Finding the Way Home • Separation of housing and services23. use, poor physical health and exhibit anti-social and criminal behaviour. People who are long-term homeless with very high • Consumer choice and self-determination. needs who make heavy use of emergency medical services and • Recovery orientation. who have high contact with criminal justice services may be • Harm reduction. specifically targeted by CHF services27. PHF is often contrasted with supported housing models that A CHF service is meant to provide a permanent, supportive extensively regulate the lives of people who are homeless, with home. There is no ‘staircase’ element to a CHF service. People the ‘choice and control’ (consumer choice and self- using a CHF service can choose to move on and be supported in determination) provided by PHF being emphasized. However, doing so, but the CHF model is designed to provide settled people who are homeless using PHF do have to accept the housing with open ended support. following three conditions to access the service24: CHF exists in several forms including: • A weekly home visit from PHF staff. • ‘Project-based Housing-First’ services developed in the USA • Signing a tenancy or sub-tenancy, which gives them some for very high need groups of people who are long-term housing rights alongside responsibilities for the apartment homeless and who present with severe mental illness, they living in. criminal and anti-social behaviour, very poor physical health, • Sign an agreement guaranteeing that 30% of their available highly problematic drug and alcohol use28. income will help pay the rent. • Services provided under the Finnish ‘Name on the Door’ Programme which has involved a large scale conversion of PHF works mainly with the private rented sector to secure hostels and emergency accommodation into what is referred housing for its service users. Private landlords are offered a full to as a ‘Housing First’ model using congregate self-contained housing management service and guaranteed rent. The actual flats with on-site staffing29. Although it shared much of the tenancy agreement is often being held by PHF itself, rather than core philosophy of PHF, the Finnish programme was originally a person who was formerly homeless. The private landlord thus developed without reference to PHF, though it began to draw has the reassurance that their tenancy is with PHF, that the on US ideas over time. ACT/ICM team will handle any housing management issues that might arise and that their rent will be paid. The use of sub- • Some examples of ‘Common Ground’ services in the USA tenancy agreements also allows PHF to rapidly move people if and Australia can be interpreted as providing a form of any difficulties arise, as the person who was homeless does not CHF30. hold the tenancy. A recent review of the possible use of housing-led services in Australia makes the important point that ‘Housing First Light’ services one of the key successes of PHF in tackling homelessness lies in Housing First Light (HFL) services share the same basic how PHF secures and manages a stock of suitable private philosophy as the PHF model, but they are a lower intensity rented housing25. service than that provided by PHF. These services are sometimes also referred to as ‘housing support’, ‘tenancy ‘Communal’ Housing First models support’, ‘case management’ or ‘housing-led’ services31. Communal Housing First (CHF) services follow the same philosophy as PHF with one important difference. CHF services provide permanent accommodation in communal (single rooms) or congregate (self contained apartments) blocks of 23 i.e. access to housing and the right to remain in housing is not conditional on treatment compliance. accommodation with on site staffing. Security of tenure is offered 24 PHF service users must also be eligible for welfare benefits to help pay their rent, these benefits but there is no choice of where to live. are conditional on being diagnosed with a severe mental illness. 25 Johnson, G.; Parkinson, S. and Parsell, C. (2012) Policy shift or program drift? Implementing CHF can directly provide psychiatric, drug and alcohol services Housing First in Australia AHURI Final Report No. 184 AHURI: Melbourne. and medical services and may use case management to access 26 CHF services would not in any way facilitate illegal drug use. to external services. CHF services follow a harm reduction 27 Larimer, M.E.; Malone, D.K.; Garner, M.D. et al (2009) ‘Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons with Severe Alcohol approach, and, as with PHF, there is no requirement to stop Problems’ Journal of the American Medical Association Vol. 301, Part 13, pp. 1349-1357. drinking, taking drugs26 or to comply with treatment in order to 28 Larimer, M.E et al (2009) Ibid. access and remain within the provided accommodation. The 29 Busch-Geertsema, V. (2010) The Finnish National Programme to reduce long-term homelessness accommodation has the same sort of requirements attached to a (Synthesis Report for European Peer Review) OESB: Vienna. normal tenancy or lease agreement i.e. agreeing not to behave in 30 It is only one type of Common Ground service the permanent housing might be seen as a form of an anti-social way and to pay the rent, or make an agreed Cnd,Pormu,oLt.h(e2r0Com‘mtoreeGtrtoouHomer:vTihesEdpenrioetnfcelswfaLongF-TeprmoUnsheltereJdsHomJelLeesvsitt, A.J.;.J,to:ees,hcarpaHCoolooxecesdnnS)11ecosFHa financial contribution towards the rent. CHF services are targeted Individuals in an Outreach and Housing Placement Program’ Qualitative Social Work 10, pp. 224- in various ways, but are generally intended for people living 263; Parsell, C. and Jones, A. (2012) Street to Home in Australia: New Approaches to Ending Rough Sleeping in Brisbane and Sydney Institute for Social Science Research, University of rough and in emergency accommodation for sustained periods Queensland who have severe mental illness, problematic drug and alcohol 31 Pleace, N. (2012) op cit. 11
Finding the Way Home
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