Benjaminsen lars presentation brussels 11 10 2016

Homelessness in a Scandinavian Welfare State A perspective from Denmark Lars Benjaminsen The Danish National Centre for Social Research

Disposition of presentation • Trends and profiles of homelessness in Denmark • Prevention of family homelessness • Homelessness policies – experiences from the national homelessness strategy • Housing First for young homeless people?

• Housing led approaches for homeless families?

• Perspectives

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Homelessness and welfare states Patterns and profiles of homelessness are closely related to general welfare and housing policies In countries with extensive welfare systems homelessness is widely concentrated to people with complex support needs In countries with less extensive welfare systems homelessness to a wider extent affects broader groups of poor people due to housing affordability problems (Stephens and Fitzpatrick, 2007)

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Factors and mechanisms Structural

Poverty, unemployment, lack of affordable housing Systemic Adequacy of welfare and housing benefits

Public housing and targeted housing allocation systems Extent of social support systems for people with psychosocial problems Individual and interpersonal

Mental illness, substance abuse problems, low cognitive functions, weak social ties Vulnerable people with psychosocial problems are most likely to be negatively affected by adverse structural trends

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Increase in homelessness 2009-2015 National (week) counts 7000 6000

5000

Other Short term transitional

4000

Family and friends 3000

Shelter Emergency Shelter

2000

Rough sleeper

1000 0 2009

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2011

2013

2015

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Increase in homelessness in larger cities 7000 6000 5000 Other areas

4000

Aarhus 3000

Copenhagen suburbs Copenhagen

2000 1000 0 2009

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2011

2013

2015

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Increase in youth homelessness 2500

18-24 year olds: 85 % increase

2000

2009:

633

2015: 1,172 1500 25-29-year 18-24-year

1000

500

0 2009

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2011

2013

25-29 year olds: 63 % increase 2009:

490

2015:

799

2015

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Low level of family homelessness and few homeless children 11 pct. of homeless women and only 1 pct. of homeless men have daily custody of children Further 7 pct. of homeless women and 11 pct. of homeless men have shared custody.

96 homeless children under 18 years were recorded in the last count 88 stayed together with a homeless parent – usually in a family shelter, in short term transitional housing, or with family and friends.

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Prevention of family homelessness Strong child welfare protection system – social support for vulnerable families and children Large public housing sector (½ million units in a population of 5½ million people Universal access for all (general waiting lists) Prioritised allocation system (one out of four vacancies) for people in acute housing need – municipal assessment of needs – families with children have high priority Relatively high social assistance benefits for families with dependent children=> public housing of a decent size is affordable in most cases Challenges in the near future: Welfare benefit reforms – ‘benefit ceiling’ that reduces social assistance benefits to families with children=>Increase in housing affordability problems?

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Homelessness in Denmark widely concentrated to people with complex support needs 80 % have substance abuse problems or mental illness 32% have both 65 % have substance abuse problems 37 % alcohol, 37 % hashish, 19 % hard drugs 47 % have mental illness TITEL

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Profiles of shelter users in Denmark 10 year period N = 25,326

Chronical (very long stays)

Episodical (many repeated stays)

Transitional (few and short stays)

Percentage of clients

16 %

7%

77 %

Percentage of client days

60 %

16 %

25 %

Average no. of episodes (stays)

4.6 stays

24.8 stays

2.2 stays

Average no. of days

802 days

483 days

68 days

Average days per episode

175 days

20 days

32 days

Mental illness (MI) (Pct.)

51 %

62 %

52 %

Substance abuse (SA) (Pct.)

73 %

95 %

74 %

MI or SA (Pct.)

81 %

96 %

83 %

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Danish homelessness strategy 2009-2013 • 65 mill. € from central government • Housing First as overall principle

• Test whether Housing First works in a Danish context • Develop and test evidence based floating support methods Assertive Community Treatment, Intensive Case Management, Critical Time Intervention • 17 municipalitites (out of 98) participated in the 2009-2013 programme • 25 municipalities in follow-up programme 2014-2016 – focus on mainstreaming Housing First into municipal social services and a particular youth homelessness programme TITEL

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Housing for the Housing First programme Public housing is 21 % of housing stock Open for everybody regardless of income (general waiting lists) Municipalities can use 25 % vacancies for people in acute housing need Public housing and the allocation system for vulnerable groups is a major explanation why overall homelessness in Denmark is low and why in particular family homelessness is very low as homeless families with children get high priority The priority access system functions as an institutionalised mechanism to provide housing for the Housing First programme TITEL

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Floating support programme Intensive Case Management (ICM) Case manager – social and practical support and coordination of use of other services – intensive and flexible support Assertive Community Treatment (ACT)

Multidiciplinary support team – social support workers, nurse, psychiatrist, addiction treatment specialist, social office worker, job office worker (only one model project) Critical Time Intervention (CTI) Time-limited case management (9 months) – social and practical support and coordination of use of other services TITEL

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Housing First also works in Denmark Housing First works for most homeless people – 9 out of 10 who were housed in the programme maintained their housing (no control groups – no RCT) People whom we never thought could have been housed were housed and we cannot predict in advance who will fail Better experiences with independent scattered housing than with congregate housing

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Challenges and barriers •

The mindshift to Housing First needs to be facilitated at many levels (service providers, shelters, municipalities, substance abuse treatment services etc.)

•

Housing First is still debated – a continued struggle between different approaches

•

Organisational structures need to be adapted and integrated to facilitate Housing First – and especially to mainstream it into general welfare services

•

Barriers for scaling up the intensive evidence-based floating support methods

•

General shortage of affordable housing and public housing

•

Reduced welfare benefits for young people and other groups

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Paradoxical results?

•

Can a homelessness programme be regarded as successful when homelessness increases?

•

Caution not to confuse results on individual and aggregate level

•

Housing First works but cannot solve the housing affordability crisis or counteract consequences of welfare benefit reforms

•

Negative/unintended consequences of general welfare reforms and housing policies are not sufficiently taken into account in the formation and rhetoric about homelessness programmes

•

Detachment of homelessness policies from general housing and welfare policies?

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Housing First for young people The first part of the homelessness strategy pointed to a need for an early housing solution with social support also for young homeless people Less good results with group homes for homeless youth The Danish youth homelessness programme is also based on Housing First (with ICM or CTI) Young homeless people also have complex problems – they need both housing and support to facilitate recovery and reconnect them to education and employment Housing affordability is a challenge for the programme – due to the lower social assistance benefits for young people TITEL

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Housing led approaches for homeless families Homeless families with children always needs immediate access to housing Vulnerable families often also need social support e.g. family counseling, therapy If the family is not housed - social problems tend to accelerate for both adults and children – very difficult to work on other social problems if the housing situation is unstable Family homelessness may negatively affect school and educational chances for children

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Perpectives/recommendations • Continue efforts of mainstreaming Housing First into municipal social services

• Scale up evidence based floating support methods – ACT and ICM • Increase supply of affordable public housing • Housing First and/or Housing led approaches should be firstline intervensions for all homeless people – single adults with complex needs, homeless families and homeless youth

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Thanks for the attention

Lars Benjaminsen The Danish National Centre for Social Research lab@sfi.dk +4533480910

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