Housing First - Provincie West-Vlaanderen

homeless people were being helped by expensivestaircase services that took quite a long time toachieve results 13 . Research in Europe has reportedvery similar problems with staircase services incountries that include Sweden 14 . The experienceof homeless people using staircase services canbe one of a series of disruptions or ‘ruptures’ asthey move between ‘steps’ in a programme andhave to readjust to a new living environment withnew rules several times before they are eventuallyable to have a settled home. This can mean thathomeless people never feel secure while they arein the staircase, because each step except the laststep (if they progress that far) is not a permanenthome, i.e. they are unable to settle because theyknow each step is temporary.There is a view that homeless people are maintainedin an insecurity regarding their accommodation aswell as their social network by staircase services.The whole system of support bases progression upthe staircase on the individual effort that the personmakes. The person must “earn” housing throughbehaviour, conformity, and engagement with care. Insystems of care in collective shelter/accommodation,people develop skills for group living. But once theyeventually reach independent housing, it will beindividual and personal skills that they require 15 . Ifunsuccessful in the progression up the staircase,the person feels individually responsible for failingto maintain their efforts. In this view of the staircasesystem, it is not the nature of the support that isbeing questioned but the failure of the person.All observations show that one of the constantsamongst homeless people is a severing of all socialties. The staircase system causes ruptures with theneighbourhood, social workers etc at each step,contributing to instability.What is Pathways Housing First?The Pathways Housing First service, founded byDr Sam Tsemberis, first appeared in New Yorkin 1992 16 Pathways Housing First (PHF) has thefollowing key characteristics 17 :❱❱provides independent housing with security oftenure immediately or as soon as possible to achronically homeless person.❱❱provides support designed to promote housingstability and service brokerage to connectchronically homeless people to essential services❱❱directly provides psychiatric, drug and alcohol,social work and medical services. The teamproviding this support is mobile and visits peopleusing the service in their homes or at otheragreed locations.❱❱gives considerable choice and control tochronically homeless people by following a harmreduction model. Chronically homeless peoplecan chose not to use the psychiatric and drugand alcohol services that are made available byPHF and can still remain in the housing providedby PHF. This is called a ‘separation’ of housingand support.1013 Devine, J. A., Brody, C.J. et al (1997) ‘Evaluating an alcohol and drug treatment program for the homeless: Aneconometric approach’ Evaluation and Program Planning 20, 2, pp. 205-215; Pleace, N. (2008) Effective Servicesfor Substance Misuse and Homelessness in Scotland: Evidence from an international review Edinburgh: ScottishGovernment.14 Sahlin, I. (2005) op cit.; Busch-Geertsema, V. and Sahlin, I. (2007) op cit.15 Tsemberis, S. and Stefancic, A. (2007) ‘Housing First for Long-Term Shelter Dwellers with Psychiatric Disabilities in aSuburban County: A Four- Year Study of Housing Access and Retention’ American Journal of Public Health 28, pp.265-279.16 Ridgway, P. and Zipple, A.M (1990) Ibid; Tsemberis, S. (2010a) Housing First: The Pathways Model to End Homelessnessfor People with Mental Illness and Addiction Center City, Minnesota: Hazelden.17 Tsemberis, S. (2010b) ‘Housing First: Ending Homelessness, Promoting Recovery and Reducing Costs’ in I. Gould Ellen andB. O’Flaherty (eds) How to House the Homeless Russell Sage Foundation: New York.