Research exploring holistic Housing First outcomes

What is this research?

Homeless Link, in partnership with Expert Link, carried out research to understand the longer-term impacts of Housing First across a wide range of different areas of someone’s life. The main aim of this research is to fill in this evidence gap and investigate how long-term, multi-year engagement with Housing First impacts on wider outcomes such as physical and mental health, offending behaviour, substance use, social networks, employment and training, engagement with meaningful activities and more.

Using a combination of survey data, individual data, and peer research with people with lived experience of Housing First, this report, entitled More Than a Roof, sets out the findings and recommendations from the research.

Who is the research for?

The report is written for anyone with an interest in Housing First and particularly those looking to influence local or national policy makers, commissioners, and funders. It is also directly relevant for policy makers, commissioners, and academics or other researchers.

Importantly this research is relevant beyond the housing and homelessness sector. Professionals in health, social care and criminal justice spaces will be interested to see the potential benefit of Housing First in their sector.

Key takeaways

Housing First works. It is an effective approach for reducing homelessness and improving health and social care outcomes and also a cost-effective intervention to reduce pressures on housing, health, social care, and criminal justice services.

Our research found:

• More than a quarter of people have shown a reduction in their overall physical health needs by the end of the first year. This is followed by 38% and 39% of people showing reduction in their physical health needs by the end of their second and third years respectively.
• Half of Housing First tenants showed a reduction in their mental health needs by the end of the first year, followed by 58% and 55% by the end of the second and third years respectively.
• There is a 20% decrease in the use of the A&E between the 6 months prior to entry into Housing First until the end of their first year, followed by a continued reduction in A&E use by the end of the second and third years.
• There is a steady downward trend in hospital admissions across the three years. 38% of people were admitted into hospitals six months prior to entry into Housing First, followed by 28%, 23% and 18% at the end of their first, second and third years respectively.
• There is a notable increase in people’s engagement with mental health services between the point of entry until the end of the first year with Housing First (23% to 39%) which sustains over the next two years.
• There is a clear downward trend in substance misuse across the three years at the same time as there is a steady increase in engagement with drug and alcohol services.
• There is a clear reduction in antisocial and offending behaviours across the three years. 84% of people were involved in antisocial and offending behaviours at the point of entry, compared to 45% by the end of the third year.
• Residents show emotional recovery, increased resilience and an improved quality of life. Only 9% of residents said they had hobbies or interests at the point of entry compared to 37% after three years of engagement, while the number of people reporting positive social networks more than doubled.

The full findings of the research including the peer research and recommendations are included in the report below.