Transcript of Ballroom A Day 1 1330 Felicity Reynolds
- 1. PERMANENT SUPPORTIVE HOUSING A DISCUSSION September 2009
Felicity Reynolds CEO, Mercy Foundation Churchill Fellow 2007
- 2. Overview
- Costs associated with crisis care for people who are
chronically homeless
- Key elements and benefits of permanent supportive housing
and
- A few examples of supportive housing models
- How do we get there from here?
- 3.
- Although chronic homelessness represents a small share of the
overall homeless population, chronically homeless people use up
more than 50 percent of the services (for single homeless adults).
The most successful model for housing people who experience chronic
homelessness is permanent supportive housing using a Housing First
approach. NAEH
- 4. Chronic homelessness much more than chronic houselessness
- People who have experienced multiple episodes of homelessness
over a year or people who have experienced ongoing street
homelessness for at least 6 months.
- Disconnectedness and social exclusion.
- Often a background of trauma and abuse.
- Trust of other people and services.
- May develop social connections, networks and supports and
become entrenched. This should not be mistaken for a lifestyle
choice.
- 5. Cost of crisis care to this population
- Now well understood that some chronically homeless people are
high users of crisis services. That is acute mental health, EDs,
IPUs, detoxes, ambulance, police, legal, shelter etc.
- Sydney estimate AUD $34,000
- As long as the individual remains homeless, these costs are
recurrent.
- We are spending this money anyway why not improve the
outcomes.
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- Berry (2003) noted that a study in the USA showed that it costs
an additional US$3196 for each person to provide substance abuse
and mental health services to homeless people, compared to clients
who were housed.
- Culhane (2004) concluded that It costs essentially the same
amount to house people as it does to leave them homeless.
- 8. Cost/benefit studies
- Many US cities have now done cost/benefit studies and now
understand that it is not only morally responsible, it is fiscally
responsible to assist chronically homeless people off the streets
and into permanent supportive housing (many models: private
housing, public housing, safe havens, community homes etc).
- Now, good evidence that service use reduces once people are in
stable housing and have adequate support.
- 9. Follow-up survey by S2H Toronto (after being housed)
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- Are you happy with housing?
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- Has housing changed your life?
- 10.
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- 17% reported no drinking since being in housing.
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- Homeless 2+ years much more likely to report decrease in
alcohol use ( 59% vs. 27% ).
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- 31% reported they had quit using drugs completely since being
in housing.
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- Those homeless 2+ years most likely to report decrease in drug
use ( 78% vs. 62% ).
- 11.
- Reduced use of crisis and emergency services
- 911 (emergency call) - 35%
- Police detox (Drunk Tank) - 75%
- 12. An example of a supportive housing model
- Support ( little or lots ) =
- 13. Key components of Housing First
- People do not have to be assessed as Housing Ready.
- Housing is provided as quickly as possible.
- People are provided with adequate and appropriate support
services in their home.
- People with alcohol or other drug addictions can access
housing.
- People do not need to be compliant with mental health treatment
separate the behaviour from the diagnoses
- Separate the management of the housing from the support.
- 14. A few models we need many
- HASI (NSW) but similar to other models in other States.
- Common Ground (more about that in a moment).
- Pathways to Housing (NYC) or S2H (Toronto).
- Safe havens a useful model for some.
- Harm minimisation accommodation services work very well with
this group (Seaton House Annex a good example).
- Ready, Willing and Able (The Doe Fund) in NYC is a good example
of an abstinence based, work skills residential program.
- 15. Common Ground
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- Permanent housing with on-site support
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- Own self contained apartment
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- Safe and secure (24 hour concierge)
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- Tenancy manager and support service are separate services.
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- High quality housing and mixed tenancies formerly homeless and
those who are not, but who work in low income jobs or study.
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- Sense of community use of community spaces etc.
- 16. Permanent NOT Transitional
- From a funding and systems point of view medium support and
transitional accommodation seems to make sense (shares those finite
resources around!).
- However from an individual point of view it may undermine
stability, connecting with local communities and with social
inclusion.
- Some people may move elsewhere eventually anyhow after gaining
some stability. Some may not and, perhaps, may always need some
level of ongoing support. Thats ok.
- 17. Joe
- 20 years street homeless.
- Excluded from many services.
- Ended his homelessness when provided with a high quality place
to stay no matter what.
- This encouraged him to give detox a go he wouldnt make himself
homeless if he failed (which he thought he probably would).
- Now almost 20 years working and managing homelessness
services.
- 18. Australian context
- Federal White Paper initiatives prevention, improving services
and breaking the cycle.
- Some State plans (NSW as example) complement Federal vision and
plan.
- Permanent supportive housing models help break the cycle also
helps prevent further episodes of homelessness.
- 19. How do we get there from here?
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- Need paradigm shift from managing crises to ending
homelessness.
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- We have an existing large and mostly well qualified workforce
of support workers/case managers just need to provide the support
within peoples homes rather than in other environments.
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- Urgent need for permanent housing stock. Councils can perform a
role here by introducing policies and planning controls that
encourage this.
- 20. Getting there from here (cont.)
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- Adopt Housing First and rapid re-housing approaches (but need
housing to do this).
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- Stop over-servicing people who dont need it (some people just
need somewhere to live and do not require support).
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- Funding incentives that encourage long term outcomes.
- 21. Discussion
- How else might we get there from here?
- What are some additional barriers to housing first or rapid
re-housing?
- How should we evaluate these types of programs?
- 22. Contact details