Housing First Policy: The Approach That's Ending Homelessness In Finland

Over the decades, the world has viewed homelessness as an ethical wrongdoing or a psychological disorder that needs to be remedied before an individual has a right to a home. Shelters had to be sober. The transitional housing required adherence to treatment plans. The rule of thumb was simple: demonstrate that you deserve to live, and then we will provide you with a roof. In Finland, a tiny Nordic state with a population of 5.5 million, the policymakers reversed that reasoning completely.

The question they put was this: what was a reward of being stable, was it the basis of being stable? The response to that question led to the creation of the Housing First model, and the outcomes have been nothing less than revolutionary.

Finland alone in the European Union where long-term homelessness has steadily reduced since the implementation of Housing First as national policy in 2008. As countries such as the United States, the United Kingdom, and France have been witnessing a runaway epidemic in homelessness, Finland has been able to practically eliminate homelessness on streets in such metropolises as Helsinki. How did they go about it? Through providing permanent, independent housing, no-strings-attached, to the most vulnerable individuals including those of active addictions, severe mental illness and criminal records. The method is radical, even irresponsible, to the product of a tough love policy upbringing. Nevertheless, the statistics cannot be denied: Housing First is effective and Finland is the living example.

This blogger post will bring you within the transformation of Finland. You will be informed about what Housing First is and what it is not (i.e., the so-called staircase model), how Finland managed to finance and scale the program and achieve actual results, what the rest of the world can learn about this silent Nordic miracle. In case you have ever assumed that homelessness is a problem that cannot be resolved, the example of Finland will open your eyes to everything that you have supposed to know.

What Is Housing First? Model definition

Housing First is a policy that focuses on offering permanent and independent housing to the homeless without prerequisites of the homeless being required to undergo treatment and show readiness to be placed in a permanent housing first. It is based on the principle that housing is not a clinical intervention but is a basic human right. In this scheme, an individual who has developed chronic homelessness, including those who actively abuse drugs or decline psychiatric medication, is provided with a lease in a standard apartment, often in a mixed-income structure.

They rent (with a subsidy to approximately 30 percent of their earnings or social benefits), and they can enjoy full tenant rights, including the right against eviction. They provide support services which are voluntary. You cannot be thrown out because you refuse to quit drinking or even miss therapy.

This is highly contrasted to the historical traditional treatment first or staircase approach that prevails in most of the countries. The classical strategy implies that the homeless people have to go through the phases: emergency shelter, transitional housing including sobriety conditions, a group home under supervision, and, eventually, after several months or years of demonstrating stability, the homeless people may be offered independent housing.

The thing is that the majority of people do not even reach the head of the staircase. They will relapse, they will miss appointments, they will be expelled out of shelters due to minor infractions and they will become stuck in a vicious cycle of perpetual homelessness. The staircase model unwillingly picks out the cases that are most readily served and leave out the most vulnerable.

Although housing first was developed in New York City during the 1990s by Dr. Sam Tsemberis, Finland was the first country to implement it on a nationwide level. Two more elements are incorporated in the Finnish version: scattered-site (not congregate) housing (ordinary apartments in ordinary neighborhoods) and intensive case management.

A social worker or a nurse is assigned to tenants and comes weekly to assist with paperwork, refer them to healthcare, and mediate with landlords. But in an hour the visitor goes. The tenant remains in his or her house. This decency of a locking front door, a cooking kitchen, a bed of your own that is the therapeutic intervention. And, it happens, it is more efficient than a compulsory treatment program.

Homelessness Crisis in Finland Pre-Housing First

It is necessary to comprehend the starting point of Finland to enjoy its success. The homelessness crisis that Finland experienced in the 1980s and 1990s was almost exactly the same as the one experienced in the United States or Canada to date. After the economic downturn of the early 1990s, the rate of unemployment shot up, mental hospitals were reduced in size, and the social safety net became riddled. In 1987, when Finland counted 4.9 million people, there were more than 18,000 homeless people in the country, a rate that was worse than in the worst years of New York City.

Even the apparent street homelessness in Helsinki was outrageous to a country that was proud of Nordic welfare. Human beings slept in rail stations, gardens and staircases. The traditional staircase model (shelters, temporary housing, and sobriety rules) was the reaction of the government.

