How to solve the homeless crisis

15 Apr 2016 Nick Garbutt    Last updated: 15 Apr 2016

Kerry Anthony

Kerry Anthony, chief executive of Depaul analyses the homeless crisis and poses a solution 

In recent months, as public debate has focussed on the issue of homelessness in Northern Ireland, Depaul has worked to dispel some of the common myths associated with homelessness and deliver coordinated solutions. We have drawn attention to the complexity of the needs of people who are rough sleeping in Belfast, and have highlighted Housing First as one of the solutions to homelessness. 

Last summer, Depaul and the Welcome Organisation carried out the Belfast Street Needs Audit, commissioned by the Northern Ireland Housing Executive, to count the number of people sleeping rough in Belfast and identify their needs. We found that up to 19 people were sleeping rough each night, with an average of 6 rough sleepers per night, over the 12 week period of the audit.  

We identified a cohort of 42 people who were long-term homeless and regularly engaged in street activity including rough sleeping. Interestingly we found that most of this cohort, which was characterised by poor mental and physical health and chaotic lifestyles, were not without shelter. When asked what their ‘last known accommodation’ was, 43% reported ‘homeless hostel’ and 26% said ‘own accommodation’. They reported restrictive rules, problems with other residents and overcrowding as barriers to accessing crisis accommodation. We found that many of them were excluded because they had negative experiences with some services in the past, and also that the entry criteria was too restrictive to access some homeless services. 

A decade ago, Depaul opened its Stella Maris service in Belfast to support people such as these with very complex needs. By working to the principles of low threshold and harm reduction - e.g. lowering the entry bar and helping residents to manage their alcohol intake rather than prohibiting alcohol use - Stella Maris has helped over 200 vulnerable people with acute alcohol addictions in Belfast. 

Depaul’s experience and the results of the Street Needs Audit show that street homelessness in Northern Ireland is much more than a housing issue. It is rooted in mental and physical illness, loneliness and addiction, and an effective response must address these underlying issues. Services such as Stella Maris, which provide one-to-one case management support and meet people ‘where they are at’, are crucial to breaking down barriers to access for some of the most vulnerable people experiencing homelessness.  

However, Depaul believes that the aim should always be a stable home and that, to break the cycle of homelessness and dependency, we should work towards Housing First as a response to homelessness. Housing First is the principle that it is more effective to house people who are homeless with complex needs in permanent accommodation with intensive supports, rather than in temporary homeless accommodation. 

The basic premise of Housing First is the need to move away from a process of making people ‘housing ready’ by accommodating them in hostels for many years. Housing First is an alternative to the traditional ‘staircase’ or ‘ladder’ model whereby people who find themselves homeless must first address their issues before moving to the next stage of a series of steps towards independent housing. Permanent housing is then seen as a reward for maintaining sobriety or complying with treatment and support plans. 

Housing First, by contrast, promotes the idea of moving people directly into independent accommodation and providing a stable environment with a variety of ‘wrap around’ supports to ensure that the individual is able to sustain their new home in the community. Housing First services advocate a harm reduction approach in relation to problematic drug and alcohol use. This means that any risky behaviour associated with a person’s addiction is managed in such a way that the potential harm is reduced. 

The two main principles of Housing First are that housing is a basic right, not a reward; and that once the instability of homelessness has been addressed through housing, clinical and social stability occur at a faster pace and in a much more stable and enduring manner. Housing First initiatives across the United States, Canada, Europe and Australia have shown the model to be not only ethically sound but financially advantageous.

In May 2013, Depaul piloted Housing First in Belfast. By working in partnership with a range of voluntary and statutory agencies including day centre services, addiction services, the PSNI, GPs and mental health practitioners, we have been able to accommodate 55 people with high support needs from homeless accommodation services into permanent supportive accommodation in the community. Once we have settled people in their own homes we provide a range of life skills supports to help them maintain their tenancies, including budgeting advice and assistance with access to benefits and completing forms. Last year we extended this programme to L/Derry, where we are currently working with 12 people in Housing First accommodation. 

Depaul’s success with Housing First in Northern Ireland shows that people with complex issues should not be overlooked or deemed incapable of living independently. The case of Sandra demonstrates this: 

Sandra was one of the first people to take part in Depaul’s Housing First programme. Sandra was 50 years old and had been alcohol dependent for approximately 25 years. She was living in Stella Maris and had been in and out of homelessness for years. Sandra’s life had been profoundly unstable – she had been traumatised by a series of suicides within her family and had a history of abusive relationships; her mental health needs were high. 

Shortly after being accommodated in her own home through Housing First, Sandra suffered a serious assault. The Housing First Team immediately implemented a crisis intervention strategy. The PSNI and social services recognised Sandra as a vulnerable adult and put in place measures to protect her in the community. Sandra began receiving morning and evening visits from Home Care Floating Support totalling 15 hours per week. 

Sandra has been supported through a harm reduction approach to address the issues underlying her addiction. She has stabilised and reduced her alcohol intake significantly. She has made positive steps for her future by participating in a Housing First service user involvement group, and by attending a day centre to encourage social interaction and help her limit her alcohol use. Sandra’s self-esteem and mental health have really improved. She has now maintained her home in the community for almost 3 years, when previously she had struggled to maintain a tenancy for more than a few months.

As with any new service there have been challenges to implementing Housing First in Northern Ireland. Securing housing within the private rented sector, and accessing rental deposits and the first month’s rent are key issues. Finding landlords who are willing to work with our client group may be a struggle going forward. Accessing mental health services, which is a critical need for the majority of our service users, continues to pose a challenge. 

Regardless of these challenges Depaul believes that, if we want to end - and not just manage - homelessness in Northern Ireland, Housing First is the way forward. 

 

 

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