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Evaluation of the Danish Homelessness Strategy: Mixed Results

FEANTSA
FEANTSA

Lars Benjaminsen's presentation in the "National Strategy on Homelessness - Key to Success or Pitfall?" workshop at the FEANTSA Annual European Policy Conference on the 10th of June 2016.

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Presentation Title
Speaker’s name
Presentation title
Speaker’s name
The Danish Homelessness Strategy
– explaining mixed results
Lars Benjaminsen
The Danish National Centre
for Social Research
Structure of presentation
• The Danish homelessness strategy
- housing provision
- floating support
- results
• Development in homelessness in Denmark in
the programme period
• Explanations of mixed results
Danish Homelessness Strategy 2009-2013
• Housing First as overall principle
• Test whether Housing First works in a Danish context
• Develop evidence based floating support methods - Assertive
Community Treatment, Intensive Case Management, Critical
Time Intervention
• Implement a mindshift away from Treatment First to Housing
First on policy level, in organisation and daily practice
• 65 mill. € from central government
• 17 municipalitites (out of 98) participated in the 2009-2013
programme
• 24 municipalities in follow-up programme 2014-2016
• Third round 2017 ambition to involve more municipalities
Housing provision for HF programme
Mainly public housing (21 % of housing stock)
Public housing is for everybody regardless of income level – general
waiting lists
Municipalities have a right to use one out of four vacancies for social
purposes – e.g. for people in acute housing need
The priority access system has been an institutionalised mechanism to
allocate housing for the Housing First programmes in municipalities
Challenges:
General supply shortages
Too high rent levels in parts of the public housing stock
Many groups ‘compete’ for priority access – the homeless, single parents,
handicapped, etc.
Sometimes tradition of Housing ready approach in housing allocation
Floating support programme
Assertive Community Treatment (ACT) Multidiciplinary support team – social
support workers, nurse, psychiatrist, addiction treatment specialist, social office
worker, job office worker
Target group: People with highly complex support needs and great difficulties in
using mainstream services, and in need of long-term support
Intensive Case Management (ICM) Case manager – social and practical support
and coordination of use of other services. Intensive support
Target group: People with considerable support needs and difficulties in using
mainstream services, and in need of long-term support
Critical Time Intervention (CTI) Time-limited case management (9 months) –
social and practical support and coordination of use of other services. 3 phases of 3
months
Target group: People with support needs who are partly able to use mainstream
services, but who need support for a while in doing so, and who mainly need
support in the transition phase from shelter to own housing.
Results from the first programme
(2009-2013)
• Housing First works for most homeless people – 9 out of 10 who were
housed in the programme maintained their housing (no control groups –
no RCT)
• People whom we never thought could have been housed were housed
• We cannot predict in advance who will fail – Housing First should be
default
• Better experiences with independent scattered housing than with
congregate housing

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Evaluation of the Danish Homelessness Strategy: Mixed Results

