Housing First in International Contexts: What We’ve Learned

Housing First in International Contexts: What We’ve Learned – Institute of Global Homelessness

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.