No end in sight for the homeless

ELISHIA, a 30-year-old formerly homeless woman in Manchester, says flatly that “if I were out there I’d be dead.” This is a reasonable guess. The average age of death for those who sleep rough is 43. But what worries the government is the swelling numbers of rough sleepers. On any night in 2017 about 4,700 people in England slept rough, up from 1,800 in 2010 (see chart). These are official estimates for a single autumn night; some researchers put the total at 8,000. In March Theresa May boldly promised to end rough sleeping in England by 2027. Yet her government’s strategy, published on August 13th, is a dampener, not least because it offers no new money. Of the £100m ($127m) backing the plan for the next two years, half was already allocated for homelessness and the rest is money “reprioritised” from other programmes, admitted James Brokenshire, the housing secretary.

The plan’s ingredients are good but “minimal” for the problem at hand, says Jon Sparkes of Crisis, a charity for the homeless. For comparison, he and many others point to Finland, which is close to ending rough sleeping. The backbone of the Finnish system is a model known as “housing first”, whereby chronically homeless people are put straight into permanent housing—rather than halfway houses like shelters or hostels—and offered tailored help from social workers. The model has been widely copied in America, Canada, Denmark and France.

Charities want a roll-out of this model in England. Instead, the government’s plan is to try it in three pilot areas—even though there have been more than a dozen pilots already, showing that it is good at ending rough sleeping among people who cycle in and out of the homelessness support system, like Elishia. She lists her health problems: anxiety, psychosis, bipolar disorder and a history of drug use. Staying at hostels for the homeless was tough. Lots of people were drunk or on drugs, she says, which affected her mental health. In a 2016 survey of hostels in England, 73% reported that they had turned away people because their needs were “too high”; 67% had refused beds to those they considered a risk to clients or staff.

Elishia has now moved into a one-bedroom flat in what she calls a “decent area”. This would have been impossible without help from Shelter, a charity that runs a housing-first project. Currently, homeless people must give up drink and drugs and go through several levels of temporary accommodation until they are deemed ready to hold on to permanent social housing. But those with what the government calls “multiple and complex needs”, such as mental-health issues, addictions and past stints in prison, rarely go all the way. Roughly half are ejected from or leave hostels before they find a home.

By contrast, about 80% of them stay housed for a year or longer when they are put straight into their own homes. Support is crucial. It is an “everything job”, says Susanne Jones, one of Shelter’s support workers. She takes her charges to doctors’ appointments, shopping, probation checks and Narcotics Anonymous meet-ups—and helps them sort out bills and apply for benefits.

Finding homes is a challenge, even for small projects like Shelter’s in Manchester, which serves 21 people. Last year England had a waiting list of 1.15m households for about 300,000 social-housing units. A government green paper on social housing, also published this week, has no targets for building more social homes. In many cities housing benefit is less than market rentals. And private owners may not let to tenants without references from employers or previous landlords, or to benefit claimants.

Recruiting social workers with the skills to provide care needed by housing-first clients can be hard. For Mike Wright, who oversees the homelessness strategy of the Greater Manchester area—where one of the new housing-first pilots will accommodate 500 people for three years—a big worry is that there may not be enough mental-health and other support staff.

When done well, a switch to the housing-first model can be a boon for the public purse. One estimate for Shelter’s project finds that for every £1 spent in its first five years there will be £2.65 in savings thanks to fewer evictions and nights spent in prisons, hospitals and hostels. Experience shows that not everybody gives up drink or drugs when housed. But many people cut down on substance abuse and anti-social behaviour. One homeless man in Manchester was arrested 54 times and imprisoned 24 times in two years. Since he was put up in a flat two years ago he has had no involvement with the police.

Unless England moves to the Finnish model, Mrs May’s promise to end rough sleeping by 2027 is unlikely to be met.