Ending Homelessness, Housing and Support

Felicity Reynolds, CEO

The Mercy Foundation

Philanthropic Foundation established by the North Sydney Sisters of Mercy in 1990

Now - focus on homelessness: more specifically ending homelessness.

Special interest in women who are homeless. We advocate, educate, develop through

partnership and make grants (GEH; Small grants; Partnership projects).

We are not a direct service provider.

Mercy Foundation Grants Grants to End Homelessness– EOIs closed last

week. About giving ‘strategically’ and to evidence

based, outcomes focused initiatives that prevent or end people’s homelessness.

A good example of a grant we made in 08/09 is to Marist Youth Care – Affordable Housing for Life. A relatively small grant ($<100,000) helped to leverage more funding (jobs stimulus almost $2million).

A few important points

My background is mostly in disability, adult mental health and in health research.

No expertise (or experience) in youth homelessness.

I do have some expertise (and experience) in adult chronic homelessness.

A passion for programs and responses that end people’s homelessness.

Hmmmmm………..

Perhaps I’m not an obvious choice to speak at a conference about youth homelessness.

But I thank YAA for inviting me and I hope that some of my observations; my knowledge of some research and my interest in solving homelessness may be of some use to you.

What I will talk about today A few observations from North America

(Churchill Fellowship study – reported 2008). The arguments for ending homelessness. Permanent supportive housing to end

homelessness for those who have experienced it long term.

Common Ground – an example of PSH. Pathways to Housing - another example. Some possible lessons for responding to youth

homelessness – including an overview of the Foyer approach.

What I hope will happen

We will talk together, as colleagues who are all interested in solving homelessness for young people.

Take what you want……and leave the rest. Any observations and conclusions are

mine….and I acknowledge that we need to adapt any programs and models to our own contexts.

I welcome feedback and robust discussion.

First….the USA….and a few things I didn’t much like……

Some additional things I have problems with……. Inadequate welfare safety net. No universal health care coverage. High rate of homelessness. Capital punishment. Guns Disparity between rich and poor. Their coffee.

Now…..a few things I did like

Before moving on

One of the strangest organisations I visited in Canada

Solving homelessness 3 essential arguments

COSTS

ETHICS

RESULTS

The costs argument

Costs the same, if not more, to continue to service homelessness than to solve it.

Numerous studies have shown this (eg. Culhane - $US 41,000 per year).

65 costs studies done by cities in the USA – results are counter intuitive (Million Dollar Murray).

People who have to get their needs met through crisis based and emergency services (ambulances, EDs, acute units, IPUs, interaction with courts, police etc) can cost more than people who are permanently housed and provided ongoing support services.

The ethical argument A very significant proportion of the chronically

homeless population have one or more of the following conditions: Mental illness Substance dependence Dual diagnosis History of trauma and PTSD Brain injury; cognitive problems; behavioural

disturbances Literacy problems Vulnerable and poor.

The results argument

Although chronic homelessness represents a small share of the overall homeless population, chronically homeless people use up more than 50 percent of the services (for single homeless adults). The most successful model for housing people who experience chronic homelessness is permanent supportive housing using a Housing First approach.

(National Alliance to End Homelessness, Washington DC).

Solving chronic adult homelessness We have discovered a solution to chronic

homelessness and it is called ‘permanent supportive housing’.

This is not a complex model to grasp. If you don’t believe me, check with people who

are homeless – Toronto survey (over 95% wanted help to find a place to live).

Housing First means exactly what it says. Housing first provides a level of stability to deal with problems. Lots of evidence (Tsemberis)….more about this a bit later.

But we must plan to end homelessness (it won’t just happen)

Planning to end homelessness – now more than 400 city plans in US; Canada also now doing 10 year plans to end homelessness. UK – rough sleepers initiative also had success (Steph will talk more about this soon – and give it some local context).

US plans focus on local areas and have public and private partnerships – the whole community owns the plan. USA has reported reductions nationwide.

11 key elements of success HUD notes 11 key elements to successfully reduce

chronic homelessness. The first five of these are considered essential elements for success. They are: Paradigm shift Clear goal set Community wide approach Organisational structure and leadership specifically for reducing chronic

street homelessness Mainstream agency involvement Trigger event Private sector involvement Local elected official commitment Progress tracking mechanism New approaches to services Strategy to combat NIMBY (Not in my back yard)

Results oriented activities Use of enumeration methodologies (counts) in order to

measure success. (Break down that 105,000 figure into more manageable local statistics).

Increased research and use of evidence based interventions (eg. Now clear evidence that the same outcomes are achieved for families who go straight to permanent housing, as opposed to transitional housing first).

Consumer focus – what do people want? (not, what is it we can we provide?)

Focus on most vulnerable and complex (chronically homeless). Can’t do everything at once – help the hardest first and the rest looks a bit easier.

But also ensure all other parts of system working (eg. Prevention; help for families etc).

