1. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
From Crisis Accomodation to
Permanent Housing
Sanna Sunikka, Simo Granat and Agnes Stenius-
Ayoade, Department of Social Services and Health
Care, City of Helsinki, Finland

2. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
• Background – Homelessness and Housing solutions in
Helsinki
• Hietaniemenkatu service centre
• How does ”Housing first”- principle work in
Hietaniemenkati service centre – the preliminary results
of a thesis in progress

3. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Definition of Homeless in Finland
Homeless people are classified in groups in a yearly report
carried out by the Housing Finance and Development Centre
(ARA), as people living:
• Outdoors, in a staircase, in an overnight shelter etc.
• In a dormitory or tourist accommodation
• Staying in different types of institutions (hospital, rehab
etc.), with no housing unit
• Temporarily with relatives and friends

4. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
The Number of Homeless in
Finland and Helsinki 2012
Finland Helsinki
Residents 5,4 million 603,854
Single homeless 7848 4100
Out of whom
- Women 1893 1150
- Under 25s 2049 1100
- Immigrants 1550 1150
Number of homeless families 446 300

5. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Source: ARA, The homeless people 2012, report 1/2013
Homeless Over Time in Finland
1987-2012

6. Housing Solutions for Homeless in Helsinki 1971-2012
0
500
1000
1500
2000
2500
3000
3500
4000
1971
1975
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
Supported housing units
Support homes
Places in small housing units
Places in boarding houses run by private service providers

7. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Hietaniemenkatu Service Centre
Provides:
• The only remaining shelter in Helsinki City
• Temporary lodging and daycentre
• Emergency housing service
• Temporary housing service
• Free breakfast and affordable meals
• Hygiene services
• Services of social workers and
• Services of nurses and physician
• Assistance in finding permanent housing and care
• Aims at decreasing long-term homelessness
Photo: Hugo Bes

8. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Health Care Services in
Hietaniemenkatu Service Centre
• Two nurses and two part time
physician
• Primary Health Care clinic for
clients of the centre
• Walk in clinic 7.30am -3pm.
• Acute cases, preventive work and
Screening and treatment for
chronic diseases and follow-up
Photo: Hugo Bes

9. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Health Care Services in
Hietaniemenkatu Service Centre
• Aims at reaching those patients
who don’t use the normal
services available
• The focus is often on the
somatic health (non-psychiatric
problems)
Photo: Hugo Bes

10. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Main Symptoms at Doctor’s
Appointment
0 % 5 % 10 % 15 % 20 % 25 %
Gynecology and urology
Oftalmalogy
Neurology
Gastroenterology
Musculotoskeletal system
Psychiatry incl. Substance abuse
Injuries and accidents
Respiratory tract, ear, nose and throat
Cardiology, circulation, internal medicine
Skin

11. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
- How does ”Housing First” work in
Hietaniemenkatu Service Centre
• Qualitative case study
• Data
• The social service client register of all homeless who slept in
Hietaniemenkatu service centre during one selected night in
November 2009
• A cross – section of 109 individuals
• The register has been analysed from the first entry to December
2011- March 2012 (About 1500 pages)
29.5.2013 11

12. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Study questions:
1. Based on the client register, what kind of clients sleeping in
Hietaniemenkatu service centre on the selected night?
2. Based on the client register, what services has Hietaniemenkatu
service centre provided for the clients?
3. How does the housing situation change after sleeping in
Hietaniemenkatu service centre?
29.5.2013 12

13. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 201329.5.2013 13
Housing Pathways in The Service Centre:
Where From and Where To

14. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
How Many Still Lived in The Arranged
Housing Solution 2 Years Later?
Were never housed
( i.e. died, clearly no need, didn’t want to)
20
Still lives in the arranged housing solution 47
The service level has been increased
(i.e. from supported housing to service housing)
12
The service level has been decreased
(i.e. from service housing to Hietaniemenkatu, from
supported housing to small unit housing)
15
Other
(i.e. died after housing, moved away from Helsinki,
moved withing the same unit)
11
29.5.2013 14

15. EUROPEAN RESEARCH CONFERENCE
Housing First. What’s Second?
Berlin, 20th September 2013
Conclusions
• The queues are long – clients becomes long-term homeless while
waiting
• Previously the homeless toured from shelter to shelter, nowadays
the same phenomenon can be observed in housing units and
service houses
• Independent housing solutions are not available, the clients move to
strongly supported housing units
• The health services play a significant role in arranging appropriate
housing solutions
29.5.2013 15

16. Photo: Hugo Bes