Finding the Way Home Housing-led services have been adopted as Federal • A full time nurse homelessness policy in the USA15 and an increasing number of • A qualified social worker, usually with specialist knowledge OECD and EU countries are incorporating, piloting and of mental health developing housing-led services. Housing-led services are being tested in Australia, Austria, Belgium, Germany, the • A specialist in supported employment18 Netherlands, New Zealand, Portugal, Sweden and the UK. • A drug and alcohol specialist Meanwhile in Canada, Denmark, Finland, France, Norway, alongside the USA, housing-led approaches are at the core of • A ‘peer specialist’ who is a qualified team member who has national homelessness strategies. The 2010 EU Consensus been through the experience of chronic homelessness Conference on Homelessness recommended the use of themselves. housing-led services following a housing-led approach at Alongside providing practical support, the ‘peer specialist’ is European level. While most countries and agencies refer to also seen as a ‘living illustration’ that ‘recovery’ from chronic housing-led services as ‘Housing First’, the 2010 consensus 19.elbissopsissensselemoh conference argued in favour of the term ‘housing-led’ because ‘Housing First’ originally referred specifically to the Pathways The ICM team has a case management role and works with model and other forms of housing-led service had arisen16. It people who are homeless who have high needs but require less is the global prominence of services following a housing-led intensive levels of support. The ICM enables someone to philosophy as an effective response to homelessness that has connect with services they need, including social work led to policy attention being focused on housing-led models at services, drug and alcohol services, mental health and medical the highest levels within Ireland (see Chapter 1). services and the welfare systems. The ICM provides some direct support itself, though its main role is focused on case Different types of housing-led services management. ICM team staff are each assigned up to 20 There are three groups of housing-led services. The first of service users20. these groups of housing-led services, called Pathways Housing First, is a well-defined mobile support service model which has PHF provides 24-hour cover which means service users can been extensively documented and researched. The second telephone for assistance whenever they might need it. The and third groups of services, which can be defined as model can provide intensive support, but it is not designed to Communal Housing First and as Housing First ‘Light’ services, provide a 24 hour staff presence in the home of someone using both encompass ranges of services that share or reflect the the service, as it is based on mobile support which has to be Pathways philosophy and a common basic approach, but available to other service users. PHF also provides open- which differ in their operational details. ended support services. The support is in place for as long as someone needing the PHF service requires and this can and It is important to note these are generalised categorisations, not does mean the provision of support that is effectively definitions of different types of housing-led service. Forms of permanent. housing-led service that do not strictly comply with the descriptions given below and hybrid services that combine The PHF philosophy is described in the follow terms21: different forms of housing-led services also exist. • Housing as a basic human right. • Respect, warmth and compassion. Pathways Housing First • A commitment to working with people for as long as they Pathways Housing First (PHF) is not a general homelessness need. service, it is specifically targeted on people with a severe mental illness who are homeless, including people • Scattered site housing, independent apartments22. experiencing long-term homelessness. PHF uses two forms of mobile support team which are an ACT (assertive community treatment) team and an ICM (intensive case management) 15 United States Interagency Council on Homelessness (2010) Opening Doors: Federal Strategic team. The ACT team directly supports people with severe Plan to Prevent and End Homelessness 2010 USICH: Washington DC. mental illness who are homeless who have the highest levels of 16 European Consensus Conference on Homelessness (2010) European Consensus Conference on Homelessness: Policy Recommendations of the Jury Brussels: FEANTSA. need. A ten-person ACT team would have a case-load of 70 17 A nurse practitioner shares some training with doctors and can prescribe some drugs. people and be comprised of: 18 The role of PHF in promoting employment has yet to be systematically investigated at the time • A Team Leader who coordinates the services provided (with of writing. support from an administrative assistant) 19 positeivAeCrTecoamesctailosnownitchufdaemaily.aTmelryesmecyiallssot’baesau‘pweolltnesosrkmanagemeolteacndtrreecsoverynonenresohwrewrpiaapihf‘linnetmoS • A psychiatrist (usually a part-time post) fsopremearllyschroeniicalelydpteodpeleewohpopaoreithiompleerss.naTseemabteirins,hSi.p(s2andaa)heacltith.y lifestyle amongpo010solrloseevslvongsd’tiic • A provider of primary medical care either a doctor or nurse- 20 Tsemberis, S. (2010a) op cit. practitioner17 (usually a part-time post) 21 Tsemberis, S. (2010a) op cit. 22 i.e. ordinary rented flats that are spread out across a city or community rather than concentrated into one or more blocks of flats. 10
Finding the Way Home
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