A few good service examples

Permanent supportive housing Common Ground (description next slide) Pathways to Housing – using ACT Street to Home (Toronto)

Housing first (can be adapted to a range of models)

Safe havens and residential managed alcohol programs (low threshold services)

Key components of the Common Ground model Permanent supportive

housing High quality housing and

close to services Safe for vulnerable people

– 24 hour concierge. Connected to community Landlord is not the

support provider Mixed tenancies – social

and affordable. (Sydney project)

Common Ground – limitations

An urban model. Fairly large developments – to achieve

economies of scale for on-site support. Probably not the best model for young

people (under 21?). Additional things need to happen at this age (not just housing and support).

Pathways to Housing

Key components: Housing First. No need to be ‘housing ready’. No specific buildings – mainly head leased (and

recommend no more than 20% clients in any one building).

Consumer focused and driven. Few rules - Need to pay 30% income in rent;

accept visits. Thanks to Dr Sam Tsemberis for some of the following slides about PTH.

Annapolis & BaltimoreMD

Hartford CT

Pathways’ Housing First Programs in the USA & Canada

Worcester, MA

Oakland, CA Salt Lake City, UT

Denver, CO

Chattanooga, TN

Charlotte County, FL

Philadelphia PA

NYC

Housing First Sites that received technical assistance from Pathways to Housing, Inc

Washington DC

Housing First Sites established 2003-2007

ColumbusOH

Richmond, VA

Portland, OR

Seattle, WA

Chicago, IL

Calgary

Toronto

Los Angeles, CA

Fort Lauderdale, FL

Current SystemHousing and service programs: A series of steps (I prefer the term ‘hoops’)

Permanent

HousingTransitional

Housing

Drop-in,

Shelter

Outreach

Eligibility criteria for supportive housing: (NYC Survey of providers in 2005)

Clean time –92.5% of providers require Insight into mental illness Compliance with treatment Credit checks (similar exclusions here

in NSW if money owed to service).

3 Assumptions of the Housing Readiness (or treatment first) Model

Referrals between agencies work – they don’t. Learning to live in congregate settings prepares

you for independent living – it doesn’t. People need to be psychiatrically stable and

clean and sober before before they can manage independent apartments.

(Reference – Sam Tsemberis)

Housing First Ends Cycling Through Acute Care Systems Permanent Supported Housing ends

homelessness for people cycling throughout the “institutional circuit”

Stopping this cycle has cost implications – as noted earlier.

4 essential elements ofHousing First Consumer Choice Separation of Housing and Services Recovery Orientation Effectiveness

What do consumers want?Housing, first! When asked, almost every person who

is homeless (w or w/o mi) says they want housing first;

Will accept immediate access to permanent independent housing; a place of their own

Do not want to participate in psychiatric treatment or attain a period of sobriety as a precondition for housing

Housing FirstHonors Consumer Choice

Once housed, consumers continue to choose the type, sequence and intensity of services (or no services).

All must agree to weekly visit.

Consumer choice as a continuous process in Housing First programs

Choices include the right to risk; people make mistakes and learn from that experience, dignity of failure.

Continued practice in making choices leads to making the right choices and the experience of success.

PSH (be it CG or other) models – what are some lessons for assisting young people who are homeless?

Provide a safe environment as soon as possible (with few pre-conditions).

Consumer focus and consumer choice (with some clear rules and boundaries).

Stability and consistency. Separate the housing management and the

support. There are probably others....any suggestions?

A bit about Foyer Not so much a ‘model’ as an approach (or a

philosophy). Originated in post-war France – help young

people adapt/connect with community from rural to urban areas – for jobs and training.

Focus is on education/training/connectedness. Although different to adult models just described

– it is not about PERMANENT housing. For this group – I agree.....why?

Why transitional housing is ok for younger people I think transitional housing models can be

de-stabilising for adults. However – for young people it is less

about a ‘roof ‘ and more about skills, education, connecting with peers and community.

Get these right and the result can be a stable housing career.

Foyer and the ‘magic mix’

Foyer in the Netherlands refer to the ‘magic mix’.

This about ensuring a good mix of young people – not all young offenders living together; not all troubled young people together. This is not normalising – this is not what communities are made up of.

Foyer – now included in Common Ground NYC CG NYC have now introduced Foyer for younger

people (who may choose afterwards go on to permanently live in CG buildings).

Saw link between young people in foster care graduating to homelessness.

The Foyer program provides educational, employment, and mentoring support in a residential setting to enable young people to create stable, independent lives.

Foyer in Australia

Lots happening (a number of projects in different States).

Foyer Foundation Australia (set up similar to Foyer Federation in UK).

We need to adapt to Australian conditions (just as UK, the Netherlands and USA have done).

Take home messages

Vision to end homelessness – but must plan – include prevention, early intervention and PSH.

PSH – many models. They end homelessness.

Key elements for young people – education and mentoring and connecting with community. Foyer is a good example.

Further information

Felicity Reynoldsexecutive@mercyfoundation.com.auwww.mercyfoundation.com.au

Phone: 02 9699 8726