Presentation given by José Ornelas, PT at the Ninth European Research Conference on Homelessness, "Homelessness in Times of Crisis", Warsaw, September 2014 http://feantsaresearch.org/spip.php?article222&lang=en

1. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Researching System Level Change Towards Housing First
José Ornelas
ISPA – Instituto Universitário

2. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Defining system
Set of actors, activities, and settings that are directly or indirectly perceived to have influence in or be affected by a given problem situation.
(Foster-Fishman, Nowell, & Yang, 2007)
Two or more entities, joined by some commonality, to form a organized structure which operates according to rules set out to address a higher order purpose, including concepts, polices, agents and institutions.
(Peirson, Boydell, Ferguson, & Ferris, 2011)

3. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
System Change
Efforts that strive to shift the underlying infrastructure within a community or target context to support a desire outcome, including shifting existing policies, programs and practices, resource allocations, relational structures, theories norms and values that guide system behavior.
(Foster-Fishman & Behrens, 2007)

4. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
System Change Dimensions
Purpose: what is the goal of change
Degree: incremental or transformative
Scope: what/who will it affect
Substance: what needs to be altered
Intensity: how much effort will it take
Duration: how much time will it take
Permanency: how sustainable is the change
(Peirson, Boydell, Ferguson, & Ferris, 2011)

5. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Ecological Principles
Kelly (2006) proposed the use of four ecological principles as a guide for analyzing social systems:
 Interdependence
 Cycling of resources
 Adaptation
 Succession

6. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Traditional Housing Readiness System
Homeless
Shelter placement
Transitional housing
Permanent housing
Treatment compliance + psychiatric stability + abstinence

7. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Homeless
Shelter placement
Transitional housing
Permanent housing
Ongoing, flexible support
Housing First Model
Transformative change: involves a paradigm shift in how problems are perceived and what strategies are used to address them

8. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Why Change? Effectiveness of Housing First Approach
Numerous studies in USA, Canada and Europe have demonstrated the effectiveness and cost efficiency of housing First approach
(Busch-Geertsema, 2013; Gaetz, 2012; Goering et al., 2014, Pleace, 2012; Tsemberis et al., 2004)

9. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
The Study
Purpose:
To evaluate how the implementation of an housing first program in Lisboa contribute for a transformative and sustainable system change (theories and values, policies, resources, and practices)

10. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
"Casas Primeiro" program:
started in October 2009
for homeless people with mental health problems
initial Protocol was signed between:
oSocial Security Institute (funder)
oAEIPS, a non-profit organization (project operator)
oISPA – University Institute (project evaluation)
oSam Tsemberis & Marybeth Shinn (consultants)
Impetus for change Housing First in Lisboa

11. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Research Questions
Interdependence
What elements made up the existing system and how do they related?
What were the factors, including in the external environment, that have influenced the direction of system change?
Cycling of Resources
What were the quantity and quality of available resources and how were they distributed and used across the system?
Are the quantity and flow of resources into, out of, or within the system altered through the process of change? Are new resources mobilized or created?

12. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Research Questions
Adaptation
How do the system and its elements/stakeholders (norms, policies, agents, institutions,) respond to change?
Are system stakeholders comfortable or resistant with the prospect of change? And why?
Succession
How does the system evolve?
Do internal system dynamics and/or external factors support sustainability of the change effort?

13. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
Study Methods
Content analyses (reports, policy documents, organizations vision declarations and documents)
Interviews with key system agents/institutions (policy makers, program managers and professionals)
Interviews with participants

14. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
HF at a city polices level
Participation in Lisboa Platform of organizations that work with homelessness to reorganize the city’s services for homeless people: inclusion of Housing First approach in the final proposal.
Participation in Lisboa Strategy for Europe Strategy 2020: proposal to upscale the housing first approach in Lisboa (to support 400 homeless people) which was included in the final official document.

15. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
HF Funding Resources
Negotiation with different funding partners:
 Institute of Social Affairs
 City Hall
 SCML
 Foundations and private sector

16. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
HF Scaling Up
In October 2012, AEIPS has started another Housing First project in the city of Cascais, funded by the local city hall.
In April 2013, AEIPS has helped another organization in Lisboa to start an housing first project for homeless people with substance misuse, and has been working as a consultant of this project.
HF National Partnership with organizations from the cities of Lisboa, Aveiro, Amadora, Braga, Cascais, Coimbra, Gaia, Setúbal, Porto, Faro that are already delivered or are interested in implementing Housing First programs in their territory.

17. 9th European Research Conference
Homelessness in Times of Crisis
Warsaw, Friday 19th September 2014
HF International Networks
European Network
Italy, France, Norway, Spain, Scotland
International Network
Europe, Canada, EUA