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

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

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

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

5. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Participants 29.2% also present a co-occurring substance abuse disorder Diagnosis Addictions

6. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Length of homelessness 50% of the participants were homeless for more than six years, and 6,9% for more than 16 years.

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

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

9. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Housing Stability Of the 60 participants that are still housed by the program, 58.3% remained in housing for one year or more

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

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

12. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Changes in emergency service use 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.

13. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Individual projects 22 participants involved became involved in school, training, employment or other activities

14. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Satisfaction with housing 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.

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

16. European Research Conference Access to Housing for Homeless People in Europe York, 21st September 2012 Support needs changed over time 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

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

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

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