Access all recordings from the Fourth International Housing First Conference.
The Fourth International Housing First Conference was held virtually on October 5 - 7, 2021, with a goal to enhance capacity to implement Housing First programs in Canada and internationally with a high level of fidelity to the Pathways Housing First model. View the conference program.
The Future of Housing First
Sam Tsemberis
While Housing First has clearly been established as an evidence-based practice that ends homelessness and promotes quality of life, less is know about its impacts on other life domains or why it is more widely disseminated in some countries than in others. This presentation focuses on the future of Housing First and ways we can improve its impact and dissemination
Closing keynote: The Future of Housing First from EENet on Vimeo.
Download the presentation summary [PDF].
Concurrent Block 4
Session 16: Housing First in the UK and Ireland: Challenges and opportunities (Ligia Teixeira, Bob
Jordan, Marion Gibbs, Allan Jones, Jo Prestidge, Alex Osmond)
This is a pivotal time in the transition of Housing First toward becoming the default in the UK and the Republic of Ireland for individuals whose homelessness is made much harder by experiences such as trauma and substance misuse. This session is an opportunity to learn about developments in different UK nations such as Scotland and England as well as the Republic of Ireland. From pilots to scale up, a common challenge appears to be to fully test, learn and improve as we go.
Housing First in the UK and Ireland: Challenges and opportunities [Vimeo].
Session 17: HF for people with developmental disabilities (Moderator: James Lachaud)
- Just Enough Support: Partnerships for the Inclusion of People with Intellectual Disabilities in Welcoming Nonprofit Housing Communities (Keenan Wellar, Julie Kingstone)
- LiveWorkPlay supports people with intellectual disabilities to live in homes of their own, with the supports they need, with autonomy and choice. The organizations is focused on support, and has no role as a housing provider, which is an atypical model of support for this population (the dominant model in many jurisdictions worldwide is for agencies to serve as both landlord and service provider, typically through group living).
The support model itself, which we call “Just Enough Support” – is very consistent with both Pathways and Core Principles. It is comprised of seven principles grounded in person-centred practices and the neuroscience of inclusion: Principle 1 = Honouring Personal Autonomy; Principle 2 = Person-Centred Thinking; Principle 3 = Authentic Valued Roles; Principle 4 = Always Building Bridges; Principle 5 = Community First Approach; Principle 6 = Assets-Based Solutions; Principle 7 = Barrier-Busting Tech.
- LiveWorkPlay supports people with intellectual disabilities to live in homes of their own, with the supports they need, with autonomy and choice. The organizations is focused on support, and has no role as a housing provider, which is an atypical model of support for this population (the dominant model in many jurisdictions worldwide is for agencies to serve as both landlord and service provider, typically through group living).
- Building Bridges to Housing – Adapting Housing First Practices For Homeless Individuals with Intellectual and Developmental Disabilities (Judy Verseghy, Barry Isaacs, Jo Connelly, Sarah Farsalas). Download the presentation summary [PDF].
- Bridges to Housing (B2H) is a modified Housing First (HF) program, aimed at supporting people with intellectual and developmental disabilities (IDD) experiencing homelessness.
B2H differs from most HF programs in the degree and intensity of supports that are provided. Clients receive flexible, cross-sector, multidisciplinary, high intensity ‘wrap around’ care from representatives from the homelessness, health, and developmental services sectors who work closely together to support clients. Supports offered include a housing case worker, Adult Protective Service Worker, and family health team which offers primary care, psychiatry, nurse practitioner, neuropsychology, social work and recreational therapy services, occupational and behavioural therapy services, and a peer support worker.
- Bridges to Housing (B2H) is a modified Housing First (HF) program, aimed at supporting people with intellectual and developmental disabilities (IDD) experiencing homelessness.
HF for people with developmental disabilities [Vimeo].
