Crisis commissioned the Social Care Institute for Excellence to produce a rapid evidence assessment (RAE) to understand what services work, to address and end homelessness, and to assess the quality of evidence that exists in published studies.

Key findings

Based on a 'best evidence' approach the study found that:

• 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 the 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 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. People with complex needs can be more difficult to engage with in terms of assessing needs and providing flexible, responsive and sustained expert-led person-centred support. 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.

The report shows that there is potentially a wealth of evidence about what works in services to end homelessness, but the evidence base is as varied in terms of quality as it is vast in scope. The gaps in type of evidence on homelessness include experimental research including Randomised Control Trials, measurement of fidelity of services, long term outcomes and cost benefit analysis. The challenge is to coordinate and develop a more coherent approach to generating reliable evidence about what works in preventing homelessness and making that evidence more accessible to those who need it.

Reference

Social Care Institute for Excellence (2018) A rapid evidence assessment of what works in homelessness services, London: Crisis.