Housing First - Provincie West-Vlaanderen

do not offer any choice about where to live, the‘housing’ is only accessible to people using theservice and is physically separated from the rest ofthe community because it is in one or more purposebuilt or converted buildings. Staff providing serviceswill also often be on site. From some perspectives,these services are delivering ‘housing’ stability, fromothers, such as that of Sam Tsemberis, the founderof PHF, these services are not actually offering whatmost ordinary citizens would recognise as ‘housing’and therefore only delivering ‘accommodation’stability 86 .In Finland, success has been reported in creatinggreater stability in housing or accommodation forlong term homeless people. Again, it is importantto note that Finnish services that follow a CHFmodel may offer long term, secure, tenure that isnot always intended to be permanent. There can beencouragement for some service users to move onto fully independent apartments in the community.Since the introduction of a ‘Housing First’ strategyin Finland, overall levels of long-term homelessnesshave either been reduced, or been halved, in theparticipating municipalities 87 . However, it has alsobeen noted that some of the reports of higher ratesof stability are anecdotal and that there are not asyet extensive data showing sustained stability inaccommodation or housing 88 .Changes in Drug and Alcohol UseThe research available on CHF services in theUS suggests a pattern of stabilisation and at leastsome reduction in drug and alcohol use, which issimilar to the results reported for PHF. Two studiesfound that CHF services that allowed chronicallyhomeless people to drink alcohol in their rooms sawthis pattern, but again, did not report that alcoholconsumption had actually stopped among mostservice users. 89Evidence on the Finnish experience is mixed. Somereports suggest that there has been a reductionin alcohol consumption in some CHF servicesin Finland 90 . Other research has indicated thatmanagement of high levels of drug and alcoholuse among some residents of CHF services hassometimes been problematic, in that tolerance of highlevels of drug and alcohol use in what is communalhousing has sometimes been difficult to manage.There are some concerns about high rates of drugand alcohol use in blocks of CHF apartments and it isbeing suggested that more provision should be madeto enable people to move away from CHF servicesand into their own independent apartments 91 . Thesearguments are linked to a possible limitation of CHFservices in respect of drug and alcohol use, theevidence that exposure to high levels of use (andtherefore to various sources of supply) can makereduction and recovery from problematic alcoholand drug use more difficult for some people 92 .Changes in mental healthUS research does not suggest that CHF servicesdeliver significant improvements in mental health,although there is no evidence to suggest that mental3086 Tsemberis, S. (2011) Observations and Recommendations on Finland’s “Name on the DoorProject” From a HousingFirst Perspective Housing First Finland http://www.asuntoensin.fi/files/1242/Tsemberis_2011_-_Observations_and_Recommendations.pdf87 Kettunen,M. and Granfelt, R. (2011) Observations from the first year of the Finnish Name on the door project –recommendations for the long-term homelessness reduction programme for years 2012-2015 http://www.housingfirst.fi/en/housing_first/reading_room/general_reading/observations_and_conclusions/ Note: While the programme has had aspecific effect in reducing long-term homelessness, overall homelessness levels in Finland have not yet fallen.88 Busch-Geertsema, V. (2010) op cit.89 Larimer, M.E. et al (2009) op cit; Collins, S.E. et al (2011) op cit.90 Luomanen, R. (2010) op cit, p. 31.91 Kettunen,M. and Granfelt, R. (2011) op cit.92 Pleace, N. (2008) op cit.