InterIM SeMInar Homelessness as unfairness: an ecological ...€¦ · of presenting “Science with and for Society” (european Commission, 2017) related to reversing Homelessness,

InterIM SeMInar

Homelessness as unfairness: an ecological perspective

ProceedingsDeliverable D7.1

(Horizon2020 Ga/726997)

InterIM SeMInar


ProceedingsDeliverable D7.1

December 2018

Organized by HOMe_eU WP1 team José Ornelas, Maria J. Vargas-Moniz, Maria F. Jorge-Monteiro, (ISPA - Instituto

Universitário, Rua Jardim do Tabaco, 34, 1149-041 Lisboa, Portugal)

Reference recommended format

HOMe_eU Project1 (2018). Interim Seminar on Homelessness as Unfairness. An Ecological Perspective (Deliverable H2020

Ga/726997 - D7.1). retrieved from http://xxxxx

Aknowledgements 1 HOMe_eU (Horizon 2020 Ga/726997) consortium study group: José Ornelas (Principal Investigator), Maria J. Vargas-

Moniz, Maria F. Jorge-Monteiro, (aPPsyCI – applied Psychology research Center Capabilities and Inclusion, ISPa-Instituto

Universitário, rua Jardim do tabaco, 34, 1149-041 Lisboa, Portugal); ronni M. Greenwood, rachel M. Manning, Branagh

O'Shaughnessy (Department of Psychology, University of Limerick, Limerick, V94 t9PX, Ireland); Inês almas, teresa Duarte

(aeIPS – the association for Study and Psychosocial Integration; Housing First project: Casas Primeiro, av. antónio José

de almeida, 26, 1000-043 Lisboa, Portugal); Francesca Disperati, Marta Gaboardi, Michela Lenzi, Massimo Santinello,

alessio Vieno (Department of Developmental and Social Psychology, University of Padova, Via Venezia, 8 -35131 Padova,

Italy); rita P. Marques, Maria Carmona, américo nave (Crescer – Community Intervention association, Bairro Qta Cabrinha

3–e/F 1300-906 Lisboa, Portugal); Freek Spinnewijn (FeantSa, european Federation of national Organisations Working

with the Homeless, Chausse de Louvain 194 Bruxelles 1210, Belgique); roberto Bernad, Borja rivero, Martin Julián (rais

Fundación, C/ Ardemans 42, 28028 Madrid, Spain); Anna Bokszczanin, Barbara Zmaczynska–Witek, Skałacka Katarzyna,

aleksandra rogowska (Institute of Psychology, Opole University, Pl. Staszica 1, 45-052 Opole, Poland); Sandra Schel,

Yvonne Peters, tessa van Loenen, Liselotte raben, Judith r. Wolf (radboud University Medical Center, radboud Institute

for Health Sciences, Impuls - netherlands Center for Social Care research, nijmegen, the netherlands); Ulla Beijer,

Mats Blid, Hakan Kallmen (STAD, Stockholm Center for Psychiatry Research and Education, Karolinska Institutet, Norra

Stationsgatan 69, 113 64 Stockholm, Sweden); teresa Bispo, tiago Cruz, Carla Pereira, (Câmara Municipal de Lisboa [the

Lisboa City Council], Praça do Município 38, 1100-038 Lisboa, Portugal); Pascal auquier, Junie M. Petit, Owen taylor (aix-

Marseille Univ, School of medicine – La timone Medical Campus, ea3279 CereSS – Health Service research and Quality

of Life Center, 27 Boulevard Jean Moulin, 13385 Marseille, France), Sandrine Loubière, aurélie tinland (Department of

research and Innovation, Support Unit for clinical research and economic evaluation, assistance Publique–Hôpitaux de

Marseille, 27 Boulevard Jean Moulin, 13385 Marseille, France).

ContentsIntroduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9

theory and Methods of the HOMe_eU Project: researching Housing First to end Homelessness in europe . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13José Ornelas, Maria Vargas-Moniz & Maria F. Jorge-Monteiro

europeans’ opinion about homelessness: preliminary results from a HOMe_eU citizen survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19Junie Petit, Sandrine Loubiere, Aurelie Tinland & Pascal Auquier

Homeless Services Users’ experiences of Housing and recovery: Preliminary Findings from eight european Countries . . . . . . . . . . . . . . . 23Ronni Michelle Greenwood, Rachel M. Manning & Branagh R. O’Shaughnessy

exploring service characteristics affecting the work with homeless people within housing first & traditional programs in Europe . . . . . . . 27Michela Lenzi, Marta Gaboardi, Francesca Disperati, Alessio Vieno & Massimo Santinello

national policies on homelessness in 8 eU countries: preliminary results from documental analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31Tessa Van Loenen, Yvonne Peters, & Judith Wolf

Social policies and local choices in Lisbon . . . . . . . . . . . . . . . . . . . . . . . . 35Maria Teresa Bispo

the unfairness of homelessness and the global economic crisis . . . . . 39Roberto De Vogli

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INTRODUCTION

the HOMe_eU: reversing Homelessness in europe is a research project aiming for social and Community-based transformative change.Considering that Homelessness persists as an eU transversal and unsolved societal challenge, this Horizon 2020 focused on Social Inequalities, expands the opportunities for reflecting on and generating systematized evidence to inform innovation in social policies of housing and community integration of people who have experience(d) long-term homelessness.the HOMe_eU Project is focused on generating debate and evidence demonstrating that the access to housing – individual, scattered and permanent – is a basic human right and is an effective response to the “glimpse of the obvious”(Sarason, 1974) that is Housing to respond to persistent and prolonged homelessness. With the studies that integrate the HOMe_eU Project we also aim to advance the Housing First Model as an evidence of effectiveness in responding to the phenomena of homelessness, by providing direct access to housing and supports aiming towards personal recovery and community integration.The perspective of effectively resolving the social situation of significant numbers of human beings that due to severe additions, mental health problems or other disabilities, life crisis or circumstances are persistently homeless through focused, evidence-based practices is a challenging endeavors that requires expertise, persistence and resilient advocators. the HOMe_EU project expects to provide an EU-based scientific contribution for those who are willing to promote change and social innovation in the field.the Interim Seminar was held on June the 20th, 2018 in the auditorium of the Orto Botanico in Padova. this event was associated with another initiative taken by the Italian Partner of the University of Padova that was the 3rd International Housing First Conference that was organized for the two previous days. In the HOMe_eU one day intensive event, there were 153 registered participants, and its main aim was to present the preliminary findings of the HOME_EU studies a series of local policy stakeholders, organizational leaders and service providers, as well as the Consortium members.the Seminar program was organized with three main emphases: a) an overview of the project framework and the Grant alignment to contribute towards an eU-based and empirically grounded theory of Justice; b) the presentation of the preliminary results of the research studies, and c) provide the opportunity for local and international policy stakeholders to exchange perspectives on how to respond to the challenges posed by homelessness.With an overall presentation of the HOMe_eU Project, Maria Vargas-Moniz (ISPa – Instituto Universitário), focused on the global and specific aims to the project emphasizing the multi-

