Tag Archives: vulnerable

How Finland put housing first

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Earlier this year, official figures showed that rough sleeping in England had risen for the sixth successive year.

The data showed that 4,134 people slept on the street in 2016, an increase of 16% on the previous year’s figure of 3,569, and more than double the 2010 figure. Many of those enduring long-term homelessness have complex and multiple needs related to mental health or addiction. While this is a growing problem in the UK, housing exclusion is by no means confined to these shores. As we reported in April, there is growing evidence of an alarming increase in homelessness across Europe.

But one European country is bucking this trend. Since 2008, the Finnish government has been working with housing agencies to reduce long term homelessness and improve prevention services. The adopted approach, called ‘Housing First’, has had a big impact, achieving a 35% fall in long term homelessness over seven years. Finland is now the only country in the European Union where homelessness continues to fall.

Housing First: what it means

Housing First is not a uniquely Finnish approach to tackling homelessness, nor is it a new idea. The practice began in Los Angeles in the 1980s. It’s based on the principle that housing is a basic human right, and turns on its head the notion that vulnerable people are only ‘housing ready’ once they have begun to engage with support services.

As the name suggests, Housing First means providing vulnerable people with permanent, affordable housing, and then offering specialised support to ensure that they don’t return to sleeping on the streets. However, acceptance of that support is not a condition for access to housing. The approach has been adopted in various American cities, as well as parts of Australia, Canada, France and Japan. But it’s in Finland that Housing First has achieved some of its most impressive results.

Housing First: how it works

One of the key players in Finland’s Housing First strategy is the Y-Foundation, an association of local authorities, church, construction, trade union and health organisations that has been supporting homeless people for more than thirty years. Starting in 2008, the foundation converted homeless shelters in Finland’s biggest cities into rental housing. At the same time, the government set targets for local authorities to build new flats in mixed housing developments. The programme is backed by money from government grants and the proceeds from Finland’s not-for-profit gambling monopoly.

Housing First: why it works

The cost estimate for Finland’s Housing First programme is €78 million. But Juha Kaakinen, chief executive of the Y-Foundation, has no doubts about its value for money. In an interview with Inside Housing, he explained:

“It’s not only good social policy; it has a big safety and security angle, as the more homeless people there are on the streets, the more unsafe the city is. And there’s an economic argument, too: taking care of these people is a good investment.”

He estimates that taking each homeless person off the streets saves social, health and emergency services around €15,000 a year.

Housing First in the UK

Homelessness charities in Britain have been taking great interest in the success of Housing First in Finland.

“It’s a stunning result,” Matt Downie, director of policy and external affairs at Crisis, told Inside Housing.  “They used to have a bigger homelessness problem than we have.” But he was less sure whether the programme could be replicated here. “We’ve got a system that is the exact opposite of Housing First. In Finland they made a strategic choice; that allowed them to change everything.”

Even so, Housing First is already gaining ground around the UK:

Scotland
A pilot project in Glasgow by Turning Point Scotland was the first Housing First project to be implemented in the UK. Between 2011 and 2013, the project provided mainstream social housing and 24/7 floating support to 22 individuals who were homeless, aged 18 or over, and involved in substance misuse. An evaluation of the project by Heriot Watt University found that none of the tenants were evicted from their flat and the majority of participants retained their tenancies.

Wales
The Welsh Government has announced that it is considering moves towards a Housing First policy. The communities and children secretary for Wales told the Welsh Assembly in April 2017 that he would be reviewing homelessness prevention in Wales, and is exploring Housing First initiatives.

Northern Ireland
Working with the Depaul youth homelessness charity, the Northern Ireland Housing Executive funded a Housing First pilot scheme in Belfast. An evaluation of the 18-month programme reported a number of positive results, including a high rate of tenancy retention, improvements in participants’ self-care, confidence and living skills, and reductions in their dependence on drugs and alcohol. A further Housing First programme has since been established in Derry.

England
In 2015, the University of York published findings from a study of nine Housing First services in England. The authors reported high levels of success in reducing long-term and repeated homelessness, with 74% of service users successfully housed for one year or more. There were also significant improvements in the physical and mental health of Housing First tenants and high levels of satisfaction. The Centre for Social Justice has called on the UK government to set up a £110m national Housing First programme, arguing that the investment would save money and lives.