Session 18: Predictors of housing instability among recipients of Housing First (Maryann Roebuck, Aurelie Tinland, Sandrine Loubière, Ayda Agha; Moderator: Tim Aubry)
Presenters will share findings of two studies examining individual characteristics associated with housing instability after 24 months of receiving HF. In order to compare findings across countries, the same analyses will be employed with study samples from Canada (At Home/Chez Soi) and France (Un chez soi d’abord). Both HF implementations had high fidelity to Pathways HF, with France also aligning with Europe HF Hub principles. Hierarchical logistic regressions will be used to determine predictors of people experiencing unstable housing at 24-months. Housing instability is defined as being housed less than 90% in the last 6 months of the 24-month period. Presenters will also share findings of a follow-up qualitative analysis of a sub-sample of study participants. Qualitative ratings of life changes in relation to housing instability, and factors that differentiate those who are stably housed and those who are unstably housed, will be examined.
Predictors of housing instability among recipients of Housing First [Vimeo].
Session 19: Understanding how Housing First affects costs (Eric Latimer; Moderator: Vanesa Cenjor del Rey)
Understanding how Housing First affects costs [Vimeo].
Session 20: Achieving fidelity in HF (Moderator: Lisa Medd)
- Balancing Fidelity and Adaptation: Collaborative Housing First Fidelity Assessment- a Pilot Approach (Kathryn Gibb, Pio Giralico, Geoff Nelson). Download the presentation summary [PDF].
- HF program fidelity, or adherence to the principles and practices of the Pathways model, is important for ensuring positive outcomes for participants in HF programs. In this session, we will review the components of fidelity assessment, supporting evidence, and outcomes from HF Fidelity. Domains and items of a measure of the program fidelity exchange model will be explained, including: observation of a program meeting, staff interviews, participant focus groups, and chart review.
Participating programs from this initial pilot, CMHA Toronto and Home for Good in Peel, will review the benefits and learnings from this approach, sharing how the teams prepared for the exercise and how it informed subsequent planning and quality improvement initiatives.
- HF program fidelity, or adherence to the principles and practices of the Pathways model, is important for ensuring positive outcomes for participants in HF programs. In this session, we will review the components of fidelity assessment, supporting evidence, and outcomes from HF Fidelity. Domains and items of a measure of the program fidelity exchange model will be explained, including: observation of a program meeting, staff interviews, participant focus groups, and chart review.
- Fidelity Findings from the Arrels Foundation Housing First Programme in Barcelona, Spain (Francesc Guasch)
- Arrels Foundation is one of the oldest homeless service organisations in Barcelona, and is one of the main promoters of Housing First in Catalonia, Spain. The programme was launched in 2015 and one year later, Arrels Foundation evaluated programme fidelity for the first time. Results indicated higher fidelity scores in the Separation of Housing and Services domain and lower scores in the Service Array domain. Barriers to fidelity were identified in the domains of Services Provision, Team Structure, Housing Processes and Structure. Analysis also underlined the benefits of local adaptations for programme fidelity. These findings provide context and perspective for comparison with other Housing First implementations and demonstrate how the programme is sufficient, sustainable, and effective in improving quality of life for adults with histories of homelessness and complex support needs.
Achieving fidelity in HF [Vimeo].
Concurrent Block 5
Session 21: The Restart Project: The experiences and contributions of a youth with lived experience advisory committee (Maritt Kirst, Karleigh Darnay, Harmony Eshkawkogan, Lauren Luliani; Moderator: Al Wiebe)
Session 22: Achieving recovery in HF (Moderator: Maryann Roebuck)
- Creating a home - building the foundation for health and well-being (Haley Bowman, Beth Fogerty). Download the presentation summary [PDF].
- Wellways Doorway program is a Housing First program adapted from Pathways and set in the Australian context. One of the key aspects of the support provided in Doorway is the importance of the Housing and recovery worker role. This role combines the usually separate support roles of Housing worker, focusing on securing a home and building tenancy literacy and the Recovery worker, who focuses on the skill development and connections that support health and wellbeing. In combining these elements of housing and recovery into an integrated role, the participant of Doorway has a single point of contact and support and an intrinsic wrap-around support.
This presentation seeks to explore with participants the housing recovery worker role and its efficacy in supporting participants to not only build their homes, but build foundations for the future.
- Wellways Doorway program is a Housing First program adapted from Pathways and set in the Australian context. One of the key aspects of the support provided in Doorway is the importance of the Housing and recovery worker role. This role combines the usually separate support roles of Housing worker, focusing on securing a home and building tenancy literacy and the Recovery worker, who focuses on the skill development and connections that support health and wellbeing. In combining these elements of housing and recovery into an integrated role, the participant of Doorway has a single point of contact and support and an intrinsic wrap-around support.