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method approach for each of the studies, and that a transnational project such as this, requires a collaborative and creative leadership that balances both the expertise of each of the partners and the concrete aims to be attained. Generating evidence through diverse research methods, combining different designs is quite challenging, considering that for each of the pieces, we have had to generate concrete protocols and guidelines in eight european languages. this effort is quite demanding and requires specific supports to be advanced to the partners to be in equal circumstances, regardless their nature, or circumstantial conditions to complete the tasks.the presentation of the preliminary results of the study by Junie Petit (Université d’aix Marseille), on the Citizen’s opinions concerning Homelessness was quite expected by all the audience, because a country perspective reflects a national portrait on the theme and a general overview of the countries’ situation. through a representative sample of about 700 Citizens from the eight partner countries, and through a telephone survey, a significant percentage of participants, with cross-country variations, refer to have been environmentally exposed to Homelessness, and a relevant rate (15%) of the overall sample reported to have a personally or have a family/friend with an experience of homelessness. the service user’s study, presented by ronni Greenwood (University of Limmerick), provides a broad analysis on how the participants in the Housing First Service Model, report positive experiences and greater recovery when compared with the service users involved in the stair case model services. the overall sample of was of 573 service user’s, and the results indicate that despite cross-national variations the overall results are consistent with other studies, particularly on residential stability, housing quality, consumer choice and satisfaction with services.With the focus on the professional’s experiences, and the psychosocial mediators facilitating their empowerment and wellbeing, Michela Lenzi from the University of Padova, presented the results of the qualitative study. through thematic analysis, a series of interviews, focus groups, and photovoice, the results indicate differences and similarities among the Housing First and the Other Services teams, on topics such as independence and self-determination, health and recovery, social integration and informal networks, individualized aims and positive relational environments.In relation with the policy analysis study, tessa Van Loennen from the rUMC (radboud universitair medisch centrum), presented the results of the policy comparative analysis focused on national policy documents of the eight partner countries. the preliminary results focus on the analysis of 20 national policy documents analyzed through a consensualized framework, and indicate differentiated aims and objectives for Homelessness Policies. The confluent aims are related with poverty, housing supply, prevention and awareness, quality of the existing resources, and the capabilities and health promotion of the homeless population.reporting an experience from a Municipality perspective, teresa Bispo (Câmara Municipal de Lisboa), presents the local pltform on homelessness response that congregates 28 partners, including

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two Housing First Programs, priviling individualized housing instead of institutionalization, a reference support professional to facilitate social integration, and advocates for scattered and integrated housing options in the city’s social fabric. the global aim of this platform is to reduce the number of homeless people, ensure their quality of life, create more housing options, and foster employment towards autonomy.Finally, the presentation by roberto De Vogli (Human rights Center – University of Padova), on the unfairness of Homelessness in connection with the 2008 global economic crisis, addresses it’s relation with persistent poverty conditions. Vogli presents a broad perspective on fairness and how policies should respond to the appeal of ending homelessness, through a brief critical literature review, considering housing as a basic human right, and that policies should focus more on tackling the concrete challenge if reversing Homelessness.the premise of this event is consistent with the Project as a whole, and aims to follow the challenge of presenting “Science with and for Society” (european Commission, 2017) related to reversing Homelessness, the HOMe_eU scope.

ReferencesHorizon 2020 Work Program 2018-2020 “Science with and for Society” european Commission

Decision C(2017)7124 of 27 October 2017), currently replaced by the (european Commission Decision C(2019)1849 of 18 March 2019) http://ec.europa.eu/research/participants/data/ref/h2020/wp/2018-2020/main/h2020-wp1820-swfs_en.pdf

Sarason (1974) the Psychological Sense of Community: Prospects for a Community Psychology. San Francisco Jossey-Bass

http://ec.europa.eu/research/participants/data/ref/h2020/wp/2018-2020/main/h2020-wp1820-swfs_en.pdf

http://ec.europa.eu/research/participants/data/ref/h2020/wp/2018-2020/main/h2020-wp1820-swfs_en.pdf

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Theory and Methods of the HOME_EU Project: Researching Housing First to End Homelessness in EuropeOrnelas J. 1,4,5, Vargas-Moniz, M2,4,5 Jorge-Monteiro, M.F.3,4,5

1Principal Investigator for the HOME_EU Horizon 2020 Project; 2 Researcher for the HOME_EU Horizon 2020 Project; 3Project

Manager for the HOME_EU Horizon 2020 Project; 4ISPA – Instituto Universitário, Lisboa Portugal, 5APPsyCI (Applied Psychol-

ogy Research Center Capabilities and Inclusion)

the Home_eU: reversing Homelessness in europe Projects (http://www.home-eu.org/) a Horizon 2020 research grant (2016-2019) approved within a highly competitive grant line - were only 2 out of 400 financed proposals. It is aimed to mainstream individualized, scattered and permanent Housing First programs as a social policy aimed at ending long-term homelessness in eU countries (http://www.home-eu.org/). according to the eurostat (2015) it is estimated that 122 million people in the european Union context, are at risk of poverty and social exclusion; this figure corresponds to a percentage of 24.4% ofthe whole EU population. Considering that the EU is one of the world’s mostaffluent regions, there are major persistent social problems of which homelessness is one of the most expressive. about 410,000 people every night sleep outdoors or in temporary/emergency shelters (μ = 4.1 million homeless people p/year, FEANTSA, 2015). Example estimates by country indicate the representativeness of the phenonmenon in Italy 50,724 (0.24% of the population) is homeless (IStat, 2015); France 140,000 (0.21% of the population, InSee, 2012); Ireland 3,808 persons (0.1% of the population, CSO, 2011). the project is anchored in a multidisciplinary and combined theoretical disciplines including psychology, public health, political science, and other social sciences, and adopts guidelines of participation, collaboration, promoting social justice, critical reflection, empowerment and mastery (Kloos, Hill, Thomas, Wandersman, Elias, Dalton, 2012; Ornelas, 2008). Furthermore, it is important to acknowledge that within the homeless population some individuals (the long-term Homeless) tend to be persistently “left behind” (Dennis, D.; Locke, G.; Khadduri, J., 2007). “traditional” programs have failed to end long-term homelessness, andthe persistent explanation for the failure of these programs to end long-term homelessness is the lack of focus on problems such as addiction, severe psychiatric disorders, extreme poverty, or other social disadvantages (Busch-Geertsema, 2014; Ornelas, Duarte & Jorge-Monteiro, 2014; Greenwood, Schaefer, Winkel, & Tsemberis, 2006; Lavanco and Santinello, 2009; Bokszczanin, Toro, Hobden & Tompsett, 2014). Housing First not only contributes decisively for housing stability for the long-term homeless, and also for the reduction of health problems (as compared to traditional approaches (tsemberis, Gulcur & Nakae, 2004; Lancione, 2015).The Housing First model was originally developed in the