Final thoughts

There is no quick fix to the problem of homelessness, but Finland has shown that adopting new ways of thinking about the problem can virtually eradicate rough sleeping. As Juha Kaakinen observes:

“Housing First means ending homelessness instead of managing it.”

Further reading on homelessness:

Child neglect, wellbeing and resilience – adopting an art’s based approach (Seminar highlights)

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upset boy against a wall

By Rebecca Jackson

‘Neglect is a complex issue but art can help, so let it’. That was one of the key messages to come out of a seminar session held at Strathclyde University last week.

The seminar is one of a series of four, looking at how arts-based techniques can be used in research and practice when interacting with neglected children. The session also considered how the arts can be used as a tool to promote resilience among vulnerable and neglected children by building self esteem, a sense of self worth, providing an outlet for emotion and supporting self efficacy.

The interactive seminar drew on a range of topics and sources. Academics from the Universities of Stirling and Dundee led the discussions and delegates included practitioners from psychology, social work, education and social research.

Lack of value placed on the arts

Some general themes to emerge from discussions included:

  • The lack of value placed on the arts as a form of assessment and interaction with children in a professional setting.
  • The over-emphasis on outcomes and funding which means that more ‘fun’ resources and methods are overlooked for more cost or time efficient ones, rather than the ones which work best for each individual child.
  • Children quite easily and quite quickly, between the ages of 10-14 go from being ‘neglected, vulnerable children’ in the eyes of society to ‘problem or troublesome children’.
  • The need to clarify what is meant by successful outcomes and the sense that outcomes have to be quantifiable, with one participant commenting:

    “I am required to produce reports and look for evidence in facts and figures, when in reality, getting a child who has suffered neglect to feel self-worth, or to say they have had fun could and should be a major indicator of the success of a scheme. That is difficult to evidence to other people who don’t know that child.”

Discussions from the day were captured by a graphic designer (Rebecca Jackson, 2015)

Discussions from the day were captured by a graphic designer (Rebecca Jackson, 2015)

Benefits of arts-based interventions

Some of the more art-specific observations from those who use it in their practice highlighted:

  • That removing children from feeling as though they are the centre of attention can be helpful in engaging them – baking, building things from Lego and drawing or colouring can help with this:

    “One-to-one interviews can be very intimidating for children, often they can cause them to close up more as they feel there is pressure and judgement from adults. Blending art activities with standard practice creates a better environment for a child and addresses some of that power imbalance which they are often acutely aware of.”

  • Distancing the child from their story, through analogies, creative writing or storytelling can also help them to open up:

    “I will quite often say, if you had a friend who…. or if there was a character in a story who…. how do you think they would feel? what would you tell them to do? who could they talk to about it? Just giving that little bit of hypothetical distance can really help a child to open up. The story creates an extra level of safety for them”

  • Resources are a big barrier:

    “I work in an office – that’s where I hold my meetings – where can I find a space to bake a cake with a child?”

  • Making full use of the community and its resources – and having the guts to ask for something if you want it:

    “You will be surprised and amazed by people’s generosity if you just ask”

  • Relationships will always be key, and arts-based practice can help encourage and shorten the time it takes for practitioners to build these relationships.

    “Quite often it is one key person, who engages with that child, who the child trusts and feels safe and comfortable around, that can make the biggest difference to that child’s progress”

Future questions

This seminar session was designed as a way to introduce arts based practices in cases of child neglect and vulnerable children and to identify some of the key strategic barriers to its use in practice in Scotland (and the UK more widely). In many ways it raised more questions than it answered.

The subsequent sessions, to be held in early 2016 at the University of Strathclyde and the University of Stirling, will use these discussions to address how academics, practitioners and policy-makers can create a strong collective voice to encourage training in, and promotion of, arts-based practice in Scotland.

Scottish Universities Insight Institute seminar series:Child neglect, wellbeing and resilience: adopting an arts-based approach

Seminar 1: Research methodologies and arts based approaches to resilience and neglect (26th October 2015)

Who was speaking?

