly Seeley, Special Projects Manager for the Institute of Global Homelessness

The video of the webinar can be found here. From Great Britain to Bengaluru, India, the speakers’ presentations had common themes in their presentations:

  • Strong leadership with multi-sector coordination including the formation of taskforces resulted in improved communication, collaborative action, and led to better outcomes, and 
  • disaggregated data allowed leaders to better understand the scope of the impact and design new initiatives that are more inclusive and better targeted to specific populations.

Below are key takeaways from each of the speakers.

Building a multi-sector COVID-19 response to achieve better outcomes

With sheltering at home being the first line of defense during COVID-19, robust strategies were needed to protect and house rough sleepers. Our first speaker, Jeremy Swain, discussed Great Britain’s  ‘Everybody In’ initiative, where they temporarily housed 15,000 people, 95 percent of the homelessness population, in self-contained accommodation including hotels. This initiative was accomplished through leveraging extensive existing data on street homelessness and a coordinated, multi-sector approach. Joint efforts between the homelessness and healthcare sector were key to providing support services. The healthcare sector was very engaged in collecting detailed health data to improve current and post-pandemic support, which was crucial when people left temporary accommodation they had a specific health outcome and package of support, which would not have happened before COVID-19.

“We can bring together different systems to get outcomes around health that we didn’t manage to achieve before.”

Data was also important to understand the movement and migration of people with no recourse to public funds as more than one-third of people experiencing homelessness in London are Central and Eastern European immigrants. Looking ahead, with inclusive data and housing-led strategies, the UK government is working to secure funding and space for post-pandemic accommodation to ensure that nobody returns to the streets.

Using data to design more impactful programs in Bengaluru, India

Dr. Surashree Shome discussed Bengaluru’s COVID-19 response as the pandemic had a large impact on homeless and migrant populations across India with over 27,000 temporary shelters opened.. In Bengaluru, at first the city’s 9 permanent shelters were utilized and then an additional one hundred temporary shelters were opened across the city to meet the increased demand. Dr. Shome and her colleagues at APPI launched a study from ten shelters — five permanent and five temporary, to better understand the demographics of the people utilizing the shelters. The objectives of the study were to help develop a more effective strategy to deliver support and to advance policy advocacy for addressing homelessness.

“Understanding the profile will help us design programs and also advocate policies for them because these are the people that are accessing shelters.”

Collecting disaggregated data by age and sex showed the need for additional shelters for women and the elderly. The study found that only 7 percent of the shelter residents were women, with many women afraid to enter shelters due to security concerns. With 82 percent of the residents above the age of 60 years old, the study showed the need for geriatric care services and exclusive spaces within shelters to protect the most vulnerable to COVID-19 infection. The data also revealed the large impact of the COVID-19 pandemic on migrant and shelter populations, about 80 percent of the shelter residents were working before the pandemic and 58 percent of the residents said they are unable to buy masks and sanitizer. Shelter residents also had difficulty accessing government benefits during the pandemic with only 62 percent having the required aadhar government ID-card. APPI and partners are using the study data from the government to create recommendations on more targeted and impactful programs.

Surveying cities to better understand COVID-19 responses

In surveying 22 cities on their homelessness sector interventions to COVID-19, Molly Seeley found that there was a wide spectrum of system responses.  Some cities reduced programs while restricting access and increasing criminalization, other cities added sanitation and protective protocols to normal services, and there were also cities that completely transitioned their systems to move the majority of rough sleepers into self-contained accommodation. For these housing-led responses, clear leadership was a common thread with many cities creating task forces between government, health, and homeless organizations. 

 “One of the really key pieces is that for systems who shifted to looking at root cause rather than mitigation, there was very clear leadership that was coordinated between city officials and homelessness experts.” 

Seeley’s research also showed that lack of resources prevented some cities from meaningful adaptations, but larger investments do not necessarily steer cities toward overhauling their system responses to homelessness.  Seeley’s research found that previous attitudes around homelessness shaped COVID-19 responses more than the availability of new resources/amount of funding. In cities that adopted COVID-19 housing-led responses, this had already been part of the city’s homeless response, or was being discussed prior to COVID-19.