- Operations & Innovations: Facilitators and Challenges to Promoting Housing First Clients’ Well-being and Connectedness (Dr Ronni Michelle Greenwood). Download the presentation summary [PDF].
- In this panel presentation, we draw on findings from a multi-country investigation of Homelessness as Unfairness ("Home_EU”) and the Irish National Housing First (NHF) implementation to identify key facilitators and challenges to delivering support services that promote HF clients’ well-being (mental health, physical health, substance use) and connectedness (relationships with family, friends, case managers, and neighbours). We draw on data collected by the Home_EU Study Consortium from homeless services users in eight European countries to identify capability-enhancing operational features and describe how these features support recovery of personal freedoms in valued life domains. We will end our presentation with an integrative synthesis of these findings and their implications for policy, practice, and future research directions.
Achieving recovery in HF [Vimeo].
Session 23: Frameworks, relationships and real-world challenges (Claire Frew; Moderator: Cilia Mejia-Lancheros)
Frameworks, relationships and real-world challenges [Vimeo].
Download the presentation summary [PDF].
Session 24: Scaling up HF in European cities (Moderator: Eric Latimer)
- Housing First scale-up as a long-term and health response to tackle chronic homelessness during COVID-19 pandemic (Cristiana Merendeiro)
- CRESCER is a NGO with 20 years of experience working with vulnerable groups in outreach settings, providing harm reduction and other services for more than 2,000 people/year.
É UMA CASA, Lisboa Housing First program was implemented in 2013 as a response for people experiencing chronic homelessness and using licit and illicit drugs. Based on Housing First methodology, this program guaranteed its maximum fidelity through the years. Started as a pilot of 7 individualized and scattered houses, scaled-up from 30 to 120 during COVID-19 pandemic as a strategy to answer the needs of people especially vulnerable to the virus.
The program is a long-term and relationship-based response, where tenants guide their own recovery, being partners in advocating for the human right to housing. Staff includes peer-specialists who help maintaining a client-driven approach, offering live examples of recovery.
- CRESCER is a NGO with 20 years of experience working with vulnerable groups in outreach settings, providing harm reduction and other services for more than 2,000 people/year.
- La mise à l’échelle du Logement d’abord sur la métropole lyonnaise : enjeux et épreuves pratiques / The scaling up of Housing First in the Lyon metropolis of Lyon: issues and practical (Nadyah Abdel Salam, Martine Chanal, Étienne Fabris)
- En France, les principes du Logement d’abord s’incarnent dans le programme démonstrateur Un Chez Soi d’Abord qui s’adresse spécifiquement aux personnes sans-abri avec un long parcours de rue et des troubles psychiatriques sévères. Ils inspirent aussi une stratégie nationale pour réformer le système d’hébergement et d’accès au logement des personnes sans-domicile, avec des territoires où les collectivités territoriales se portent volontaires pour copiloter avec l’État, cette réorientation annoncée de l’action publique. La métropole lyonnaise est l’un de ces territoires de mise en œuvre accélérée du Logement d’abord.
Scaling up HF in European cities [Vimeo].
Session 25: Homelessness policy in different countries (Geoffrey Nelson, Eoin O’Sullivan, Sam Tsemberis; Moderator: Tim Aubry)
In this panel, we discuss three examples of policy change. First, in Canada, based in large part on the successful results of a large-scale Housing First (HF) initiative decided that 65% of its funding would go to HF across Canada. However, the new government quickly regressed back with no mention of HF and only a commitment to reducing chronic homelessness by 50% in 10 years in its subsequent National Housing Strategy. Second, in Europe, the Portuguese EU Presidency released a Declaration on the European Platform on Combatting Homelessness that commits all 27 member states of the EU to ending homelessness by 2030, with the provision of permanent housing. Third, the National Center on Veterans Homelessness advocated for and trained VA medical Centers in HF. The HUD-VASH program remains the largest and most effective federal initiative addressing chronic homelessness among veterans, reducing veterans’ homelessness by 56%. We draw lessons from these three examples for homelessness policy change.
Homelessness policy in different countries [Vimeo].
Download the presentation summary [PDF].