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Manchester is putting Housing First – and the results look good

This article is part of ‘The Meteor Explores: Homelessness in Manchester‘ series.

Decadence, procrastination and occasional nudity. It would be tricky to explain some of our private domestic activities to an imagined third-party observer, but anarchic indulgence is for many the wholly necessary backend to the economically functional front which the aforementioned observer would probably wish us to display whilst out and about. Ponder at the fragility of your four walls, and the accompanying symbols of respectability which cloak your natural human frailties. Just a membrane of brick and glass, and maybe a paycheck or two, between your comfy nest and the filth and danger and cold of the city at night.

Let’s say the barrier falls apart. Those recuperating rituals must now be performed under the vague and judgemental gaze of the world. Stay in sight, for safety, or out of sight, for sanity? Life is heavy when you feel hunted. Hungry. Feel like you want to go home, but there is none. Habits die, replaced by instincts.  Easy to grab a moment of blissful release, and wake up three steps back from stability with an unshakeable hangover. If only you’d held on through a hundred more bars of Vivaldi, you’d have sorted it with the benefits people. Worth another cycle through the system? Somehow, it works. A new house needs a housewarming – a few drinks with your trusted new friends. Out on your arse. ‘Intentionally homeless,’ say the council – you violated your contract of abstinence. Damaged goods. Good luck getting a hostel. Streets, hostel, streets.

The traditional system of housing the chronically homeless on condition of good behaviour inevitably creates a ‘revolving door,’ through which homeless people pass as they go between the housing system and sleeping rough.

Housing and support without judgement

Enter Housing First (HF), a policy for tackling homelessness by offering housing and support without judgement. Housing First started out in New York in the early 90s, steadily spreading throughout the world, and is now being piloted in Manchester by Shelter’s Big Lottery-funded Inspiring Change Manchester programme.

Housing First operates on the principle that everyone has a right to a home regardless of addiction, injury or mental health condition. A true HF programme will offer housing and support to someone in need without demeaning or disempowering them. Flexible support is offered as long as it is needed, but the support is offered independently of the housing, so if the service user ceases to engage with the service provider, they still get to live in the house.

Most users, however, accept the wrap-around support which is so integral to the success of the programme. HF finds its cost-efficient niche in primarily housing the chronically homeless and those with complex needs – the minority of homeless individuals who are most costly to the taxpayer due to their dependence upon A&E services and their frequent interactions with the police. As a result, the people who are housed through HF are the most in need of help with the minutiae of occupying a house which wouldn’t occur to most of us to be particularly challenging but can represent a major hurdle to happiness and social integration to someone who has been sleeping rough for a while.

What sets Housing First apart from other, ‘treatment first’ housing schemes, is that its provision of housing as a gift not only sends a powerful message, but displays shrewd practicality. The standard practise is to allow housing on condition of commitment to a course of treatment, and evict the tenant if they deviate from that course. Human nature being as it is, most deviate and are kicked out, back into the streets where they suffer greatly, cost the public purse thousands, and eventually re-enter the revolving door of traditional homeless provision. The participants of a Housing First programme, on the other hand, are permitted autonomy and only evicted for the same reasons any other tenant might be. HF eschews the carrot-and-stick approach of yesteryear and instead places an emphasis on human connection and community to get the best out of people.

Encouraging results for Housing First

Shelter’s Inspiring Change Manchester programme began in April 2016 with the aim of using the Housing First method to engage with up to 20 people by March 2018. In the project’s most recent report, compiled by the Centre for Housing Policy at York University, participants speak in glowing terms about the project so far.  

“These people are texting me every day, or phoning me back every second day and saying that there is this on, there is that on, getting involved in all sorts. I think they are a really ****ing good team,” said Alex, who has been using the service*.

As Housing First is geared towards helping the chronically homeless, it deals with some of the most challenging members of our society. They often have to relearn, or learn for the first time, the habits involved with inhabiting a place. In extreme examples, this could be something as simple as having the confidence to sleep in a bed. For most, the assistance received will be to do with things like cooking, cleaning, finding treatment, and getting reminders to attend important meetings.