The staircase model collapsed disastrously in Finland, as it has in all other places. Homes were inadequately crowded and unsafe. The waiting lines of the so-called transitional housing units were usually years long. The worst part is that the system created a revolving door: one would go to a shelter, a sober living facility, relapse in one night, would be kicked out of it, and would go back on the street within a few weeks. Scholars discovered that permanent homeless people spent an average of seven times in the system and never found permanent dwelling.

This failure was astronomical in its cost, emergency room visits, police calls, bed in a shelter or jail all totaled tens of thousands of euros per person per year, and the results were the same.

At the beginning of 2000s, the Finnish policymakers had a decision to make. They might go further with the staircase model by increasing the number of beds where someone can get shelter and tighten the regulations, or they can be radical. This changed in 2007, when a right-wing government, unprecedentedly, took on a report by a working group that suggested a national Housing First plan.

The Finnish Model: Staircase to Housing First

The change in Housing First to staircase in Finland was not only a policy change, but a revolution. The old system presupposed that a homeless person was not able to handle a lease until he or she was rehabilitated. The new system presupposed the reverse: the fact that it is having a lease that allows rehabilitation.

Finland demolished the majority of the larger emergency shelters, and turned them into normal housing units. Indicatively, the Helsinki City Shelter, an infamous 220-bed shelter, was refurbished into a new organization called Helsinki Housing First Unit a combination of studios and one-bedroom apartments with on-site services. Emergency shelter beds had reduced to less than 500 currently compared to more than 1,500 in 2008. That led to permanent housing funding.

More importantly, Finland did not simply construct supportive housing in the American meaning (massive segregated houses to the homeless). They instead developed a scattered-site model. It was done in collaboration with a non-profit-making organization, the Y-Foundation (Y-Saatio), which buys out current apartments in the free market and offers them to tenants of Housing First at reduced prices.

The Y-Foundation is also one of the biggest landlords in Finland with a total of more than 20,000 apartments in the country. Standard lease is signed by tenants and they pay their rent (with the aid of housing benefits) and cannot be evicted because of alcohol or drug use. The non-payment of rent or gross intolerance of the neighbors are the only reasons why one can be evicted the same way any other tenant.

There are three reasons as to why this design is brilliant. One, it does not incur the stigma of homeless housing since the tenants reside in ordinary buildings with working families. Second, it is scalable: the Y-Foundation has an opportunity to purchase any apartment that is available, not necessarily new building. Third, it generates automatic integration. The Housing First tenant of Helsinki may have a teacher, a nurse, or a retiree as a neighbor.

The fact that social mixing decreases isolation and informal support. Finland also spent heavily on the supportive case management. Every Housing First resident is given a team of social workers, nurses and peer supporters who visit no less than once a week. However, the assistance is optional. In case the tenant declines to visit the case worker walks away and comes back to visit on another day. The lease is not threatened at all. The secret sauce is that unconditional respect.

Finland Funding and Scaling Housing First

The cost is one of the most widespread arguments against Housing First. Opponents believe that free apartments are prohibitively costly to give out. The response of Finland is easy: it is cheaper than the other one. In Finland, the emergency services, including shelters, ambulances, police, jail and psychiatric emergency rooms, were costing about 15000 euros annually on a chronically homeless person before Housing First.

The approximate price of subsidized apartment and support services in the year after the implementation of Housing First is approximately 12,000. That is a savings of 20 per cent. However, the actual savings are associated with the fewer crisis services that are of high cost being utilized. The tenants of Finnish Housing First were studied and the results showed a reduction of 60, 50, and 75 percent in emergency room visits, police contacts, and inpatient psychiatric days, respectively. The program recovers itself after two years.

Housing First in Finland is funded by the national and local budgets. National government has offered block grants to cities so that they can construct affordable housing and even give them rental subsidies. The services (case managers, nurses) are funded by the municipalities through their social services budgets but they recoup the expenses through closing costly shelters and limiting the police overtime. The first driving force was the PAAVO program that operated between 2008 and 2015, and invested 240 million to construct 3500 new housing units. Since that time, Housing First has been integrated into the normal housing and social welfare systems of Finland. It is not a pilot program anymore, but just the way Finland does business.