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United States to resolve chronic (long-term) homelessness, for people with serious mental health problems and co-occurring substance abuse (Tsemberis & Eisenberg, 2000). In Canada the action research program at Home/ Chez Soi (aubry, nelson, tsemberis, 2015), was crucial to consolidate Housing First, and the first country to assume it as a national social policy.While several studies investigated the effectiveness of Housing First on consumers’ health and housing stability, less is known about its effects on their level of social and community integration and capabilities gains (Patterson, Rezansoff, Currie & Somers, 2013; Ornelas, Martins, Zilhão & Duarte, 2014; Pleace and Quilgars, 2013; tsai et al., 2012, Goering et al., 2011; Shinn, 2015). Moreover, most of the studies in the field evaluated individually-based treatments for homeless people, but did not take into account changes in the socio-political environment that can affect individual well-being (Patterson et al., 2013).With an ecological and context-based research approach, a consortium of 12 partners from nine EU Countries (Fig. 1), is probing to fill this gap in our knowledge of the ways that Housing First, not only benefits persistently homeless people, but also reduces social inequalities and promotes innovative and useful community-based science.

Figure 1 – the Consortium composed by 6 Universities, 1 research Institute, 3 nGOs, 1 Foundation and 1 Municipality

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the global aims of this project are to provide a comprehensive understanding on how the europeans perceive, tolerate and contest the extreme inequality of Homelessness. these aims are to be attained within five levels of analysis:1) to develop a continuum indicator from tolerance to Contest capacity of eU Citizens towards

long-term homelessness, and to identify variability among the different countries;2) to Observe if people who are currently homeless and people who have been integrated in

Housing First Programs report differences on their capabilities gains, personal recovery, and their opinions on the service efficacy;

3) to understand the perspectives of service providers about the ways that their organizations effectively reverse homelessness, promote capabilities, and contribute toward the (in)formation of social policies;

4) to analyse social policies on homelessness in terms of result orientation toward housing policies aimed at reversing homelessness through Housing First and Community Integration

5) to establish a dialogue of the four precedent ecological levels of analysis: a) eU Citizens perceptions; b) people who are currently long-term homeless, and people that have been integrated in Housing First Programs; c) service providers for the currently Homeless, and those in Housing First Programs; d) key-stakeholders on policy development and eU social policies, all intended to respond to homelessness in order to profile each partner country on the key elements of program efficacy

Considering the quantitative/qualitative combinations of the selected measures, including telephone surveys, surveys, interviews, focus-groups and photo voice, the first months of project implementation were dedicated to the translation and cultural adaptation of all the measures (30) of the several studies, including scales, interview guides and protocol guidelines, that constitute at this stage a portfolio of measures in english, Dutch, French, Italian, Polish, Portuguese, Spanish and Swedish, that constitute a relevant “tool box” to be made available for future use within further research endeavors. the studies developed have differentiated designs e.g. Citizen’s knowledge, attitudes, practices and willingness to pay, with a telephone survey, the service users with a time zero and time one (one-year follow-up), and a purposive sample of qualitative interviews, the service providers studies comprised a qualitative phase (interviews for team coordinators, focus-groups for teams and a photo voice) and a quantitative phase with a survey, the policy studies comprised a documental analysis of homelessness policies and particularly the national legislative or programmatic endeavors including housing first and a survey for service directors and representatives of national homelessness programs or policy sectors. each of the studies has a series of programmed deliverables that comprise specific sections country-based comparisons of the KAP, and WTP for eU Citizens; the users and providers of Housing First and the Staircase homeless services; as well

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as the national/regional policies and leaders. a selection of nested data is being modeled in order to understand the dynamics of the several sectors (Citizens Opinions; Service User’s; Service Providers, Policies and Policy Stakeholders) on a beneficiary country based analysis.

The HOME-EU influencing within partner countries the implementation of a policy-driven project like the HOMe_eU requires a process focus on strategic interventions or continuing efforts to influence the dynamics of Housing First implementation within the partner countries. Some of the attained achievements were focused on dissemination, active participation, as consolidating national or transnational partnerships. On dissemination, we emphasize the efforts the focus on the vision that long-term homelessness is a solvable human rights social problem. through the active participation in national and already some transnational events and bodies the HOME_EU Project is influencing service-model developments and contributing with programmatic pieces, for advanced training, and direct policy influence.Considering that there have been many significant national advancements in new legislative pieces, and national strategies (e.g. France, Ireland, Portugal) or renovated socio-political dynamics (e.g. Spain, Poland), the beneficiary teams are more embedded into national and transnational networks and acting as consultants or facilitator for the development or consolidation of housing first programs. ReferencesKloos, B., Hill, J., Thomas, E., Wandersman, A., Elias, M.J., Dalton, J. (2012) Community Psychology:

Linking Individuals and Communities. Belmont, Ca: Wadsworth

Ornelas, J. (2008) Psicologia Comunitária. Lisboa: Fim de Século

Bokszczanin, A., Toro, P.A., Hobden, K., & Tompsett, C.J. (2014). Post-traumatic stress disorder among homeless adults in Poland: Prevalence and predictors. Open Journal of Psychiatry, 4, 9-15.

Busch-Geertsema, V. (2013). Housing First europe Final report. Brussels: european Union Programme for employment and Security.