  • Professor Brigid Daniel, School of Applied Social Studies, University of Stirling
  • Cheryl Burgess, Research Fellow, University of Stirling
  • Jane Scott, Business Development, WithScotland
  • Dr Susan Elsley, Independent Researcher and associate of CRFR at University of Edinburgh
  • Professor Divya Jindal-Snape, Education, Inclusion and Life Transitions, University of Dundee

Fighting the cold: working to reduce excess winter deaths

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Image from Flickr user FranTaylor under Creative Commons License

Image from Flickr user FranTaylor under Creative Commons License

We may have all breathed a sigh of relief when last week’s cold snap finally eased, but for those working in public health the consequences of the cold weather are still playing out.

Cold weather poses a significant risk to health. There is a notable rise in deaths, and also illnesses and injuries, during the winter period. Indeed, in England and Wales there were 11.6% (18,200) more deaths in 2013/14 during the winter period (December to March) compared with the non-winter period (known as “excess winter deaths”).

Older people, particularly those aged over 75 years old, are most vulnerable to cold weather-related illness. The majority of excess winter deaths occur within this age group and those living on their own or who are socially isolated are most at risk. Other groups at risk include those experiencing chronic or severe illnesses, particularly heart conditions or circulatory disease, children under the age of five, and homeless people /street sleepers.

The reasons why cold weather has such a negative impact on health are complex and interlinked with fuel poverty, poor housing and health inequalities. There can be an increase in circulating infectious diseases, particularly flu and norovirus, and snow and ice can cause falls. Cold weather has also been linked to increased cases of hypothermia, carbon monoxide poisoning (from faulty heating appliances), and mental health problems such as depression and anxiety.

However, there is evidence to suggest that many of these ill effects are preventable. In some northern European countries, such as Finland, the rate of winter deaths is far lower than that in England, despite experiencing much lower temperatures.

To help address this, the Government has published an annual ‘Cold Weather Plan’ (CWP) since 2011 aimed at local authorities, health and social care staff and any professionals working with vulnerable people. The plan operates a system of cold weather alerts, comprising five levels (Levels 0-4), from year-round planning for cold weather, through winter and severe cold weather action, to a major national emergency. Each alert level aims to trigger a series of appropriate actions, which are detailed in the plan. The latest CWP was published in October 2014.

It stresses the importance of year round planning and all-winter action for reducing excess winter deaths and relieving the additional pressures on the NHS and social care which occur during the winter months. Recommended all-year actions include:

  • addressing fuel poverty
  • improving housing and energy efficiency measures
  • raising awareness of preventative actions among staff.

All-winter actions (November to March) include:

  • communicating with the public about what they can do to reduce the risk of cold weather to their health
  • identifying vulnerable clients
  • supporting vulnerable clients to seek appropriate help.

There are also key public health messages which should be communicated with residents/patients, relating to flu vaccinations, keeping homes adequately heated and ventilated, available financial support, and looking after vulnerable older neighbours and relatives.

A guide to communicating effectively with the public during periods of extreme weather was published recently by the Local Government Association (LGA). The LGA have also provided guidance for local authorities on how they can help to reduce the negative effect of cold weather on health. It highlights examples of innovative schemes, including the installation of free temperature sensors and a volunteer ‘winter squad’ to care for vulnerable residents.

Investing in cold weather planning is important – although the media focuses on travel disruption during cold weather, for many of the most vulnerable in our society it can be a death sentence.

Further reading

The Information Service has a number of resources on cold weather planning – a selection are listed below.

Cold weather plan for England 2014: making the case – why long-term strategic planning for cold weather is essential to health and wellbeing

A turn for the better (Liverpool’s Healthy Homes Programme), IN Property Journal, Jul/Aug 2014, pp42-44 (Ref No. A51407)

Staying in touch (social media), IN Local Government News, Vol 36 No 2 Mar/Apr 2014, pp44-45 (Ref No. A49753)

Behind cold doors: the chilling reality for children in poverty

Reducing harm from cold weather: local government’s new public health role

N.B. Abstracts and access to journal articles are only available to members.