European Research Conference Access to Housing for Homeless People in Europe York, 21st September...

European Research ConferenceAccess to Housing for Homeless People in Europe

York, 21st September 2012

Casas Primeiro / Housing First in Lisbon

José Ornelas

ISPA – University Institute

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Casas Primeiro (Homes First) Immediate access to individualized and permanent

housing.

People are not required to participate in psychiatric treatment or attain a period of sobriety in order to obtain housing.

Scatter site apartments in mainstream neighborhoods in Lisbon. Apartments are not in the same building or street.

Rental subsidy. Tenants pay 30% of their monthly income towards rent.

Provides – off site – services (7-24 on call) to help consumers keep housing, facilitate recovery and community integration.



Participants

Criteria of priority:

People with mental illness

People who are living on

the street

People who are the

longest in the situation of

homeless



Participants

• 91,6% have Portuguese nationality • All participants were unemployed or inactive• Only 28 participants had some source of income

Sex

Age



Participants

Alcohol

Drugs

Alcohol and drugs

Not applicable

11,1%

2,8%

15,3%

70,8%

29.2% also present a co-occurring substance abuse disorder

Diagnosis

Addictions



Length of homelessness

< 2 years 3 - 5years

> 6 years0%

20%

40%

60%

50% of the participants were homeless for more than six years, and 6,9% for more than 16 years.



Support services• Team (6 staff – ratio 1 staff to 10 participants)

• Home visits at least 6 times per month per participant. All tenants must agree to regular home visit.

• Support services are provided in the community (access to community resources and services)

• Team use a recovery focus and assist with community integration. Participants can beneficiate from others AEIPS programs (e.g. supported employment)



Ecological approach



Housing Stability

83,3%

16,7%

Yes

No

Of the 60 participants that are still housed by the program, 58.3% remained in housing for one year or more



Changes in income

0

20

40

60

80

Before After

Income

The number of participants that had a monthly income increased substantially from 28 to 70 (social benefits and salary).



Changes of quality of life

The impacts of housing in participants’ perceived quality of life are clearly significant, in terms of personal safety, nutrition, level of stress, sleeping habits, social life health and mental health.



Changes in emergency service use

Before

After

Called 112 46% 6%

Admitted in psychiatric hospital 58% 6%

Spent one night on police squad 20% -

The number of participants reporting having to use 112 emergency service decrease 87%. The number of admissions in psychiatric hospitals decreased by 90%. No one reported having spent the night on a police squad after move into housing.



Individual projects

Job site training

University

School

Workshops

Community center

Computer training

9

1

1

2

3

6

22 participants involved became involved in school, training, employment or other activities



Satisfaction with housing

0%

20%

40%

60%

80%

100%

Satisfactionwith the neigbourhood

Satisfaction with the house

Satisfaction with neighbourhoods: the resources nearby and the relationship with neighbours.

Satisfaction with the house: privacy, tranquillity, comfort and sense of control over the space.



Program satisfactionAll participants were satisfied with the program, pointing out as important aspects the speediness of the process the support of the team in:

solving immediate problems managing the house facilitating access to existent

neighborhood services.



Support needs changed over time

0%

10%

20%

30%

40%

50%

60%

Increase Staying thesame

Decrease Don't know

70%

60% of participants considered that in the short term, there will be no major changes32% consider that their needs for support will decrease over time and only 4% considered they will need greater support from the team



Overall changes

98%

2%

Life overall improvement

Don’t know

On the referred improvements participants highlight the gains in a large sentiment

of freedom and hope, a wide range of study opportunities, getting a job,

fulfilling personal projects and the development of social connections



Costs

• Casas Primeiro – 16,40 euros per client per day (€498,83 per month)

• Night Shelters – 18,60 euros per client per night

• Hostels rooms – 30,77 euros per client per day

• Psychiatric hospitalization in acute wards have a one time cost of €2500 per client



Research Community integration & Recovery

qualitative narrative interviews interviews with quantitative measures

community integration recovery choice satisfaction with housing and support services

Social change key informant interviews landlords interviews

European Research Conference Access to Housing for Homeless People in Europe York, 21st September...

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