Central Statistics Office (2011). Census 2011 Results. http://www.cso.ie/en/media/csoie/census/documents/homelesspersonsinireland/Homeless,persons,in,Ireland,a,special,Census,report.pdf

Dennis, D., Locke, G., & Khadduri, J. (2007). Toward understanding homelessness: The 2007 national symposium on homelessness research. http://aspe.hhs.gov/sites/default/files/pdf/120751/report_0.pdf

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eurostat (2015). europe 2020 indicators: poverty and social exclusion. retrieved from http://ec.europa.eu/eurostat/statistics-xplained/index.php/europe_2020_indicators_-_poverty_and_social_exclusion Institut national de la Statistique et des études Économiques (2012). Conditions de vie-Société: Logement. retrieved from http://www.insee.fr/fr/themes/document.asp?ref_id=ip1455

IStat Istituto nazionale di statistica (2015). Italia in cifre: edizione 2015. http://www.istat.it/it/archivio/166216.

Goering, P., Streiner, D., adair, C., aubrey, t., Barker, J., Distasio, J., . . . Zabkiewicz, D. (2011). the associated with document ref. ares (2016) 4021467 - 01/08/2016

Greenwood, R.M., Schaefer-McDaniel, N., Winkel, G., & Tsemberis, S. (2005). Decreasing psychiatric symptoms by increasing choice in services for adults with histories of homelessness. american Journal of Community Psychology, 36 (3/4), 223-238

Lancione, M. (2015). Housing First: successo, modelli e sfide politiche. Psicologia di Comunita', 2, 23-40. doi:10.3280/PSC2015-002003

Lavanco, G, & Santinello, M. (2009). I senza fissa dimora. Analisi psicologica del fenomeno e ipotesi diintervento. Milano: Paoline editoriale Libri.

Ornelas, J., Duarte, T., & Jorge-Monteiro, F. (2014). Transformative organizational change in community mental health. In G. Nelson, B. Kloos & J. Ornelas (Eds), and Community psychology and community mental health: towards a transformative change (pp. 253-277). new York: Oxford University Press.

Ornelas, J., Martins, P., Zilhão, M.T., & Duarte, T. (2014). Housing First: An ecological approach to promoting community integration. european Journal of Homelessness, 8 (1), 29-56.

Patterson, M., Rezansoff, S., Currie, L., & Somers, J. (2013). Trajectories of recovery among homeless adults with mental illness who participated in a randomized controlled trial of housing first: a longitudinal, narrative analysis, BMJ Open 3 (9), 1-8.

Pleace, N., & Quilgars, D. (2013). Improving health and social integration through Housing First: A review. Brussels: FeantSa.

Shinn, M. (2015). Community psychology and the capabilities approach. american Journal of Community Psychology, 55 (3/4), 243–252.

Tsai, J., Mares, A., & Rosenheck, R. (2012). Does housing chronically homeless adults lead to social integration? Psychiatric Services, 63 (5) 427-434.

tsemberis, S. and eisenberg, r. (2000) Pathways to Housing: Supported Housing for Street-Dwelling Homeless Individuals with Psychiatric Disabilities, Psychiatric Services 51 (4) pp. 487-493.

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Tsemberis, S., Gulcur, L., & Nakae, M. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with dual diagnosis. american Journal of Public Health, 94 (4), 651-656.

aubry t, nelson G, tsemberis S. 2015 Housing First for People with Severe Mental Illness Who are Homeless: a review of the research and Findings From the at Home-Chez soi Demonstration Project. Canadian Journal of Psychiatry nov;60(11):467-74.

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Europeans’ opinion about homelessness: preliminary results from a HOME_EU citizen surveyPetit JM1 , Loubiere S1,2, Tinland Aurelie1,3, Auquier P1, HOME_EU consortium study group.

Author information

1 Aix-Marseille University, EA 3279 Research Unit, France -13385.

2 Department of Epidemiology and Health Economics, Department of Research and Innovation, Assistance Publique Hôpi-

taux de Marseille, APHM, France-13005 Marseille

3 Department of Psychiatry, Sainte-Marguerite University Hospital, France-13009 Marseille

AbsTRACT

IntroductionSince the early 1990s, the Housing First model appeared as a promising approach for a paradigm shift in the care of homeless people. this innovative care model offers immediate access to permanent housing - with no requirements for sobriety or treatment adherence, and support from a multidisciplinary team as a prerequisite for recovery and community integration of homeless people with mental and/or chronic medical illnesses (i.e. mental illness, alcohol or drug addiction, disability) (tsemberis et al. 2004; Goering et al., 2011; tinland et al., 2013). In the USa, in Canada, and in various european countries, experiments and pilot Housing First programmes have been implemented (aubry et al., 2015). to date, there is little research on the views of the general population regarding homelessness and programs targeting its reduction (Toro & McDonnell, 1992; Tompsett et al. 2006). Public stakeholders would benefit from an evaluation of public perception, to better understand what drives public support when it comes to homeless.

Objectivesthe primary objective of the present abstract is to present some preliminary results of the HOMe_eU citizen survey on europeans’ opinions about homelessness and programs targeting its reduction.

Methodsa telephone survey using landlines and mobile phones was conducted from March to December 2017 in France (Fr), Ireland (Ir), Italy (It), the netherlands (nL), Poland (PL), Portugal (Pt), Spain (SP), and Sweden (Se) following an initial random selection of adults (18 years or older) from opt-in panels (n=2,500 per country). Bilingual interviewers were recruited and trained. A quota sampling approach was carried out to optimize the representativeness of the sample with regards to age and gender for each country (Curtin et al. 2005). additionally, national census data (eurostat

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database) were used to apply weights to the sample as regards to educational attainment. an indicator of exposure to homelessness was computed to measure respondents’: i) environmental exposure, i.e. whether or not they saw homeless people regularly; ii) interaction, i.e. whether or not they had regular interaction with homeless people through volunteer work; iii) membership, i.e. whether or not they had ever been homeless during the course of their life or whether they had a relative or acquaintance who was ever homeless; homelessness was defined as rough sleeping or using emergency shelters in all countries. Data on participants’ perception of the magnitude and the main causes of homelessness, and the funding of services addressing homelessness were gathered and compared to the Eurobarometer 2010 (TNS Opinion & Social, 2010).

