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- From evidence to practice: Implementation of the Housing First program in PolandPublication . Bokszczanin, Anna; Rogowska, AleksandraLikewise in other EU countries, also in Poland a large number of people experience homelessness. In particular, the growing number of long-term homeless people with complex mental problems, for whom effective help is a challenge for stakeholders, i.e. politicians, professionals, scientists and ordinary citizens, is worrying. An innovative solution in this areas is the Housing First (HF) program designed for long-term homeless people with mental problems and/or addictions. The effectiveness of the HF model were shown, among others, by the results of the HOME-EU research project implemented under the Horizon 2020 program. The goal of our article is to present the current situation of homeless people and outline the existing help system. We also want to show what barriers and challenges are connected to the implementation of the HF program in Poland.
- Homeless adults’ recovery experiences in housing first and traditional services programs in seven european countriesPublication . Greenwood, Ronni Michelle; Manning, M; O' Shaughnessy, Branagh; Moniz, Maria João Vargas; Loubiere, Sandrine; Spinnewijn, Freek; Lenzi, Michela; Wolf, Walter; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Monteiro, Maria Fátima Jorge; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Rivero, Borja; Julián, Martin; Zmaczynska–Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; Van Loenen, Tessa; Raben, Liselotte; Beijer, Ulla; Blid, Mats; Bispo, Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Leon; Tinland, AurelieAcross Europe, as governments turn to housing-led strategies in attempts to reverse rising rates of homelessness, increasing numbers of Housing First (HF) programs are being implemented. As HF programs become more widespread, it is important to understand how service users experience them compared to the more prevalent traditional treatment-first approach to addressing long-term homelessness. Although there is a large body of research on service users' experiences of Housing First compared to treatment-first in North American contexts, comparatively less is known about how these two categories of homeless services are experienced in the European context. In a correlational and cross-sectional study, part of a larger examination of homelessness in Europe, participants (n = 520) engaged with either HF (n = 245) or traditional services (TS; n = 275) programs in seven countries completed measures of their experiences of services (consumer choice, housing quality, and service satisfaction) and recovery (time in independent housing, psychiatric symptoms, and community integration). Across the seven countries, participants engaged with HF programs reported experiencing more consumer choice, better perceived housing quality, and more satisfaction with services than participants engaged in TS programs. Participants in HF programs also reported a greater proportion of time in independent accommodation, fewer psychiatric symptoms, and more community integration. Varying patterns of association between experiences of services and recovery outcomes were observed. Findings indicate HF consistently predicts greater recovery than TS across diverse sociopolitical and economic contexts. Implications of findings for configurations of homeless services and homeless services policy are discussed.
- Structure and agency in capabilities‐enhancing homeless services: Housing first, housing quality and consumer choicePublication . Greenwood, Ronni; Manning, Rachel; O'Shaughnessy, Branagh R.; Vargas‐Moniz, Maria; Auquier, Pascal; Lenzi, Michela; Wolf, Judith; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Spinnewijn, Freek; Ornelas, JoséThe capabilities approach, a framework for understanding and measuring inequality, stipulates that equality is best understood as the freedom to do and be within a particular context. Homelessness has been referred to as a situation of ‘capabilities deprivation’, and the extent to which homeless services restore or enhance capabilities is of increasing interest. As part of a large, eight-country study of homelessness in Europe, we examined the extent to which adults with histories of perceived the services they receive as capabilities-enhancing. We collected data at two time points: baseline (nt1 = 565) and follow-up (nt2 = 399). Measures included perceived capabilities, choice and housing quality. Participants engaged with Housing First (HF) programmes perceived services as more capabilities-enhancing than participants engaged with treatment as usual (TAU); this relationship was mediated by consumer choice and perceived housing quality. Implications for social policy, practice and training are discussed.