  • 1. Presentation Title Speaker’s name Presentation title Speaker’s name The Danish Homelessness Strategy – explaining mixed results Lars Benjaminsen The Danish National Centre for Social Research
  • 2. Structure of presentation • The Danish homelessness strategy - housing provision - floating support - results • Development in homelessness in Denmark in the programme period • Explanations of mixed results
  • 3. Danish Homelessness Strategy 2009-2013 • Housing First as overall principle • Test whether Housing First works in a Danish context • Develop evidence based floating support methods - Assertive Community Treatment, Intensive Case Management, Critical Time Intervention • Implement a mindshift away from Treatment First to Housing First on policy level, in organisation and daily practice • 65 mill. € from central government • 17 municipalitites (out of 98) participated in the 2009-2013 programme • 24 municipalities in follow-up programme 2014-2016 • Third round 2017 ambition to involve more municipalities
  • 4. Housing provision for HF programme Mainly public housing (21 % of housing stock) Public housing is for everybody regardless of income level – general waiting lists Municipalities have a right to use one out of four vacancies for social purposes – e.g. for people in acute housing need The priority access system has been an institutionalised mechanism to allocate housing for the Housing First programmes in municipalities Challenges: General supply shortages Too high rent levels in parts of the public housing stock Many groups ‘compete’ for priority access – the homeless, single parents, handicapped, etc. Sometimes tradition of Housing ready approach in housing allocation
  • 5. Floating support programme Assertive Community Treatment (ACT) Multidiciplinary support team – social support workers, nurse, psychiatrist, addiction treatment specialist, social office worker, job office worker Target group: People with highly complex support needs and great difficulties in using mainstream services, and in need of long-term support Intensive Case Management (ICM) Case manager – social and practical support and coordination of use of other services. Intensive support Target group: People with considerable support needs and difficulties in using mainstream services, and in need of long-term support Critical Time Intervention (CTI) Time-limited case management (9 months) – social and practical support and coordination of use of other services. 3 phases of 3 months Target group: People with support needs who are partly able to use mainstream services, but who need support for a while in doing so, and who mainly need support in the transition phase from shelter to own housing.
  • 6. Results from the first programme (2009-2013) • Housing First works for most homeless people – 9 out of 10 who were housed in the programme maintained their housing (no control groups – no RCT) • People whom we never thought could have been housed were housed • We cannot predict in advance who will fail – Housing First should be default • Better experiences with independent scattered housing than with congregate housing
  • 7. Challenges • Scarce supply of affordable housing for allocation – not enough units and too high rent levels in parts of the public housing stock • Income/welfare benefits are not sufficient to meet the increasing gap to rent levels – especially for young people • Scaling up is difficult – municipalities are reluctant to finance the intensive floating support services out of their own budgets when central government programme funding runs out • Challenges of coordination – within municipalities and with local actors – e.g psychiatric services on regional level • Mainly use of CTI and ICM, a particular challenge to get municipalities to use ACT
  • 8. Increase in homelessness during strategy period Homelessness situation Week 6, 2009 Week 6, 2011 Week 6, 2013 Week 6, 2015 Rough sleepers 506 426 595 609 Emergency night shelter 355 283 349 345 Shelter 1.952 1.874 2.015 2.102 Hotel 88 68 70 113 Familiy and friends 1.086 1.433 1.653 1.876 Short term transitional 164 227 211 178 Release from prison with no housing 86 88 64 90 Release from hospital with no housing 172 173 119 138 Other 589 718 744 687 Total 4.998 5.290 5.820 6.138
  • 9. Large increase in youth homelessness Age 2009 2011 2013 2015 % 09-15 <18 200 204 144 96 -52 18-24 633 1.002 1.138 1.172 85 25-29 490 596 617 799 63 30-39 1.221 1.155 1.189 1.261 3 40-49 1.357 1.263 1.414 1.423 5 50-59 744 734 833 951 28 60+ 235 232 289 301 28
  • 10. Largest increase in cities 2009 2011 2013 2015 % 09-15 Copenhagen 1.494 1.507 1.581 1.562 5 Frederiksberg 233 203 178 226 -3 Copenhagen suburbs 701 1.028 1.341 1.364 95 Aarhus 466 588 617 668 43 Odense 208 178 110 173 -17 Aalborg 218 231 259 241 11 Medium sized towns 1.056 1.053 1.198 1.300 23 Rural areas 622 502 536 604 -3 Total 4.998 5.290 5.820 6.138 23
  • 11. Paradoxical results… • Can a programme be regarded as succesful when homelessness increases? • Caution not to confuse results on individual and aggregate level • Succesful interventions but structural barriers and challenges • Housing First works but cannot solve the housing affordability crisis or counteract consequences of welfare benefit reforms…
  • 12. General learnings • Problem that most homelessness programs/strategies are particularistic – model projects, testing of methods etc. • Decoupling of the homelessness problem from general housing and welfare problems – housing shortages, benefit levels • Negative/unintended consequences of general welfare reforms are not sufficiently taken into account in the formation and rethoric about homelessness programmes/strategies