Preliminary Results Overall 5,631 interviews were collected (about 700 for each country). responses rates varied between 30.4% and 33.5%. at least, 46% of the sample reported having been exposed to homelessness, with no differences in exposure between men and women. On environmental exposure, Se and PL exhibited higher rates than all other countries (44% and 43% respectively). although respondents from Pt and Ir were less likely to see three or more homeless per week (25%), they were more likely to have volunteered with an organisation assisting homeless people (22% and 16%, respectively); respondents from nL reported the lowest exposure through interaction (5%). Overall, 15% of the sample either reported having a personal experience of homelessness or having a relative or friend with such an experience, with Ir and nL showing the most extreme rates (9.5% and 18.7%, respectively). Overall, three-quarter of respondents thought the magnitude of homelessness had increased, a perception that was consistent with the estimates from the eurobarometer 2010 survey. Similarly, perceptions varied across countries, ranging from 59% in NL to 90% in FR and IT (p = .003). Markedly, a difference of 6 points in the beliefs that homelessness had increased over the last three years was found between exposed and non-exposed respondents (77% vs. 71%). the three leading causes of homelessness reported by surveyed participants were: 1) job loss, 2) addiction issues, and 3) rent arrears. addiction issues was mostly cited in PL (77%), Pt (74%), Ir (67%), and Se (65%). a clear majority of respondents (76%) reported that government spent too little on homelessness, with exposed respondents being more likely to encourage governmental funding; this opinion varied significantly between countries (p<.0001). For example, while 25% of respondents from SE and FR believed that the level of governmental spending was sufficient, less than 7% had the same belief in SP, Pt and It. Interestingly, though 28% of French respondents thought the government spent too much on social welfare, only 2.6% thought that national expenditures on homelessness were already too high. these nuanced perceptions between funding of homeless programs and the overall welfare system were observed in all countries, except in Pt and It.

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DiscussionThese preliminary results described opinions on homelessness in Europe. More specifically, differences in perceptions appeared between respondents according to their personal exposure to homelessness: awareness seemed more acute in exposed respondents (toro et al. 2007). Unsurprisingly, respondents more often perceived factors related to economic constraints as the leading causes of homelessness. This may reflect the growing socioeconomic strain in Europe, wherein employed people struggle to have a decent living standard and an unrestrictive access to care (Stuckler et al. 2017). Most strikingly, almost 17% of respondents reported that their government spent too much or enough money on homelessness. When these results were put in light of their overall assessment of the government spending on social welfare, something interesting emerged, questioning the redistribution of wealth. Finally, in light of the development of programs such as Housing First aimed at reversing homelessness, those preliminary results could provide stakeholders with a better understanding of the drivers of public support when it comes to homelessness.

Referencestsemberis, S., Gulcur, L., nakae, M. Housing First, Consumer Choice, and Harm reduction for

Homeless Individuals With a Dual Diagnosis. am. J. Public Health 2004; 94, 651–656.

Goering, P., Streiner, D.L., adair, C., et al. the at Home/Chez Soi trial protocol: a pragmatic, multi-site, randomized controlled trial of a Housing First intervention for homeless individuals with mental illness in five Canadian cities. BMJ Open. 2011 Nov 14;1(2):e000323.

tinland, a., Fortanier, C., Girard, V., et al. evaluation of the Housing First program in patients with severe mental disorders in France: study protocol for a randomized controlled trial. trials 2013;14, 309.

aubry, t., nelson, G., tsemberis, S. Housing First for People With Severe Mental Illness Who are Homeless: a review of the research and Findings From the at Home–Chez soi Demonstration Project. Can. J. Psychiatry rev. Can. Psychiatr. 2015; 60, 467–474.

toro, P.a., McDonnell, D.M. Beliefs, attitudes, and knowledge about homelessness: a survey of the general public. am. J. Community Psychol. 1992; 20, 53–80.

tompsett, C.J., toro, P.a., Guzicki, M., et al. Homelessness in the United States: assessing Changes in Prevalence and Public Opinion, 1993-2001. am. J. Community Psychol. 2006; 37, 29–46.

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toro, P.a., tompsett, C.J., Lombardo, S., et al. Homelessness in europe and the United States: a Comparison of Prevalence and Public Opinion. J. Soc. Issues 2007; 63, 505–524.

Stuckler D, Reeves A, Loopstra R, et al. Austerity and health: the impact in the UK and Europe. Eur J Public Health. 2017 Oct 1;27(suppl_4):18-21.

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Homeless services Users’ Experiences of Housing and Recovery: Preliminary Findings from Eight European CountriesRonni Michelle Greenwood, Rachel M. Manning, Branagh R. O’Shaughnessy

Psychology Department, University of Limerick, Ireland

Introductionthe eU-funded Horizon2020 project, “Homelessness as Unfairness” (Home-eU) aims to understand the extent to which social policies, the characteristics of homeless services, and citizens’ attitudes toward homelessness and homelessness interventions are poised to reverse or sustain homelessness in eight European countries. It is also the first cross-national investigation of experiences of services and recovery among adults with histories of homelessness, the preliminary findings of which are the focus of this report. Home-EU takes a capabilities approach (Lyon-Callo, 2008; nussbaum, 2011; Sen, 2010) in which homelessness is conceptualized as an extreme situation of inequality and unfairness. as homelessness continues to increase across most European countries, politicians and policymakers are challenged to reconfigure homeless services in ways that go beyond merely managing homelessness to reversing it through policies that increase individuals’ capabilities, or freedom to realize their full potential. Housing First (tsemberis, 2010) is an evidence-based, with histories of homelessness and complex support needs that not only ends homelessness but is also hypothesized to enhance capabilities (Shinn, 2015). Recently, the European Commission endorsed the reconfiguration of “Staircase model” services toward “housing led” approaches (european Commission, 2013), of which Housing First is the gold standard. This report describes preliminary findings from a comparison of experiences of homeless services users engaged either in Housing First programmes or Staircase programmes in eight european countries.

ObjectiveOur primary objective was to test the hypothesis that participants engaged in Housing First services report more positive experiences of homeless services, and report greater recovery on key indicators, than participants engaged in Staircase services. Materials and Procedures: Consenting materials and 13 valid and reliable measures were translated from english into Dutch, French, Italian, Polish, Portuguese, Spanish and Swedish using best practice translation-back translation techniques (Beaton, Bombardier, Guillemin, & Ferraz, 2000). Outcome measures assessed at this first time point included residential stability, housing quality, consumer choice, satisfaction with services, psychiatric symptoms, community integration, and capabilities enhancement. Participants were recruited through connections with local service

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providers in each country. Measures were administered individually to each participant by trained research interviewers and in accordance with standardized procedures that were agreed and codified in a common protocol.

ParticipantsA total of 573 homeless services users (Housing First = 244 and Staircase services = 329) completed this first wave of data collection. Reflecting the adult homeless population, most participants were single (n = 348, 60.7%%), men (n = 435, 75.9%), and on average, 47.3 years old (range = 19-84, SD = 11.73). Please see Table 1 for participant characteristics by country.

