The 'casas primeiro' program in Lisbon supports homeless individuals with mental illnesses in securing and maintaining independent housing, without requiring them to engage in psychiatric treatment or sobriety. The program provides immediate access to housing, a rental subsidy, and ongoing support services to help participants achieve stability and community integration. Evaluation shows high satisfaction rates among participants regarding housing stability, community support, and improvements in overall quality of life.

1. CASAS PRIMEIRO Program in
Portugal – a community approach
José Ornelas/Inê Almas
s
AEIPS
Interdisciplinary
Center 'Sciences
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Pisa, 16th September 2011

2. What is “Casas Primeiro”?
The "Casas Primeiro" Program supports
homeless people with mental illness in
Lisbon in accessing and maintaining
independent apartments, rented from
community landlords in mainstream
neighborhoods.
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3. Participants
Criteria of priority:
 People with mental illness
 People who are living on the street
 People who are the longest in the situation
of homeless
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4. What is “Casas Primeiro”?
 Provides immediate access to individualized and
permanent housing
 Consumer are not required to participate in
psychiatric treatment or attain a period of
sobriety in order to obtain housing.
 Rental subsidy
 Provides – off site – services (7-24 on call) to
help consumers keep housing, facilitate recovery
and community integration.
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5. Independent Apartments
• Scatter site independent apartments.
Apartments are not in the same building or
street
• Mainstream neighborhoods in Lisbon
• Rental units available on the open market
(350€ a 400€)
• Tenants pay 30% of their monthly income
towards rent.
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6. Independent Apartments
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7. Landlords as program
partners
The partners have common goals: quality, safety
and well managed apartments
• Agency that ensure rent is paid on time
• Agency and landlord communication responsive to
landlord concerns
• Agency responsible for tenant damages
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8. Others partners
 Outreach teams
 Social services
 Plataform PSA Lisboa
 Health services
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9. Support services
• Team (5 staff for 50 participants)
• Home visits at least 6 times per month per participant. All
tenants must agree to regular home visit.
• Support services are provided in the community (access
to community resources and services)
• Team use a recovery focus and assist with community
integration. Participants can beneficiate from others
AEIPS programs (e.g. supported employment)
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10. Participants
Sex
Man
Woman
36%
64%
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11. Participants
Diagnosis
Schizophrenia
Bipolar
19% Others
10%
71%
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12. Participants
Additions
Drugs
17%
Not applicable Alcohol
59,5% 16,7%
Alcohol and drugs
4,8%
40.5% of participants have dual diagnosis
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13. Participants
Length of homelessness
40%
30%
20%
10%
0%
<1 year 1-2 years 3-5 years 6-10 years 11-15 years 16-20 years
62% were homeless for more than 6 years
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14. Length of housing
80% of the participants were housed for more than seven
months.
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15. Housing stability
Housing stability
Yes
90,5%
No
9,5%
90.5% of participants remained in their houses
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16. Neighborhood and housing
satisfaction
100%
80%
60%
40%
20%
0%
Neighborhood satisfaction Housing satisfaction
Participants are satisfied with their current housing and
neighborhood.
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17. Most valuable support
Dealing with the landlord
100%
Social benefits
80% Listening to concerns
Budgeting
60%
Accessing health services
40% Grocery shopping
Finding employment
20% Connecting to services
in the neighbourhood
Legal issues
0%
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18. Changes in need for follow-up
60%
support
50%
40%
30%
20%
10%
0%
Increased Stayed Decreased Don’t know
the same
The majority of participants considered that they will need to
maintain the support of the team, but for new projects (training,
employment and other activities in the community).
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19. Wellbeing and quality of life
improvements
100%
Personal safety
80% Food
Level of stress
60%
Sleeping habits
40%
Mental health
Health
20%
Social interaction
0%
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20. Changes in emergency service
use
Before After
Call 112 41,7% 4,2%
Ambulance 45,8% 4,2%
Hospitalization 45,8% 4,2%
Get arrested 12,5% 0%
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21. Overall changes
60%
40%
62,5%
20% 32,5%
0%
Improved a lot Improved somewhat
All participants feel they have more opportunities to study, get a job or
develop other activities in community.
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22. Participants voices
“This project addresses the practical situation of the homeless. "
"We recovered our personal and human dignity. "
"Life
needs foundations. Home provides the foundation to realize our
dreams. "
“Housing opens a range of possibilities for our life. "
"Housing is fundamental to regain individualized citizenship: we are
holding a key, we are neighbors, we have rights.”
(Casas Primeiro participants)
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23. Film
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