Housing First: A Project for Homeless People with Mental Illness in Lisbon

EUROPEAN RESEARCH CONFERENCEHomelessness, Migration and Demographic Change in Europe

Pisa, 16th September 2011

Interdisciplinary Center 'Sciences

for peace’

CASAS PRIMEIRO Program in Portugal – a community approach

José Ornelas/Inês Almas

AEIPS



What is “Casas Primeiro”?

The "Casas Primeiro" Program supports homeless people with mental illness in Lisbon in accessing and maintaining independent apartments, rented from community landlords in mainstream neighborhoods.



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



What is “Casas Primeiro”?

Provides immediate access to individualized and permanent housing

Consumer are not required to participate in psychiatric treatment or attain a period of sobriety in order to obtain housing.

Rental subsidy

Provides – off site – services (7-24 on call) to help consumers keep housing, facilitate recovery and community integration.



Independent Apartments

• Scatter site independent apartments. Apartments are not in the same building or street

• Mainstream neighborhoods in Lisbon

• Rental units available on the open market (350€ a 400€)

• Tenants pay 30% of their monthly income towards rent.



Independent Apartments



Landlords as program partners

The partners have common goals: quality, safety and well managed apartments

• Agency that ensure rent is paid on time

• Agency and landlord communication responsive to

landlord concerns

• Agency responsible for tenant damages



Others partners

Outreach teams

Social services

Plataform PSA Lisboa

Health services



Support services

• Team (5 staff for 50 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)



Participants

36%

64%

Man

Woman

Sex



Participants

Diagnosis

19%

10%

71%

Schizophrenia

Bipolar

Others



Participants

Alcohol16,7%

Drugs17%

Alcohol and drugs4,8%

Not applicable59,5%

Additions

40.5% of participants have dual diagnosis



Participants

0%

10%

20%

30%

40%

<1 year 1-2 years 3-5 years 6-10 years 11-15 years 16-20 years

Length of homelessness

62% were homeless for more than 6 years



Length of housing

80% of the participants were housed for more than seven months.



Housing stability

Yes90,5%

Housing stability

No9,5%

90.5% of participants remained in their houses



Neighborhood and housing satisfaction

0%

20%

40%

60%

80%

100%

Neighborhood satisfaction Housing satisfaction

Participants are satisfied with their current housing and neighborhood.



Most valuable support

0%

20%

40%

60%

80%

100%Dealing with the landlord

Social benefits

Listening to concerns

Budgeting

Accessing health services

Grocery shopping

Finding employment

Connecting to services in the neighbourhood

Legal issues



Changes in need for follow-up support

Increased Stayedthe same

Decreased Don’t know

0%

10%

20%

30%

40%

50%

60%

The majority of participants considered that they will need to maintain the support of the team, but for new projects (training, employment and other activities in the community).



Wellbeing and quality of life improvements

Personal safety

Food

Level of stress

Sleeping habits

Mental health

Health

Social interaction

0%

20%

40%

60%

80%

100%



Changes in emergency service use

Before After

Call 112 41,7% 4,2%

Ambulance 45,8% 4,2%

Hospitalization 45,8%

Get arrested

4,2%

12,5% 0%



Overall changes

0%

20%

40%

60%

Improved a lot Improved somewhat

62,5%

32,5%

All participants feel they have more opportunities to study, get a job or develop other activities in community.



Participants voices“This project addresses the practical situation of the homeless. "

"We recovered our personal and human dignity. "

"Life needs foundations. Home provides the foundation to realize our dreams. "

“Housing opens a range of possibilities for our life. "

"Housing is fundamental to regain individualized citizenship: we are holding a key, we are neighbors, we have rights.”

(Casas Primeiro participants)



Film

Health & Medicine

Housing First: A Project for Homeless People with Mental Illness in Lisbon