ResultsSee Tables 2 and 3 for a summary of findings. Results of a 7 (Country) x 2 (Group) between-subjects analysis of variance indicated that participants engaged with Housing First reported greater residential stability, housing quality, consumer choice, and greater satisfaction with homeless services. Further, Housing First participants reported fewer psychiatric symptoms, greater community integration, and greater capabilities enhancement. although differences between Housing First and Staircase services were stronger in some countries (e.g., Ireland, Italy, and Sweden) than others (France, the netherlands), the overall pattern across the full sample demonstrates the greater efficacy of Housing First for increasing residential stability, providing recovery-oriented services, and promoting recovery in important domains.

Conclusions and Limitationsevidence from seven european countries suggests that Housing First does work in different locations with different political, economic, and social contexts to end homelessness and promote recovery for adults with histories of homelessness and complex needs. although these findings are consistent with a large and expanding body of evidence of positive outcomes of Housing First implementations, they must be interpreted with some caution. these data are cross-sectional and correlational. Participants were enrolled in homeless services for various lengths of time. Housing First programmes in different countries were at different developmental stages. Some programmes were older and more established (e.g., France and Portugal), while some were younger (e.g., Ireland and Italy). they also varied in terms of size and number of programmes in each country. this research is ongoing, and we intend to use this baseline data set to control for programme differences in our analysis of time 2 data collected on the same measures.

Policy RecommendationsBased on these and other findings, we recommend European expansion of HF programmes with high fidelity to the original model through the implementation of new programmes and

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reconfiguration of staircase services to Housing First. To accomplish this goal, we encourage the european Commission to promote and support professionals’ training in delivering client-led, empowering, recovery-oriented supports and services to all individuals who experience homelessness or who are at risk of homelessness. We encourage the european Commission to develop policy incentives to increase all eU countries’ capacities to obtain affordable scatter-site, independent housing through rent supplements and other schemes for adults with histories of homelessness. Independent scatter-site housing is important because it not only decreases stigma that sustains inequality and unfairness, but it also improves community integration, while addressing the safety, security, and privacy needs of adults with histories of homelessness. Housing First, the gold standard of ‘housing led approaches’ is an evidence-based model of homeless services delivery that reverses homelessness and decreases unfairness and inequality through a combination of scatter-site housing and empowering, time-unlimited supports. (800 words) ReferencesBeaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of

cross-cultural adaptation of self-report measures. Spine, 25, 3186-3191.

european Commission. (2013). Confronting homelessness in the european Union.

Lyon-Callo, V. (2008). Inequality, poverty, and neoliberal governance: activist ethnography in the homeless sheltering industry. toronto: University of toronto Press.

nussbaum, M. C. (2011). Creating capabilities. Boston: Harvard University Press.

Sen, a. (2010). the idea of justice. London: Penguin.

Shinn, M. (2015). Community psychology and the capabilities approach. american Journal of Community Psychology, 55, 243-252.

tsemberis, S. J. (2010). Housing First: the Pathways model to end homelessness for people with mental health and substance use disorders. City Centre, Mn, USa: Hazelden.

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Table 1Participant Characteristics

Sample Size age (in years) Gender (Male) relationship (Single)

HF OS HF OS HF OS HF OS

France 40 39 M=41 M=43 62.5% 82.1% 72.5% 84.6%

Ireland 38 45 M=42 (SD=2)

M=40 (SD=14) 76.3% 72.1% 47.4% 60.5%

Italy 38 46 M=58 (SD=10)

M=54 (SD=10) 84.2% 84.4% 42.1% 32%

Poland 0 45 - M=46 - 68.9% - 57.8%

Portugal 41 36 M=45 (SD=12)

M=49 (SD=9) 78% 69.4% 87.8% 69.4%

Spain 34 35 M=47 (SD=10)

M=49 (SD=6) 76.5% 71.4% 52.9% 51.4%

Sweden 21 48 M=54 (SD=8)

M=48 (SD12) 81% 83.3% 61.9% 57.4%

the netherlands 32 35 M=48 (SD=9)

M=47 (SD=13) 65.6% 82.9% 71% 65.7%

Table 2Housing and Services Outcomes

Group France Ireland Italy netherlands Poland** Portugal Spain Sweden Group Mean

residential Stability*OS 37.90 6.29 2.72 26.40 20.67 4.60 11.50 2.50 14.07

HF 79.80 76.90 90.30 87.40 - 81.50 82.90 42.80 77.37

Housing QualityOS 2.65 2.97 2.67 3.06 2.93 2.63 2.27 2.95 2.77

HF 2.84 3.59 3.31 3.18 - 3.29 3.55 3.56 3.33

Consumer ChoiceOS 3.20 2.74 2.01 3.35 2.97 2.15 2.78 3.05 2.78

HF 4.21 4.52 4.07 4.26 - 4.13 4.49 4.74 4.35

Satisfaction with Services

OS 3.62 3.44 2.79 3.45 3.43 3.43 3.46 2.92 3.32

HF 3.51 4.18 3.75 3.81 - 3.81 4.73 4.27 4.01

*Proportion of time in independent accommodation in past six months. **Poland does not have a Housing First programme and was not included in the anOVa. Bold type indicates significant group differences within country (p < .05).

Table 3Outcome

Group France Ireland Italy netherlands Poland* Portugal Spain Sweden Group Mean

Psychiatric symptoms

OS 1.09 2.24 2.10 2.03 2.38 2.53 2.32 2.52 2.15

HF 0.77 1.80 1.69 2.30 - 2.15 1.78 1.91 1.77

Community integration

OS 2.34 3.85 3.62 3.98 4.18 3.27 3.42 3.40 3.51

HF 3.60 4.07 4.11 3.94 - 3.81 3.96 4.26 3.96

Capabilities enhancement

OS 3.25 3.29 3.02 3.58 4.51 3.53 2.97 3.29 3.43

HF 3.67 4.02 4.20 3.70 - 4.09 4.28 4.12 4.01

*Poland does not have a Housing First programme and was not included in the anOVa. Bold type indicates significant group differences within country (p < .05).