It took cross party political will to scale up. Outstanding, Housing First in Finland has both had the backing of the center-right and center-left. The saving of emergency services (conservative politicians); the humanitarian outcome (left leaning politicians). The major opposition was only the True Finns party (anti-immigrant populists), but they did not have much power. The policy is also backed up by Finnish citizens. In 2019, a poll conducted among Finns showed that three out of four expressed the opinion that homeless individuals should be provided with a permanent home with support services instead of a shelter bed. This agreement was not achieved by chance.

The government conducted a social campaign that demonstrated that a large majority of homeless individuals are not dangerous drug addicts but just a normal Finn who went into poverty, trauma or even sickness. Arguing that Housing First is an economically efficient, humane, and sensible intervention won the day.

Lessons to the Rest of the World

Then what can other nations learn of Finland? The initial one is that Housing First needs political courage and long-term outlook. Finland was not going to get results overnight. The PAAVO program only produced small reductions in the levels of homelessness within the first two years since it requires time to construct housing and train the personnel. Numerous politicians would have dropped the policy in the wake of one election.

Finland persisted with it over 15 years. Other countries such as the United States have tested Housing First locally in cities such as Denver and Salt Lake City, but never nationally. Housing first is still a patchwork of small programs with no nationwide funding and coordination, which are overwhelmed by demand. The lesson of Finland is, go big or go home.

The second lesson is that Housing First is not limited to housing only, but also involves integrated work with healthcare, income support, and tenancy rights. Finland was already enjoying universal healthcare, disability benefits, and tenant protection. The existence of that social infrastructure facilitated the implementation of Housing First.

In the US and other countries where these supports do not exist, such as the US where healthcare is job-based and disability benefits are insignificant, Housing First needs more aggressive case management and will fail to work in the event of funding reduction. Nevertheless, the Housing First remains more effective compared to the staircase even in the less generous systems. It is important to begin with the most needy and high cost homeless persons since they yield the highest savings. Any city is able to do that.

The third one is on messaging. Finland positioned Housing First as a viable solution to an expensive issue, rather than a handout or a left-wing experiment. They exploited information at will. All budget proposals had the cost benefit analysis of Housing first saving money. They did not also romanticize the issue but humanized it. Finland media published reports about homeless people as persons with complicated issues, not as saints and monsters.

This avoided the political backlash that has killed Housing First endeavors in other nations. Last but not least, Finland did not wait till everything was perfect. They began with a small pilot in 2008, and demonstrated that it would work, and grew. Any state or city can do the same. Whether Housing First works or not is not a question, it does. The question is whether we are willing to make attempts.

Conclusion

The Housing First policy of Finland has revealed that there is nothing deep about homelessness being a disease. It is a policy decision. We have decided to blame the plight of the homeless over a decades-long period of punishing them until they become stable enough to be provided with housing, which is almost impossible to gain on a sidewalk or a shelter cot. This was what we referred to as tough love but it was mere cruelty in the form of pragmatism. Finland demonstrated another way, the radical, evidence-based concept that a home is not the reward of good behavior. It is on its basis that good behavior is based.

 In thousands of cases, once-long-term homeless people are staying in regular apartments, paying rent, meeting with caseworkers, and, above all, have a door with a lock on it. They continue to be addicted, mentally ill, and poor. But they are not fighting in the street, they are fighting in safety of a home. And that is all the difference.

It is now the rest of the world that is catching up. Scotland has implemented a national plan in Housing First. Canada is testing out pilots. The success has been witnessed even in cities such as Newark and Houston even in the fragmented system of the United States.

However, none of the nations have been as consistent and scaled as Finland. It is a simple lesson, to achieve homelessness, you should cease constructing shelters and begin constructing homes. Cease insisting on preparation and begin giving unconditioned dignity. It is not gullible. It is not an idyllic state. It is as it stands, this very moment, in the cold, in the dark, of a Finnish winter. It is just lacking the political will to do the same in the rest of the places.

Also Read: A Case Study of Housing Development in a Health Care for the Homeless (HCH) Program