Charlie*, another participant of the programme, praised the support they’d received in reconnecting with their family:

“I’m in touch with my daughters, my grand-kids, my family now, that is all through these [workers], I wasn’t in touch with any of them before… and it makes a big difference to your head, because before I didn’t even know where they was.”

One can only imagine the level of dedication which must go into facilitating such a reunion. The emphasis on developing the working relationships between staff and participants is key to the success of Housing First. Without co-production (the collaboration between service users and staff to set and achieve goals), the participants would be unlikely to develop their self-esteem and independence.

Service users also noted the stark contrast between the more traditionally bureaucratic methods of support: “You always get that initial we are going to help you, but you never even get a call back”, versus the trusting relationship with someone who cares: “These don’t [just want to tick a box]. [Housing First workers] want to know in their own mind that you are alright.”

The numbers are similarly encouraging. As of October last year, 16 people had engaged with the Inspiring Change Manchester pilot and 15 had been housed. Small scale HF projects across the UK have been achieving a 70-90% success rate, whilst larger-scale rollouts in other countries have had even more promising results. In Utah, HF has pushed chronic homelessness down by 91%. In Finland, homelessness has been all but eradicated using a plan in which HF featured prominently, inspiring Communities Secretary Sajid Javid to become an advocate for Housing First in the UK.

The preliminary findings of the Cost-Benefit Analysis being run by the Greater Manchester Combined Authority Research Team predict that the pilot will break even in its first year, and go on to save £376,893 if allowed to run for five years.

Researchers have calculated:

  • an almost 50% reduction in the number of nights that clients spent in prison (potentially saving £42,968)
  • a 96% reduction in hospital inpatient episodes (potentially saving £876,744)
  • a 35% reduction in street homeless and 92% reduction in people living in temporary accommodation (potentially saving £83,884)
  • a 50% reduction in housing evictions (potentially saving £74,458)

“Not a magic bullet”

Housing First clearly has a fiscally compelling argument as a well as moral urgency and a growing political will behind it in the UK. Greater Manchester Mayor Andy Burnham recently welcomed £7 million of funding from the Chancellor to extend the Housing First projects which GMCA announced last November. If these programmes bear any similarity to Shelter’s Manchester pilot, then the 450 new HF places created will go a long way towards curing this city’s homeless problem.

Despite this progress, the big question is whether Housing First can scale up and stay true to its principles in the context of the Great British Housing Crisis. Sarah Walters, development manager at Inspiring Change Manchester, said:

“Our experience so far is that giving a homeless person a new home is not a magic bullet. People with complex needs often require long-term support. This might be to rebuild their self-esteem, or to get them into the brand new routine of having their own home. At the same time, we have to tackle the hugely complicated problems that pushed them into homelessness in the first place.

“But no matter what we do, Housing First can’t fix the chronic shortage of affordable housing which is one of the biggest obstacles to finding someone a permanent home. That’s why the government urgently needs to help councils build more new homes for rent that people can genuinely afford.”

Housing First’s “Psychology-Informed Environment” is commendable, but if the living environment does not contain enough houses, then people can’t be housed. Actually, there are enough homes – nearly 200,000 that have been empty for 6 months. There is also enough land, and the capacity to build more houses on it, provided it can be wrestled from property speculators and put to good use. Of course, this will be a futile exercise if the houses built go for market rates or what the government deems ‘affordable’.

There are only three areas of Manchester where private rents match local housing allowance rates. Market forces should not dictate rent levels. More unaffordable housing will only result in a ‘doughnut effect’ of social cleansing, pushing people further and further away from their own communities towards outlying districts where they have no connections, at great cost to their own mental wellbeing, community cohesion in those areas and, (if there is anything left in them) local budgets.

More funding for bold ideas such as Housing First should be celebrated, along with the promising results of pilots such as those being carried out in Manchester, but while the root economic causes of the housing crisis remain, no single policy can save the day. What Housing First has shown so far, however, is that starting from the principle that housing is a right rather than a reward for good behaviour yields huge benefits, and this can only be a step in the right direction.

Georges Almond

*Participants’ real names have not been used

Keep an eye out for the next Inspiring Change Manchester Housing First report in Spring 2018.

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