Housing First: A place to call home

As Scotland’s Housing First programme is scaled up across the country, the government still has a huge homelessness problem it needs to get to grips with

When Housing First Scotland stopped publishing its monthly tracker in August last year the numbers were way off target.

Launched to great fanfare in 2018, Housing First’s initial aim was to provide permanent homes and wrap-around support to 830 vulnerable rough sleepers across Aberdeen, Dundee, Edinburgh, Glasgow and Stirling by March 2021. Funding was provided by the Scottish Government, charitable organisation the Merchants House of Glasgow and the hundreds of business executives who took part in mass sponsored sleepouts organised by social enterprise Social Bite.

Housing First was, said First Minister Nicola Sturgeon in October 2018, about showing that “now is the time for action and to end homelessness in Scotland once and for all”.

Yet when March 2021 came around, just 483 tenancies had been signed and by August the number had risen to just 545. Though progress had been made in Aberdeen and Dundee, both of which were within spitting distance of meeting their initial targets, in Edinburgh, where 123 of a planned 275 people had been found homes, the programme was not even close to being on track.

That does not mean Housing First has been a failure, though – far from it, in fact.

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As a concept, Housing First seeks to turn street homelessness on its head. Though the vast majority of rough sleepers have a plethora of vulnerabilities that have led them into a life on the streets – mental health issues, drug and alcohol addictions, problems coping after a lifetime of trauma and abuse – in the past it was those very vulnerabilities that locked them into that life on the streets: people weren’t deemed capable of maintaining a home while in active addiction yet they had no hope of dealing with problems such as addiction without the stability of a permanent roof over their heads.

Having heard of a project in New York that gave people homes first then the support needed to deal with their other issues, Turning Point Scotland’s then operations manager Ian Irvine visited the US to see how it worked. He liked what he saw and in 2010 the charity launched its own version in Glasgow. That proved to be a success – a number of people who have been involved with the project from the start are still in their tenancies – so when in 2017 the Scottish Government tasked its Homelessness and Rough Sleeping Action Group with finding a way to eradicate rough sleeping, Housing First was one of its key recommendations.

Though Turning Point had essentially already run a pilot, six, three-year projects known as pathfinder programmes were set up to test the system before it could be rolled it out across the country. Doug Gibson, change lead at Homeless Network Scotland – which was responsible for the pathfinders until they were transitioned across to the relevant local authorities over the past six months – says that with so many different organisations involved those tests were seen as vital to making sure that what Housing First was offering was right.

“There are challenges in doing it because you’re implementing something that, over time, changes a system,” he says.

“There are key things to learn about the time it takes to build the partnerships to do this. It’s multiagency [and involves] criminal justice, the third sector, the housing sector. They all need to play their part around the table so the relationships there are key, in particular between the people delivering the housing and the people delivering the support. They are dealing with people who are at crisis point so they need to be able to communicate clearly with each other.”

Everyone involved in the pathfinders agrees they have been a success, with around 84 per cent of the tenancies that have been signed being sustained. Although that is lower than the 90 per cent that would normally be expected in homelessness circles, the characteristics of the group being served mean there have been a number of deaths among the cohort while some tenants have had to give up their homes due to starting long-term prison sentences. No one housed as part of the programme has been evicted.

They are dealing with people who are at crisis point so different agencies need to be able to communicate clearly with each other

There are also early indications that other parts of the country have learned valuable lessons from the six pathfinder schemes, with the Scottish Government – which took over reporting Housing First data last August – recording that 227 new tenancies began between April and December last year, with 25 of Scotland’s 32 councils running their own Housing First programme. Although the numbers do not add up to the original 830 target even with more councils on board, seven non-pathfinder authorities – West Dunbartonshire, North Lanarkshire, Renfrewshire, Midlothian, North Ayrshire, Fife and Falkirk – hit the ground running, signing between 10 and 21 Housing First tenancies apiece in the first few months of launching a scheme. 

Eileen McMullan, policy lead at the Scottish Federation of Housing Associations, whose members have signed up to provide homes as part of Housing First, says that “the really strong message is that Housing First does work and it really benefits those people with really complex needs”. Tony Cain, policy manager at the Association of Local Authority Chief Housing Officers, agrees, noting that, “Housing First has worked for the people that have gone through it”.

Like Gibson, McMullan says key to this success is making sure “the different parts of the system are working together”, something that has not been easy as funding for support organisations is always tight and finding appropriately qualified staff has become an issue in the wake of Brexit and the coronavirus pandemic. Despite the difficulties, Kelly Parry, a councillor in Midlothian and Cosla’s spokesperson for community wellbeing, says local authorities have taken the learning of the past three years and worked with other agencies to come up with innovative solutions under the Housing First umbrella.

“Ultimately, councils make operational decisions about lots of things but the most important thing is that we want to do what’s right for people and stopping them becoming homeless in the first place is what’s important,” she says.

“How that interacts with other policy decisions – on health inequalities, violence against women and girls, deprivation and the justice system – is key. All those things cost money, but Housing First is about making sure people have got the right outcomes and ultimately, in terms of the long-term vision, this about making really positive interventions that actually work.

“One of the really good things about Housing First is that it can adapt where you need it to. Fife has focused on youth homelessness and have put in place a support service for under 25s in partnership with the Rock Trust. Midlothian and East Lothian have [focused on] domestic violence and worked it into Housing First along with Women’s Aid. If you have a perpetrator of domestic abuse who lives in a household with someone that’s affected it’s not always the case that the woman would stay in the property. We’ve turned that on its head.

