26 Simon Communities of Ireland as interventions for all forms of homelessness. variations on the original service model Housing-led services are a specific intervention appeared (Pearson et al, 2007; Pleace, 2012) designed for a specific aspect of homelessness l The spread of Housing-led/Housing First ideas and this clear targeting has also been important in into Europe and the emergence of European the successes achieved in experiments in Housing housing-led services. Several European ‘First’ services elsewhere in Europe (Busch- countries had been moving towards service Geertsema, 2013; Pleace and Bretherton, 2013c). models that emphasised greater choice and control for people who are homeless. In The development of housing-led services in the Finland, a large scale replacement of the economically developed world has had four broad existing shelter system had been underway at stages. These stages can be summarised as: the point at which connections began to be made with the ideas of Housing First that were l The development of the Housing First model in advancing in the USA. Finland, as had been New York by the Pathways organisation during the case in the USA, was using what were in the 1990s, drawing on the ‘supported housing’ effect several versions, or variations on the service model which was developed for the original Pathways Housing First model. In resettlement of people leaving psychiatric Finland, this includes conversion of shared hospital (Ridgway and Zipple, 1990). A series emergency shelters and hostels for people of evaluations, including a randomised control who are homeless into blocks of independent trial and quasi-experimental (comparison flats or apartments to which support was group) studies began soon after the Pathways provided (Tainio and Fredriksson, 2009; Housing First model was first developed. Tsemberis, 2011). This communal or These evaluations first began to indicate that congregate model of Housing First was also the Pathways Housing First model was being experimented with in the USA (Larimer successfully ending “chronic homelessness”. et al, 2009). The experience in Finland and the Pathways Housing First was targeted at increasing dissemination and discussion of the people whose long term and repeated consistently strong results being delivered by homelessness was directly associated with Housing First services in the USA, drew severe mental illness and often with attention from European policy makers. A problematic drug and alcohol use, sustained review produced for the 2010 European worklessness, poor social supports (poor Consensus Conference on Homelessness relationships with friends and family) and poor (Busch-Geertsema et al, 2010) and the physical health. High rates of success in subsequent verdict of the Consensus housing sustainment – ending chronic Conference Jury both recommended use of the homelessness – were demonstrated by a Housing First approach (ECCH, 2011; succession of evaluations (Tsemberis, 2010a). O’Sullivan, 2012). The Consensus Conference l “Housing First” becoming integrated into Jury also noted that the term ‘Housing First’ Federal level homelessness policy in the United was encompassing both the original Pathways States. The process of integrating the Housing Housing First model and a range of other First model into Federal homelessness policy related service models. The Jury began under the Bush Administration and recommended the use of the term housing-led continued under the Obama Administration to describe those services which, while they (Stanhope and Dunn, 2011). While on some reflected the Pathways Housing First model, levels this process marked a major success for did not entirely replicate it (ECCH, 2011). In the Pathways Housing First approach, it was 2013, the European Commission also also the case that a wide range of service recommended a housing-led approach providers began to develop and operate (European Commission, 2013). services that were partially modelled on the l The development of a global evidence base. original Pathways Housing First model. As By 2013, it was evident that housing-led Housing First spread across the USA as an approaches were successfully reducing idea and more and more pilot services chronic homelessness, i.e. long term appeared across different cities, more homelessness associated with high support
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