- Working with people experiencing homelessness in EuropePublication . Gaboardi, Marta; Santinello, Massimo; Disperati, Francesca; Lenzi, Michela; Vieno, Alessio; loubiere, sandrine; João Vargas Moniz, Maria; Spinnewijn, Freek; Greenwood, Ronni Michelle; Wolf, Judith R.; Bokszczanin, Anna; Bernad, Roberto; Blid, Mats; Ornelas, José; Shinn, MarybethIn Europe, the widespread transition from the Traditional Staircase (TS) model to the Housing First (HF) model is transforming the way social service providers work with people experiencing homelessness. This study examined social service providers’ perspectives in both models regarding factors that facilitate or hinder their work. Data were collected through 17 photovoice projects involving 81 social service providers from eight European countries. The results show factors affecting social service providers’ work at three levels: systemic, organizational, and individual. Professionals in TS and HF identified similar topics; however, TS providers discussed more obstacles to work. Implications for practice are discussed.
- Psychometric properties of the measure of achieved capabilities in homeless servicesPublication . Greenwood, Ronni; O'Shaughnessy, Branagh R.; Manning, Rachel; Vargas-Moniz, Maria; Sacchetto, Beatrice; Ornelas, José; Jorge-Monteiro, Maria F.; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Lenzi, Michela; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Bernad, Roberto; Rivero, Borja; Julien, Martin; Bokszczanin, Anna; Kalinowska-Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; vanLoenen, Tessa; Raben, Liselotte; Wolf, Judith R.; Beijer, Ulla; Blid, Mats; Källmen, Håkan; Bispo, Maria Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Pascal; Loubière, Sandrine; Tinland, AurélieBackground Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.
- European public perceptions of homelessness: A knowledge, attitudes and practices surveyPublication . Petit, Junie; Loubiere, Sandrine; Tinland, Aurlie; João Vargas Moniz, Maria; Spinnewijn, Freek; Manning, Rachel; Santinello, Massimo; Wolf, Judith; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Ornelas, José; Auquier, PascalAddressing Citizen's perspectives on homelessness is crucial for the design of effective and durable policy responses, and available research in Europe is not yet substantive. We aim to explore citizens' opinions about homelessness and to explain the differences in attitudes within the general population of eight European countries: France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden.
- Europeans’ willingness to pay for ending homelessness: A contingent valuation studyPublication . Loubiere, Sandrine; Taylor, Owen; Tinland, Aurelie; Moniz, Maria João Vargas; O'Shaughnessy, Branagh R; Bokszczanin, Anna; Källmen, Håkan; Bernad, Roberto; Wolf, Judith R.; Santinello, Massimo; Loundou, Anderson; Ornelas, José.; Auquier, PascalThe purpose of this study is to assess the utility value European citizens put on an innovative social program aimed at reducing homelessness. The Housing First (HF) model involves access to regular, scattered, independent and integrated housing in the community with the support of a multidisciplinary team. Currently, HF is not implemented by most European countries or funded by healthcare or social plans, but randomised controlled trials have stressed significant results for improved housing stability, recovery and healthcare services use. The broader implementation of HF across Europe would benefit from a better understanding of citizens' preferences and "willingness to pay" (WTP) for medico-social interventions like HF. We conducted a representative telephone survey between March and December 2017 in eight European countries (France, Ireland, Italy, the Netherlands, Poland, Portugal, Spain, and Sweden). Respondent's WTP for HF (N = 5631) was assessed through a contingent valuation method with a bidding algorithm. 42.3% of respondents were willing to pay more taxes to reduce homelessness through the HF model, and significant differences were found between countries (p < 0.001); 30.4% of respondents who did not value the HF model were protest zeros (either contested the payment vehicle-taxes- or the survey instrument). Respondents were willing to pay €28.2 (±11) through annual taxation for the HF model. Respondents with higher educational attainment, who paid national taxes, reported positive attitudes about homelessness, or reported practices to reduce homelessness (donations, volunteering) were more likely to value the HF model, with some countries' differences also related to factors at the environmental level. These findings inform key stakeholders that European citizens are aware of the issue of homelessness in their countries and that scaling up the HF model across Europe is both feasible and likely to have public support.
