Most of us experience and think about our world from the perspective of an individual; homelessness for me is very much in this vein, a daily personal observed experience. Having the opportunity to contribute to the evidence about what works to end homelessness, is a matter for pride for me, where once there was little else than a feeling of shame.

Both the scale of the problem and context to these solutions are important to consider when addressing what works. According to Heriot-Watt University, nearly 160,000 households, estimated to represent 236,000 people, are experiencing the worst forms of homelessness across Britain.

Ending homelessness

As part of its 50^th year, Crisis has embarked on a project to research and evidence long term solutions for ending homelessness due to be published on 11 June. As part of this strategy Crisis needed to understand the available evidence on homelessness services, their effectiveness and how much they cost to implement. With this in mind Crisis commissioned the Social Care Institute for Excellence (SCIE) to conduct a rapid evidence assessment (REA) to review the evidence on current and past services targeted at addressing and reducing homelessness across England, Scotland and Wales.

Our REA has been framed around Crisis’s five definitions of ending homelessness: 

1. No one sleeping rough
2. No one forced to live in transient or dangerous accommodation such as tents, squats and non-residential buildings
3. No one living in emergency accommodation such as shelters and hostels without a plan for rapid rehousing into affordable, secure and decent accommodation.
4. No one homeless as a result of leaving a state institution such as prison or the care system
5. Everyone at immediate risk of homelessness gets the help they need that prevents it happening.

Overall, and in relation to each of the five definitions above, the review looked at effectiveness of services, barriers to implementation, the quality of the evidence available, and how these solutions could prevent homelessness, provided rapid response and sustained support for those with complex needs. The review also addressed the extent to which the evidence showed how effective these were for specific groups including black, Asian, and minority ethnic (BAME) and young people.

There is a wealth of evidence about what works to address homelessness, but there are also gaps in the evidence that need filling. You can read a summary of the review and our findings in the full report. 

Person-centred approach

The long and the short of it is that we need to work together to develop an ongoing base of evidence about what works to address the many different forms of homelessness, and to better understand how to meet the needs of diverse groups and those with complex needs; and most importantly how to develop and provide the kind of person-centred time critical support that is so important in achieving the best possible outcomes. 

More specifically the review found:

• Sustained services, targeted to meet specific needs across time are effective. Effective services include those which provide Intensive Case Management, Critical Time Interventions and Housing First. Effective services incorporate Permanent Supported Housing elements, support for people into accommodation through provision of housing vouchers and subsidies, and guidance on benefits and information about services.
• A number of features contribute to the effectiveness of services, including: adhering to particular aspects of models/designs of service that are found to be successful (fidelity); adapting and aligning services to local settings and context; developing and providing a range of person-centred responses that are attuned to and reflect the personal circumstances of people, particularly with regards to their journey out of homelessness; integration and multi-agency working; a housing market that respond flexibly to the needs of homeless households.
• Challenges include a lack of services for people with complex needs such as mental health issues. There were also challenges regarding access to housing in the local market and a lack of data and monitoring to inform service design.
• A lack of evidence about what works for a number of specific population groups, for instance with black and minority ethnic (BAME) groups and people living in transient accommodation (squatting, unsafe environment) who have rarely featured in studies and when they have, outcomes have not always been as positive as for other groups. 
• The assessment suggests that involving and engaging people with lived experience of homelessness, and the wider community in service design would enable services to better access and engage harder-to-reach groups.

Researchers like me need to think about how we bring our expertise to work in partnership with homelessness services and those with lived experience of homelessness, so that together we can develop a better base of evidence about what works, and also ensure that we develop and maintain a virtuous cycle of learning and improvement. I agree with the statement that homelessness is ‘unacceptable’, but as a researcher what is no longer acceptable to me, is that we have yet to get our evidential act together to make homelessness a study of history, rather than it being an ever-present mark of communal and personal shame. Crisis, via their forthcoming plan to end homelessness and the Centre for Homelessness Impact are doing something about this.