1. Discus Amsterdam Support in Life and Living
Wessel de Vries, teammanager Discus Amsterdam
Walter Kamp, City of Amsterdam

2. Homeless policy in the Netherlands
2006: Action Plan for the G4 Amstetdam, The Hague, Rotterdam, Utrecht). In total: 3.0 million inhabitants (out of 17 million)
people constantly very unstable: homeless, psychiatry, substance abuse, moving in and out of various services.
Municipalities responsible

3. Homeless policy in the Netherlands
Conclusion on the basis of research: 60-70% serious health problems but (mental) health care is absent.
Conclusion: regular policies failed. Problems were not solved.

4. Homeless policy in the Netherlands
Action plan meant:
Extra funding
Cities took control on different levels:
Overall political responsibility
Responsibility for acces to services
Person to person logitics
people were taken into a program:
Housing
Medical care
Income
Labour

5. Homeless policy in the Netherlands
Access to services controlled by City.
Services were added to: housing, medical services (ACT, FACT), labour/day activities, hospitals.
Cliënts are monitored.
Prevention pojects started up

6. Homeless policy in the Netherlands
Results :
Home evictions down by 40%
Rough sleeping down by 80% (but up on acount of migrant workers)
people in a stable programme
Nuisance/criminality down by 65%

7. Homeless policy in the Netherlands
Place of Housing First in all this:
Experiment
Not the initiative of the City
No priority
Skipping the promotion model made us skeptical
Money made it possible

8. Discus Amsterdam Support in Life and Living
Initiative in 2006
Housing Association Alliantie Amsterdam,
OGGZ „Arkin“ (mental health organisation)
HVO Querido (care for homeless people and mental health care)
First year objective: 80% still in the programme: succes.
Core bussiness: small housing association without property for special target group: double diagnosis

9. Discus Amsterdam Support in Life and Living
Housing First principles
Forget about the promotion model
Make people an offer the can‘t refuse (cause they‘ve got something to lose)
Few requirements up front (no references, no medical terms)
Do not cause a nuisance and pay the rent
Double diagnosis (psychiatry and substance abuse), history on the streets, shunning formal care

10. Discus Amsterdam Support in Life and Living
Differences between New York – Amsterdam
Little care, many opportunities versus a lot of care, few opportunities
A choice to create opportunities with the right support
Rehabilliation method-Empowerment, Strenght based (academic workplace)
Close coöperation with medical professionals of mental health ACT-teams

11. Video 1

12. Discus Amsterdam Support in Life and Living
Results after 5 years
90 housing first dwellings
20 housing first dwellings for aftercare for cliënts formerly in a 24 hour environment
10 special rental properties on the basis of housing first
Projected growth in the yrs
25% of client perform above expectation, 50% well-reasonable, 25% in danger zone
Independent Research Radbout University of Nijmegen

13. Discus Amsterdam Results in Life and Living
Results after five years

14. Discus Amsterdam Support in Life and Living
Results after 5 years
123 clients taken into the programme until april
Ca. 20% female and 80% male
7 cliënts left the programme and now live indenpendently
12 cliënts moved on to another facility (mental hospital, 24 hour care, detention)
6 cliënt have left the programme
3 cliënts deceased

15. Discus Amsterdam Support in Life and Living

16. Discus Amsterdam Support in Life and Living
Changes in domains from a cliënts perspective

17. Discus Amsterdam Support in Life and Living

18. Video 2

19. Video 3

20. Discus Amsterdam Support in Life and Living
Cost of Discus versus 24 hour services:
Discus: max € per client per year
Reduction of costs after a certain period
24 hour services: per year. No reduction

21. From a municipal point of view
From skepticism to enthusiasm:
Easy to build
Results
Problem solving
Cost effective
Flywheel for change

22. From a municipal point of view
Housing First gives you something to talk about:
Supported Housing is no longer a reward at the end of the line but (more and more)
mainstream service
From medical practitioners to social workers
From health care to common sense

23. Flywheel for change: Six years ago: street Night shelter
24 hour services
Supported
housing

24. Flywheel for change Now: street Supported Housing Housing First
24hour services
Hospital/
detention

25. Medical model versus Social Care
Housing First started as a new ACT-team
Soon: medical professionals were pushed back in their rol.
Services are delivered by common sense professionals. Attitude is more important than training.

26. From a municipal point of view
Limitations:
Access should always be restricted
Housing First is not for everyone
Dwellings are a scarce commodity