Eradicating homelessness is possible
In 2016, the European Federation of National Organisations Working with the Homeless ( FEANTSA ), with the support of the Stavros Niarchos Foundation , published the Housing First Europe Guide . This document describes how to implement and operate Housing First in Europe. It provides general guidelines for Europe, but implementation requires adaptation to the specific realities of each country.
Housing First is an innovative approach to reducing homelessness among people with high support needs, initially developed by Dr. Sam Tsemberis in the United States. This approach focuses on fulfilling a basic human right: the right to decent housing . This is a right that is inherent, not acquired as a reward for demonstrating merit or readiness. This shift in perspective is fundamental. In the case of homeless individuals with mental health issues and addictions, it means moving from the sequence of treatment-sobriety-housing to housing-treatment-(perhaps) sobriety.
A new life, a new hope
Over the years, and through experience gained in various countries in Europe and the United States, Housing First has proven highly effective in combating homelessness , especially among individuals with mental health issues and addictions. In some countries, such as Finland, Housing First is the cornerstone of the national strategy for addressing homelessness and has achieved a significant reduction in chronic homelessness rates. Studies in the US, Canada, and Europe show that Housing First typically helps at least eight out of ten people leave homelessness. It has proven particularly effective with individuals who are not well-integrated into society after prolonged or recurring homelessness, with homeless individuals suffering from severe mental illness or problematic drug and alcohol use, and with homeless individuals in poor physical health.
As stated in the guide, treatments that promote self-determination have been shown to be more effective in reducing symptoms than other treatments based on adherence to a treatment plan. It has also been observed in several communities that Housing First transforms the practices of other related services and care systems when introduced into a community, evolving from an isolated service to a more community-based approach.
Housing First's approach is a challenge to society and forces it to question its beliefs, values, and social norms regarding homeless people, who are housed in ordinary apartments integrated into the community and who receive comprehensive support.
The Housing First Europe Guide is a key resource for those new to this strategy, explaining its origins, development, experiences in different countries, and the scientific evidence behind it. It is also a tool for fully understanding the fundamental principles of Housing First, how to provide support, how to evaluate the experience, and how to integrate the approach into comprehensive care strategies. Ultimately, it is a valuable resource for policymakers and organizations working with people experiencing homelessness.
Basic principles of Housing First
The fundamental principles of Housing First are directly derived from the Pathways model, developed by Dr. Sam Tsemberis in the early 1990s, but they are not exactly the same in Europe due to significant differences between the United States and Europe.
The eight fundamental principles of Housing First are:
Housing is a human right.
As the UN states, everyone should be able to live in safety, peace, and dignity. Housing First does not expect homeless people to earn their right to housing or to remain in a home. Housing First users are expected to follow the rules of their rental or occupancy agreement in the same way that any other tenant would, and they are offered support to help them do so. Housing First services also expect regular contact between users and the professional intervention team, for example, through a weekly meeting to assess any potential issues in the home.
Choice and control for users.
A Housing First client has the capacity to make real decisions about how they want to live their life and the type of support they will receive. Self-determination is the starting point for recovery. Shared decision-making between clients and service providers is an essential part of recovery in the Housing First model.
Separation of accommodation and treatment.
Housing First guarantees that the human right to housing is not compromised by the obligation of service users to undergo treatment, whether to access or remain in housing. Although Housing First provides support for as long as needed, a service user will continue to have their home even after they stop using support services. If a person no longer needs Housing First services, they will not have to move elsewhere.
Recovery orientation.
A service with a recovery approach focuses on the overall well-being of the individual. Well-being includes their physical and mental health, their level of social support (from their partner, family, or friends), and their degree of social integration, such as being part of a community and actively participating in society. A recovery approach is much broader and more ambitious than simply addressing a person's drug and alcohol use or encouraging their participation in treatment. It aims to achieve a safe and fulfilling life for the individual and create an environment that fosters, in a broad sense, their integration into the community, housing, and a positive social and economic life.
Harm reduction.
It is based on the idea that ending problematic drug and alcohol use can be a complex process and that services requiring abstinence or detoxification do not work well for many homeless people. According to the guide, there is more than enough evidence to show that harm reduction is more effective in helping homeless people with large or complex needs than abstinence- or detoxification-based services. The goal is not necessarily to completely stop drug and alcohol use, but rather to reduce the harm it causes to the individual and help them reduce and manage their use. A harm reduction approach supports people who want to remain abstinent, but also engages with those who are actively using substances and works with them to encourage them to reduce their consumption.
Active commitment without coercion.
Housing First clients should never feel threatened by sanctions for behaving in a certain way. Using a recovery and harm reduction approach, Housing First actively and continuously emphasizes that support, treatment, and counseling are always available, and that positive changes in health, well-being, social integration, and overall quality of life are possible.
Person-centered planning.
Users are encouraged and supported to decide the kind of life they want to live. Choice and control play an important role in this, so that, in Housing First services, users make real decisions about the types of support and treatment they wish to receive.
Flexible support available for as long as needed.
Housing First defends the right to housing from a different perspective, which is why they maintain contact with individuals even after eviction. If a Housing First client is evicted, whether for late rent payments, disturbances to neighbors, or damage, Housing First stays in touch and works to find them new housing. Similarly, if a Housing First client is unable to live independently and leaves their home, Housing First continues to support them.
When implementing a Housing First program, many challenges arise , particularly in providing the necessary support throughout the process: housing management and retention, health and well-being support, and social integration; in providing housing itself: neighborhood relations and navigating both the private and social housing markets. This Guide provides the keys to addressing each of these issues.
Featuring
