A presentation given by José Ornelas, PT at a FEANTSA Research Conference on "Access to Housing for Homeless People in Europe", York, September 2012

1. Insert your logo here
Casas Primeiro / Housing First
in Lisbon
José Ornelas
ISPA – University Institute
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

2. Casas Primeiro (Homes First)
 Immediate access to individualized and permanent
housing.
 People are not required to participate in psychiatric
treatment or attain a period of sobriety in order to obtain
housing.
 Scatter site apartments in mainstream neighborhoods in
Lisbon. Apartments are not in the same building or street.
 Rental subsidy. Tenants pay 30% of their monthly income
towards rent.
 Provides – off site – services (7-24 on call) to help consumers
keep housing, facilitate recovery and community integration.
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

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
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

4. Participants
Sex
Age
• 91,6% have Portuguese nationality
• All participants were unemployed or inactive
• Only 28 participants had some source of income
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

5. Participants
Addictions
11,1%
Alcohol
15,3%
Drugs
Alcohol and drugs
2,8%
Diagnosis Not applicable
70,8%
29.2% also present a co-occurring substance abuse disorder
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

6. Length of homelessness
60%
40%
20%
0%
< 2 years 3-5 > 6 years
years
50% of the participants were homeless for more than six years, and 6,9%
for more than 16 years.
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

7. Support services
• Team (6 staff – ratio 1 staff to 10 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)
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

8. Ecological approach
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

9. Housing Stability
16,7%
Yes
No
83,3%
Of the 60 participants that are still housed by the program, 58.3% remained
in housing for one year or more
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

10. Changes in income
Income
80
60
40
20
0
Before After
The number of participants that had a monthly income increased
substantially from 28 to 70 (social benefits and salary).
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

11. Changes of quality of life
The impacts of housing in participants’ perceived quality of life are clearly significant,
in terms of personal safety, nutrition, level of stress, sleeping habits, social life health and mental health.
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

12. Changes in emergency service use
Before After
Called 112 46% 6%
Admitted in psychiatric hospital 58% 6%
Spent one night on police squad 20% -
The number of participants reporting having to use 112 emergency service decrease 87%.
The number of admissions in psychiatric hospitals decreased by 90%.
No one reported having spent the night on a police squad after move into housing.
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

13. Individual projects
1
Job site training
3
School
1 9
Workshops
2 Community center
Computer training
University
6
22 participants involved became involved in school, training, employment
or other activities
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

14. Satisfaction with housing
100%
80%
60%
40%
20%
0%
Satisfaction Satisfaction
with the neigbourhood with the house
Satisfaction with neighbourhoods: the resources nearby and the relationship with neighbours.
Satisfaction with the house: privacy, tranquillity, comfort and sense of control over the space .
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

15. Program satisfaction
All participants were satisfied
with the program, pointing out
as important aspects
 the speediness of the
process
 the support of the team in:
 solving immediate problems
 managing the house
 facilitating access to existent
neighborhood services.
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

16. Support needs changed over time
70%
60%
50%
40%
30%
20%
10%
0%
Increase Staying the Decrease Don't know
same
60% of participants considered that in the short term, there will be no major changes
32% consider that their needs for support will decrease over time
and only 4% considered they will need greater support from the team
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

17. Overall changes
2%
Life overall improvement
Don’t know
98%
On the referred improvements participants highlight the gains in a large sentiment
of freedom and hope, a wide range of study opportunities, getting a job,
fulfilling personal projects and the development of social connections
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

18. Costs
• Casas Primeiro – 16,40 euros per client per day
(€498,83 per month)
• Night Shelters – 18,60 euros per client per night
• Hostels rooms – 30,77 euros per client per day
• Psychiatric hospitalization in acute wards have a one
time cost of €2500 per client
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012

19. Research
 Community integration & Recovery
 qualitative narrative interviews
 interviews with quantitative measures
 community integration
 recovery
 choice
 satisfaction with housing and support services
 Social change
 key informant interviews
 landlords interviews
European Research Conference
Access to Housing for Homeless People in Europe
York, 21st September 2012