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6.2. Future Applications of Housing First

Housing First is designed to have a specific function, to end homelessness among people with high support needs by rapidly providing them with housing and intensive support services. There is scope to expand the ways in which Housing First is used, but the basic function and role of Housing First are fixed; it is not intended for groups of homeless people with low support needs, nor as the sole component of an effective homelessness strategy.

It is important to note that while there are services that draw on the ideas of Housing First, for example using ordinary housing and low-intensity support services to help homeless people without high support needs (sometimes called housing-led or housing support services), these are not Housing First. The use of such services predates the introduction of Housing First in Europe. It was sometimes argued that Housing First represented nothing new in some European countries, because these services already existed. However, there can be important differences in the core principles, the intensity and duration of support between these low-intensity services and a Housing First approach.

Widespread use of Housing First has potential implications for some existing homelessness services. It is not the case that Housing First can or should act as a replacement for all existing homelessness services, because Housing First is only designed for one group of high-need homeless people. However, there is clear evidence that Housing First outperforms some existing service models for ending homelessness among people with high support needs (see Chapter 1). In some cases, for example in Finland, homelessness service providers have changed the way in which they provide services, moving from staircase models to Housing First and have seen improvements in service effectiveness as a result((Pleace, N., Culhane, D.P., Granfelt, R. and Knutagård, M. (2015) The Finnish Homelessness Strategy: An International Review Helsinki: Ministry of the Environment –

6.2.1. The possible future uses of Housing First include:

  • Preventative use of Housing First. Housing First can be employed as a means to resettle people with high support needs who are leaving institutions such as psychiatric hospitals, prison or long-stay supported housing. Some US services work with people leaving psychiatric hospital who are assessed as being at high risk of homelessness or have a history of homelessness((Tsemberis, S.J. (2010) Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction Minneapolis: Hazelden.))
  • Using specialised models of Housing First for particular groups of homeless people. This is another area that can be explored at strategic level. For example:
    • Homeless women with high support needs. There is evidence that women with high support needs can often experience homelessness in different ways from men, particularly in their avoidance of services and their use of informal and sometimes precarious relationships to keep themselves in accommodation((Mayock, P., Sheridan, S. and Parker, S. (2015) “It’s just like we’re going around in circles and going back to the same thing…”: The dynamics of women’s unresolved homelessness Housing Studies DOI:10.1080/02673037.2014.991378)). Housing First, by providing homeless women with high support needs with their own homes, should be more accessible than some other forms of homelessness service, in which women may not feel safe. However, the experiences of women, which may include high rates of gender-based/domestic violence and other abuse, mean that there is a case for the development of specialist Housing First, staffed by women with specific training. In Manchester in the UK, Threshold Housing has developed a Housing First service for homeless women with high support needs who have had contact with the criminal justice system((
    • Young people with high support needs at risk of homelessness may also require specific forms of support. Again, this is because their needs, characteristics and experiences may differ from those of other groups of homeless people((Quilgars, D., Johnsen, S. and Pleace, N. (2008) Review of Youth Homelessness in the UK, York: Joseph Rowntree Foundation – For example, young homeless people remain disproportionately likely to have had experience of social services, foster and children’s homes and to have had negative experiences during their childhood.
    • Families with high and complex needs can be supported by Housing First. There are specific needs here which centre on a Housing First service not just supporting an individual, but also being able to understand and support positively an entire family, including children((Jones, A., Pleace, N. and Quilgars, D. (2002) Firm Foundations: an Evaluation of the Shelter Homeless to Home Service, London: Shelter. – The needs of these households around mental health problems, drug/alcohol issues and poor health, may be similar to those of lone homeless people, but different forms of support may be needed when an entire family is being supported by Housing First.
    • Former offenders with high support needs may also require specific support when they leave prison. This is another example of how Housing First might be tailored, or adjusted, to meet specific sets of needs. Another example might be the use of a specialised model of Housing First for homeless people with high support needs who have experience of military service.