"East Lothian has put aside four properties for women who can immediately seek shelter rather than having to go into a domestic abuse refuge. Both Midlothian and East Lothian have worked really hard with local Women’s Aid. It’s all about making sure that you have that wrap-around support regardless of what it is. This is about preventing people from falling into homelessness but also sustaining a tenancy – it’s not just about getting a roof over your head but about keeping it.”

Even bearing in mind the difficulties with Housing First – the woeful lack of housing in cities such as Edinburgh, concerns about the provision of support – it is clear that the system is doing what it set out to do for at least some of the group of people it is designed to help. Given that it forms just a small part of a much wider homelessness strategy that includes Rapid Rehousing, though, anyone thinking the scale-up of Housing First means Sturgeon has succeeded in “ending homelessness once and for all” needs to think again.

“Housing First is fantastic and welcomed by us and all the partners but it isn’t a cure all,” says Parry. “It won’t fix all our homelessness issues and there’s much wider work we need to do around mental health and making Scotland a safer place for women and girls. All that has to go on around it, but it’s a very good piece of the housing puzzle.”

Martin Gavin, improvement lead at Homeless Network Scotland, agrees. “About half of people [making a homelessness application] just need a house. There’s another half that need support and a very small proportion of that half will benefit from Housing First,” he says.

Taking that small group off the streets may give the impression that homelessness has been dealt with, but by definition Housing First can do nothing for the 14,000-plus households that were assessed as homeless in the sense of having no fixed address in the six months to September 2021 or the 13,000-plus living in temporary accommodation during that same period.

What we’ve learned from the pathfinders is that there’s definitely a client group for whom mainstream housing is problematic – they need much more care and support and even Housing First doesn’t meet that criteria

At the same time, while it is accepted that Housing First does work for a very small, very vulnerable group of people, Cain says the pathfinders have also highlighted what he and others working in the sector were saying from the start: that within that cohort there is an even smaller group whose needs are so complex and whose vulnerabilities are so extreme that Housing First was never going to be the answer for them. It is those people, Cain says, that solutions must now be found for if rough sleeping is ever to be consigned to the past.

“The debate [four years ago] was that councils were adopting a tenancy-ready approach [for dealing with rough sleepers] but that that wasn’t right, you should give them a tenancy and deal with their problems afterwards,” Cain says. 

“The really important thing at the moment is what we’ve learned from the pathfinders is that there’s definitely a client group for whom mainstream housing is problematic. They need much more care and support and even Housing First doesn’t meet that criteria. We’ve now agreed this group exists and we’ve agreed they have fairly profound health problems.

"For me the challenge now is not has Housing First done what it set out to achieve, it’s this is the group for whom we are really failing. We fail them in health, we fail them in housing, we fail them in social care. That’s a general public-sector failing. For me the challenge now is [recognising] that we have a group that are already benefiting from Housing First but we also have this other group that exists and at the moment we don’t have anything for them.”

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With the handover of the pathfinders completing in March, all eyes are now on how councils' individual schemes can continue creating positive outcomes for the longer term. Funding for Housing First now comes solely from the public purse, with Sturgeon announcing in her 2021-22 Programme for Government that “an additional £50m to tackle homelessness and rough sleeping, and extend the transformative Housing First approach right across Scotland” was being made available.

It is not clear how much of that money will go specifically to Housing First and how much is earmarked for Rapid Rehousing, but Nicky Miller, head of homelessness at Turning Point, says that given the scope of what Housing First aims to do, there should be a more joined-up way of funding it.

“Housing First should not be a homelessness response – we believe it should be a health and social care responsibility,” he says.

“We need to change how we fund issues. We fund homelessness, we fund alcohol and drugs, we fund mental health. In some European countries services are financed and it doesn’t matter which door you came through. In Scotland we say you came through that door so you can’t access that service over there.

"The reason someone hasn’t been able to sustain a tenancy is often to do with health needs. We believe in long-term supported accommodation with health-based support that focuses on someone’s physical and psychological wellbeing. That’s not about making someone tenancy ready, it’s about managing their health needs.”

All the main parties have pledged their support for Housing First, meaning the policy is likely to survive any future change of government, but McMullan at the SFHA says that from a housing point of view landlords are more likely to come on board – and so Housing First could meet its targets more quickly – if they have better visibility of exactly how their tenants are going to be supported. 

“The cost of keeping someone in their home is much less than dealing with repeated homelessness so going forward that investment in Housing First is really key,” says McMullan.

“At the moment it seems to be okay, but the challenge with that kind of commitment and that kind of funding is that the contracts are always short-term and that makes it difficult for organisations to plan. At the moment there’s a very strong commitment from the Scottish Government around ending homelessness so that gets funded centrally, but there’s always an issue. It’s so important to have the funding there so the support is in place – that makes landlords much more confident about working with people with complex needs and they are much less likely to be risk averse in terms of housing people.”

With Housing First being rolled out across the country the needs of Scotland’s rough sleeping population are, to a degree at least, being met. Yet the issue of the hidden homeless – the sofa surfers, the families parked in temporary homes, the people still finding themselves housed in unsuitable accommodation such as B&Bs – is more pressing than ever. Housing First may be aimed at a very small section of the homeless population, but it formed part of a much wider Ending Homelessness Together action plan that promised to rapidly rehouse people by default. Until that has been done Scotland cannot, as a society, say it has ended homeless either once or for all.

As Miller at Turning Point says: “Housing First was designed to be a springboard to change the rest of the system in Scotland. It’s now time to change the rest of the system.”