Housing First - Provincie West-Vlaanderen

Delivering a Pathways HousingFirst ServiceThere is extensive guidance on the delivery of aPHF service in the ‘manual’ written by the founderof PHF, Sam Tsemberis, which is entitled HousingFirst: The Pathways Model to End Homelessnessfor People with Mental Illness and Addiction 27 . Inaddition, guidance is available on the Pathwayswebsite 28 .This section provides a summary overview ofthe operation of PHF, including information on thefollowing areas:❱❱Which groups of homeless people is a PHFservice designed to help?❱❱What are the aims of a PHF service?❱❱How is the service accessed?❱❱How is a PHF service delivered?❱❱What does a PHF service cost?❱❱Risk managementWhich groups of homeless people isPHF designed to help?PHF is targeted only at chronically homeless people.The needs, characteristics and experiences ofchronically homeless people can include:❱❱A disrupted childhood and/or experience of thechild care system.❱❱Problematic/addictive use of drugs, includingillegal drugs❱❱Problematic drinking of alcohol (i.e. unhealthy ordangerous levels of consumption).❱❱Severe mental illness, i.e. psychiatric conditionsthat are severe enough to impede capacity tolive independently, secure and sustain work andwhich in some instances might represent a riskto an individual or to those around them.❱❱Low level criminality, including ‘survival’ crime tofeed and clothe themselves and also crime tosustain problematic drinking and/or drug use.❱❱Nuisance behaviour, sometimes linked to lowself esteem, poor mental health and to drug andalcohol use.❱❱Poor physical health, linked to poor diet, alcoholand drug consumption, poor physical environment(i.e. living on the street and in emergencyaccommodation for sustained periods).❱❱Sustained worklessness, linked to low educationalattainment, health and support needs.❱❱Alienation from mainstream society linked to poorself-image and low self-esteem and sustainedexclusion from ordinary social and economic life.❱❱Repeated and sustained homelessness.What are the aims of a PHF service?PHF is ‘housing first’ but it is not ‘housing only’.Through a harm reduction led philosophy thatemphasises choice and control for the people usingthe PHF service, a series of goals are pursued:❱❱Housing stability, including developing the capacityof formerly chronically homeless people to livelargely or wholly independently over time.❱❱Reductions and where possible cessation ofproblematic drug and alcohol use.❱❱Reductions in criminal behaviour (if present).❱❱Reductions in severe mental illness and othermental health problems among service users.❱❱Improvements in physical health by emphasizingwell-being and ensuring contact with medicalservices where necessary.❱❱Reengagement with normal social and communitylife, developing friendships, re-establishing familyties where possible and developing and sustainingsuccessful personal relationships.1427 Tsemberis, S. (2010a) op cit.28 www.pathwaystohousing.org