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Exploring service characteristics affecting the work with homeless people within housing first & traditional programs in EuropeMichela Lenzi, Marta Gaboardi, Francesca Disperati, Alessio Vieno & Massimo Santinello

Department of Developmental Psychology and Socialisation, University of Padova, Italy

Introduction In the current work, preliminary findings of Work Package 4 (WP4) of the H2020 project “Homeless as unfairness” were presented. the main aim of WP4 is to examine which service characteristics influence the work with homeless people, by comparing Housing First (HF) and Other (traditional) Services (OS). Several actors are involved in the programs: service users, providers, citizens, the political background and its policies. the current work focuses on the role of service providers. the Providers’ Study is based on the “Capabilities approach” (nussbaum, 2011) and on the “empowering Community Settings model” (Maton, 2008) frameworks. these theories underline the importance of services characteristics on promoting some psychological mediators (such as motivation or self-efficacy) in the members of a group, that in turn are associated to their empowerment and well-being.

Aimstherefore, the Providers’ Study start with the research question: which services characteristics influence the work with homeless people? The WP4 Providers’ Study includes a qualitative and a quantitative study: in the first one, focus groups, semi-structured interviews and photovoice projects were conducted, both in HF programs and traditional services. exploring how the participants describe the characteristics of their service allows which of these factors could affect their working with homeless people.

Procedure and methodsthe Study was conducted in 8 european countries involved in the project (France, Ireland, Italy, netherland, Poland, Portugal, Spain, Sweden). a research protocol was shared among partners and approved by european ethic Committee. In this section we present our preliminary analyses of the data collected through focus groups (2 HF and 2 OS programs in each countries). Two main questions guided the discussion: first, we asked them to describe the main aims of the program, and what specific characteristics promote or hinder their work.

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Data analysisWe used thematic analysis to interpret responses to questions. two independent coders conducted the qualitative data analysis. In the first step, each coder independently read and re‐read data for familiarization. The second step involved coding the data: a first set of codes was created based on the empowering community settings model (Maton, 2008); the codes were then integrated with new ones based on the content of the focus groups. Codes were then used to create themes.three main themes were examined: service goals, vision and system of values, relational environment. HF programs and traditional services were compared in relation to these three areas. In this stage, data were analyzed altogether, without taking into account potential cross-country differences.

Results In relation to service goals, providers mostly talked about users’ well-being, particularly users independence and self-determination, as main aims of the service. this was much more frequent on HF programs than in traditional services (21 vs 4 sentences).In both kind of services participants talked about health and recovery (7 sentences in both kind of services). However, considering the specific content of the sentences, it is possible to note that in HF programs providers mostly referred to recovery and the overall quality of life, while in traditional services they mostly talked about meeting users’ health needs and solving health problems.additional dimension related to service goals are social integration and inclusion. Social integration was more frequently mentioned as one of the main aims in traditional services (20 vs 8 sentences). In both services participants talked about the importance of the informal social network; in traditional services they were also referring to homeless services in the community and work trainings, while in HF they also mentioned the need to address inequalities in society as a possible pathway to homeless people integration.Finally, participants talked about the importance for the service to have a larger purpose; in this category, the most frequently discussed topic had to do with preventing, reducing or eliminating homelessness.In relation to vision and system of values, in both services, providers talked about the importance of sharing a system of values, underlying how the lack of it can be an obstacle for the effectiveness of the program. In addition, the relation between principles and practice was a very frequent topic of discussion. Most of the sentences coded in this category described the struggle of dealing with an inconsistency between principles and practice. this was a very frequent topic of discussion especially in HF programs (26 vs 4 sentences), probably due to the many innovative aspects of the model that are difficult to realize or to the high expectations that usually characterize HF providers.

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In relation to specific values, in both services the most frequently mentioned were: dignity, respect, honesty and non judgmental attitude. In both services, service providers underlined the importance of working with passion and idealism. the importance of a person-centered approach was a very frequent topic of discussion in HF programs: providers underlined the importance to give users responsibility and decide the direction of their individualized program and its goals (27 sentences). also in traditional services providers underlined the importance of a person-centered approach, although most of the times they described the need to adapt the program to users’ needs (instead of resources).regarding the relational environment, in both services participants underlined the importance of having caring relationships with colleagues and the availability of support and social cohesion as critical aspects promoting the effectiveness of the program. Moreover, in HF as well as and other services, providers underlined the need to develop a strong relationship with the users, since this makes it easier to work with them on their skills and resources.Finally, in both services providers talked about the importance of the supervision for the staff (7 sentences in HF, 10 in OS), underlying that the lack of supervision can be an obstacle for the effectiveness of the program.

Discussionalthough the analyses of the focus groups are still ongoing, a number of factors have been identified as key factors for programs in homeless services.In particular, it is important to note that some characteristics are different between the two programs. regarding the goals in HF participants are more concentrated on users’ well-being using a person-centered approach, useful to promote choice on clients. OS are more concentrated on social integration, understood as possibility to find resources in the community. Perhaps, because OS need of find a solution for homeless people outside the programs, not having housing available. the differences emerged in the theme of system of values underline the theme of inconsistency between principles and practice in HF programs. Perhaps, the principles of HF (focused on choice, harm-reduction and recovery) are on ambitious high-level, difficult to reach with people that are living extreme condition of poverty with different problems (addictions, mental-illness…). regarding the relational environment, it is interesting to note that in both services participants underlined the importance of having caring relationships in the team and a strong relationship with the users. the relationship seems to be an essential ingredient of the work with this target.

Conclusion It is important to underline that in this stage we presented also some preliminary data. In fact, data were analyzed altogether, without taking into account potential cross-country differences.

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Moreover, the themes emerged could be analyzed more in deep to find sub-themes of meanings.nevertheless, these results already show factors to consider to the implementation of a service with homeless people.

ReferencesMaton K. I. (2008). Empowering Community Settings: Agents of Individual Development, Community

Betterment, and Positive Social Change. american Journal of Community Psychology, 41, 4-21.

nussbaum, M. C. (2011). Creating capabilities: the human development approach. Cambridge, Ma: Belknap Press.

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National policies on homelessness in 8 EU countries: preliminary results from documental analysis Van Loenen T , Peters, Y., & Wolf, J.L.R.M.

Impuls - Netherlands Center for Social Care Research, Department of Primary and Community Care, Radboud University

Netherlands.

Introduction the Work package 5 (WP5) of the Home_eU project focuses on policies on homelessness within 8 partnered eU countries, with a particular interest in participation as a determinant of the quality of daily life of citizens and an essential issue for human recovery.

Objectivesthe aim of WP5 is to perform a comparative study of both policies on homelessness and policies that promote implementation of Housing First in europe. the aim of this presentation is to examine the orientation and objectives of the national policies in the 8 countries participating in the Home_eU project and how they relate to the social quality model that describes necessary conditions for participation and self-direction.

