Housing First Revisited


By Juha Kaakinen, Chief Executive Officer, Y-Foundation, Finland

This editorial originally appeared in the December 2018 edition of Parity: Housing First.  Subscribe or log in to read the full edition

 

It is now ten years since we started the National Program to End Long-term Homelessness and implemented our model of Housing First in Finland. This is a good time to look back and analyse the lessons we have learned so far.

We call it the Finnish Housing First as it was developed independently of the Pathways Model. The basic philosophy and the core principles are very similar, but there are also some small but significant differences especially in the practical implementation. The Finnish Model and its implementation have been described in detail in the book Home of Your Own.1

The basic tenets of the Finnish Model are an independent, permanent, affordable rental flat with own rental contract and flexible support based on individual needs. We follow the core principles of Housing First as defined in the Housing First Europe Guide.2 When we started implementing Housing First in 2008 these European principles were not yet defined.

You cannot have Housing First without having housing…first.

In recent years Finland has been the only European Union country where homelessness and especially the most severe form of homelessness, long-term homelessness, has decreased. We have a broad definition of homelessness including people living temporarily with friends and relatives. According to the latest statistics there are 7,112 homeless people of whom 84 per cent are living temporarily with friends and relatives. Most homeless people are single and there are 214 homeless families with 193 children. This spring, our Government made a decision in principle that the rest of the Finnish homelessness should be halved in the next four years.

The Finnish success in reducing homelessness has mainly been explained by an integrated national strategy including measures for prevention, implementing Housing First and converting temporary shelters and hostels into permanent supportive housing.3 It can be argued that it was Housing First and especially the way it has been implemented that was the basis and decisive factor in the paradigm shift in Finnish Homelessness policy.

These past ten years have taught us some important lessons. In my opinion the most important is very simple: You cannot have Housing First without having housing…first.

The lack of affordable housing (in most countries meaning affordable social housing) seems to be the main obstacle for scaling up Housing First. In Finland we have used all possible channels to get the housing needed. Affordable social housing built by municipal housing companies and non-profit NGOs is the main route out of homelessness, but sufficient supply of social housing is at the same time the most important structural measure to prevent homelessness. Other main sources for housing have been renovating shelters and hostels into supported housing and building new supported housing units as well as buying flats from the private market to be used as rental flats for homeless people. The Finnish housing for homeless people has for a long time been mainly independent scattered housing. Y-Foundation and other NGOs have been buying these flats from the private market already for 30 years.

Our experience shows that you cannot build Housing First solely on one housing option. In Finland housing options include scattered housing in individual rental flats or in supported housing units which are single-site buildings with independent rental flats, common facilities and on-site personnel. One size does not fit all: there are long-term homeless people who fear isolation and loneliness in scattered housing and there are homeless people for whom living in single-site supported housing is too stressful. There is also a need to provide alternative housing for ex-homeless people who, without support, cannot maintain their housing in scattered housing. In these cases, supported housing units which provide more intensive support have been valuable options.

As much as there is a need for housing options there is a need for flexible support arrangements. The Finnish support in scattered housing is mainly based on Intensive Case Management and the use of basic social and health services. However, there are individuals who have more intensive support needs than this floating support can provide. In these cases, even a highly qualified multi-professional team would not be enough if the support is not available at the right critical time. There are individuals whose support needs are very time-intensive, in some cases meaning 24-hour support. In our understanding this kind of support can be arranged in a reasonable way only in supported housing units.

Introducing Housing First should have an impact on the whole homelessness service system. In Finland Housing First was implemented at the same time as the conversion of shelters and hostels into supported housing units was started. It can be argued that these simultaneous processes have generated the decreasing trend of homelessness in Finland.

The big question with Housing First is can it be the catalyst that leads to a paradigm change from managing homelessness to ending homelessness. As Housing First requires permanent housing it should be obvious that it leads to ending homelessness. But there is an important path-dependency that must be taken into account. In managing homelessness temporary accommodation in shelters and hostels is the main service, but at the same time it is also the main reason that keeps people in homelessness. If Housing First is leading to ending homelessness, it is crucial how it is implemented. In many countries, implementation is done with gradually upscaling and expanding small projects and pilots. This method of implementation means that there seems to be less room for decreasing shelter capacity or converting it into supported housing as the process of getting permanent housing is slow.

So, it seems that the paradigm change is only possible if Housing First is implemented on a national scale and the shelter capacity is at the same time decreased and converted into modern supported housing. Of course, one can always argue that implementation on a national scale is possible only if there is housing available. This will remain as the unsolved dilemma with Housing First, unless it is solved by doing something about it. In my understanding and experience implementation on a national level is the only way to make the paradigm shift and also the best way to create pressure on different actors to provide the permanent housing needed.

There is already quite substantial evidence of the success of Housing First in different environments. For that reason, it is difficult to understand the need for more pilots or experiments followed by evaluation studies to prove what we already know: Housing First works and it is so far the best approach to help people out of homelessness. But to get the most out of Housing First more courage is needed. If the implementation is based on small projects, there is a risk of Housing First ending up as one more alternative model among others. With Housing First small is not beautiful if and when we want to end homelessness.

Endnotes

1. https://ysaatio.fi/en/housing-firstfinland/ a-home-of-your-own-handbook 2. http://housingfirstguide.eu/website/ 3. https://pure.york.ac.uk/portal/ en/publications/using-housingfirst- in-integrated-homelessnessstrategies( 92c35864-8084-4a27- bd68-9c1ce701cbb5).html

 

This editorial originally appeared in the December 2018 edition of Parity: Housing First.  Subscribe or log in to read the full edition