- Home as a base for a Well-Lived Life: Comparing the capabilities of homeless service users in housing first and the staircase of transition in EuropePublication . O' Shaughnessy, Branagh; Manning, Rachel; Greenwood, Ronni; João Vargas Moniz, Maria; Loubiere, Sandrine; Spinnewijn, Freek; Gaboardi, Marta; Wolf, Walter; Bokszczanin, Anna; Bernad, Roberto; Blid, Mats; Ornelas, JoséNussbaum’s Central Capabilities refer to the elements of a well-lived life, and many adults who experience homelessness are deprived of these capabilities. The study aim was to investigate whether service users experience different homeless services as affording or constraining capabilities. We conducted semi-structured interviews with homeless service users (n = 77) in Housing First (HF) and staircase services (SS) in eight European countries. We used thematic analysis to identify three themes: autonomy and dependency, the relational impact of living arrangements, and community interaction and stigma. While SS participants were able to address their bodily integrity and health, their higherorder capabilities were constrained by their homeless situations. HF participants described home as a base from which they could enact a wide range of capabilities indicative of a well-lived life. We conclude that housing-led service models with appropriate supports are key to affording service users’ capabilities. Practical and policy implications are discussed.
- Comparison of housing first and traditional homeless service users in eight european countries: Protocol for a mixed methods, Multi-site studyPublication . Greenwood, Ronni Michelle; Manning, Rachel; O'Shaughnessy, Branagh R.; Cross, Oisin; Moniz, Maria João Vargas; Auquier, Pascal; Santinello, Massimo; Wolf, Judith R; Bokszczanin, Anna; Bernad, Roberto; Källmen, Håkan; Spinnewijn, Frederik; Ornelas, JoséHomeless services expend considerable resources to provide for service users' most basic needs, such as food and shelter, but their track record for ending homelessness is disappointing. An alternative model, Housing First, reversed the order of services so that homeless individuals are offered immediate access to independent housing, with wraparound supports but no treatment or abstinence requirements. Although the evidence base for Housing First's effectiveness in ending homelessness is robust, less is known about its effectiveness in promoting recovery.
- Psychometric properties of the measure of achieved capabilities in homeless servicesPublication . Greenwood, Ronni Michelle; O'Shaughnessy, Branagh R.; Manning, Rachel M.; Vargas-Moniz, Maria; Sacchetto, Beatrice; Ornelas, José; Jorge-Monteiro, Maria Fátima; Almas, Inês; Duarte, Teresa; Disperati, Francesca; Gaboardi, Marta; Lenzi, Michela; Santinello, Massimo; Vieno, Alessio; Marques, Rita P.; Carmona, Maria; Nave, Américo; Bernad, Roberto; Rivero Jiménez, Borja; Julien, Martin; Bokszczanin, Anna; Zmaczynska-Witek, Barbara; Katarzyna, Skałacka; Rogowska, Aleksandra; Schel, Sandra; Peters, Yvonne; vanLoenen, Tessa; Raben, Liselotte; Wolf, Judith; Beijer, Ulla; Blid, Mats; Källmen, Håkan; Bispo, Maria Teresa; Cruz, Tiago; Pereira, Carla; Auquier, Pascal; Petit, Junie M.; Loubière, Sandrine; Tinland, AurélieBackground Purposeful participation in personally meaningful life tasks, enjoyment of positive reciprocal relationships, and opportunities to realize one’s potential are growth-related aspects of a meaningful life that should be considered important dimensions of recovery from homelessness. The extent to which homeless services support individuals to achieve the capabilities they need to become who they want to be and do what they want to do is, in turn, an important indicator of their efectiveness. In this study, we developed a measure of achieved capabilities (MACHS) for use in homeless services settings, and assessed its construct and concurrent validity. Methods We analysed data collected from homeless services users at two time points in eight European countries to assess the factor structure and psychometric properties of the new measure. Participants were adults engaged with either Housing First (n=245) or treatment as usual (n=320). Results Exploratory and confrmatory factor analyses yielded a four-factor structure of the capabilities measure: community integration, optimism, safety, and self-determination. We obtained evidence for construct validity through observed correlations between achieved capabilities and recovery, working alliance and satisfaction with services. Moreover, we obtained evidence of the measure’s concurrent validity from its positive association between HF and personal recovery, which was fully mediated by achieved capabilities. Conclusions Findings demonstrate that the MACHS is a valid and reliable measure that may be used to assess the extent to which homeless services support their clients to develop capabilities needed for growth-related recovery. Implications for practice and future research directions are discussed.