Our CEO Declan Flynn explains the origins, logistics, and challenges of maintaining a Housing First programme in London.
I have never written a blog post before but here goes. I read a post on Twitter yesterday claiming that Bench Outreach and Lewisham Council are providing a “bastardised” Housing First service and this made me so angry I decided to put the record straight and tell you about Bench Housing First.
The Housing First approach was developed in New York in the 1990s to tackle the huge number of people sleeping rough. Many of these “street people” had mental health issues and were not able to use night shelters or hostels. A clinical psychologist, Sam Tsemberis, started a programme – Pathways to Housing – which provided “ordinary” housing with high levels of support for this group rather than placing them in traditional treatment programmes. In random control trials, this approach proved to be more effective than the treatment focused approach. The model that emerged from the Pathways to Housing programme became known as Housing First.
While here in England we have not yet hit the levels of homelessness seen in New York, the trend shows a worrying rise in rough sleeping. After many years of austerity, resources are scarce. We have a housing shortage, cutbacks in all council departments and the closure of services we took for granted just a few years ago. Lewisham Council has experienced 60% cuts since 2010. Because of this violent attack by central government on the health and social care sector, small charities providing Housing First services must focus on helping the most vulnerable in society – people with histories of entrenched street homelessness; people with mental health needs and drug and alcohol problems; people with histories of offending; people with physical health needs; and people who experience domestic violence.
As the Housing First approach developed, principles emerged that identify true Housing First services from variations on the more traditional treatment oriented models. The first and most important is that housing is seen as a basic human right. Support is provided to the person for as long as it is needed. This support is aimed at helping the person maintain their tenancy and if they do not accept or use that support, it does not affect their right to housing. In true Housing First services, the individual is given choice and control. The person using the service and the Housing First worker collaborate to use that person’s strengths to help them achieve their goals. Finally, while the person has a right to refuse the support offered, the Housing First worker adopts a proactive approach to keeping the person involved with the service and tries to ensure that harm through drug and alcohol use is kept to a minimum.
Bench Housing First is committed to these principles. We are fortunate here in Lewisham that our collaboration with Lewisham Council means we have access to social housing. Given the housing crisis and the high cost of private rents, this is a great blessing and since we started in 2014, all except one of the 40 tenancies we have helped create have been social tenancies.
I am amazed at the resilience of our Housing First team. They enjoy sharing in the successes of the project – seeing people settle into their homes, being reunited with their families, taking care of their grandchildren – but they also experience the pain of seeing people being abused, threatened, disrespected; the pain of watching people they care about putting themselves at risk through drugs and alcohol, the pain of watching people in acute mental turmoil and the pain of watching people die. We have seen a number of people die in the service. It was not an outcome we considered when we started, but in many ways it is a consolation that they died with some dignity in their own homes. We are proud of Bench Housing First and the support we provide, but if we can offer nothing else, we are able to offer the dignity of a home in life and in death.
For more information about Bench Outreach’s Housing First, visit https://www.benchoutreach.com/housing-first.