Methods WP5 relies on a two-stage qualitative study consisting of 1) documental analysis of policies on homelessness and 2) survey among national and municipal key stakeholders. this presentation focuses on preliminary results of the documental analysis. this was done in a few steps. at first a protocol was developed with specific guidelines for the search for documents in the 8 countries. Several sources were described to identify relevant policy documents: a) Databases of public records (e.g., records of legislative changes, media communications, annual reports from government departments), b) researchers (i.e., those whose research may have been used in the policymaking process), c) Policymakers (i.e., legislators or policy advisers). Inclusion criteria for documents were as follows: 1) documents concerning the long-term homeless population (houseless and roofless)2) documents focusing on reversing homelessness or promoting HF3) the time frame was set for 2011-2017A framework of analysis was developed to describe documents on specific topics e.g. a description of the policy and the policy context, aims and policy measures, involvement of stakeholders, level of choice for target population, effectiveness and outcomes. Considering the 8 european languages involved in the Consortium the research team delineated a protocol in order to harmonize the data into a common framework of analysis in english. the developed protocol had several feedback rounds in order to make sure that it was applicable in the different contexts of the 8 countries.

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after the feedback rounds, all Home-eU partners from participating countries started to search documents, include them according to inclusion criteria and complete the framework of analysis in english for each included document. all the completed frameworks of analysis were then sent to the WP leader (rUMC) for further analysis. the contents of the included policy documents were analysed using the social quality model. This model is based on the following definition of social quality: “The extent to which citizens are able to participate in the social, economic and cultural life of their communities under conditions which enhance their well-being and individual potential” (Beck, van der Maesen & Walker, 1998). The model consists of two dimensions: The first dimension – structural versus individual – reflects the fundamental tension between social structures and human agency. the second dimension – relational versus institutional – refers to the tension between informal relationships in the community (family, networks, groups) and the formal relationships in institutions (e.g., healthcare, employment, educational, financial). Combining these two dimensions results in four necessary conditions for the participation and self-direction of members of society.

Preliminary results In total rUMC received 79 documents analyzed by partners’ countries. of which 20 were initially selected considering the national level scope. the remaining documents are to be analyzed within a regional/local (municipal) programmatic perspective. Based on the aforementioned criteria, 59 were excluded. twenty frameworks of analysis from 8 countries were included and analyzed. Figure 1 shows orientations and objectives of european policies along the dimensions of the social quality model. Key results of documental preliminary analysis can be summed as follows: 1. Most policies are focusing more on the system world (formal relations) than on the life world

(informal relations)2. Very few policies include elements that are focused on social empowerment. 3. Within some countries the homelessness policy focuses on just one or a few elements of a

single dimension of the social quality model (for instance in Poland the policy focus is to strengthen and improve the existing resources), while policies in other countries focus on several elements of different dimensions of the social quality model (such as the national strategy of Spain).

DiscussionIn these preliminary analyses we showed that homelessness policies within the 8 eU countries focus on different kinds of aims/objectives and vary considerably concerning the width of their scope. the intended survey among national and municipal key-stakeholders might provide more in-depth and comparable information on the specific focus, level of implementation and evaluation of the national and municipal social policies of the 8 countries.

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ReferencesBeck, W., van der Maesen, L., & Walker, A. (1998). The Social Quality of Europe. Bristol, Policy

Press.

Confronting Homelessness in the european Union. Brussels, Belgium: european Commission; 2013.

Figure 1. Preliminary results: Policy orientations and objectives of 8 european countries along the dimensions of the social quality model.

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social policies and local choices in Lisbon1

Maria Teresa Bispo

(Advisor to the Lisbon City Councillor for Social Rights and Coordinator of NPISA - Rua do Arsenal, 54 - 2º piso, 1100-040

Lisboa)

IntroductionLisbon is a city of sharing where everyone must have access to their fundamental rights. For better understanding it is important to know what happened in recent times in the City of Lisbon. Since the last decade of the 20th century, the Lisbon City Council has developed a number of programs aimed at people with social vulnerability. However, we can mark the beginning of a transformative change only a few years ago. From 2013 onwards, the Social action policy from the Lisbon City Council was renamed as Social rights Sector.

ObjectivesIt is easily understandable what such modification in the designation may mean in terms of public and local policy. this change comprehends a new aim in which every citizen can access and exert their fundamental rights. the new approach leaves behind the mere assistance perspective. nowadays, this aim is covered under the Department of education and Social rights designation, which includes all matters concerning Homeless People 2.

MethodsIn this context we have three types of responses: emergency, transition and Housing. Lisbon has also 10 Street teams that are present all year round, 365 days both during daytime and night time. All the responses have a strong financial support from the municipality. On the other hand, the existence of many homeless people has gained a national concern in Portugal that gives rise to a national strategy and approach to the social problem of homelessness - enIPSSa 2017|2023. this Portuguese national Strategy aims to organise and integrate prevention and intervention approaches, therefore one doesn’t need to stay on the street for lack of alternatives3.

In order to implement the national Strategy it was created the nPISa (s) - Planning and Intervention team for Homeless People. It is a free model structure based on the cooperation of a network of local partners. In Lisbon, nPISa is coordinated by the Municipality, through the City Councillor for education and Social rights. Until recently, the nPISa had a structure based in two axes - the Planning axis and the axis of Intervention. With the new councillor for education and Social rights, two more axes were added to the structure, considered decisive in the approach and direct action on

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the homeless population – the Health axis and the Housing and employability axis. Currently nPISa has 28 partners and two of them have been developing the housing first programme - AEIPS Casas Primeiro (50 houses/flats), integrated housing project for people with mental health problems and CRESCER É Uma Casa (30 houses/flats), integrated housing project for people with addition problems. Housing First (HF) is one of the most successful approaches to homelessness in Lisbon. the expectations are high and HF has been corresponding to it. therefore, the municipality wants to increase the funding of more 50 houses/flats, 25 for each project.It is important to reaffirm that in Lisbon the HF approach develops according to three fundamental principles: (i) individual housing instead of institutionalisation; (ii) always with a social support practitioner in order to reach social integration; (iii) psycho-social monitoring and scattered in the community, distributed by different sites in Lisbon.

DiscussionHousing First is getting greater acceptance and good outcomes, even so the Lisbon municipality still considers the improvement of employability and the autonomy of the former homeless people, a relevant purpose, that is: the full citizenship and social rights. In this context, both the new municipal program and the new structure respond to this integrated objective: Housing, employment and autonomy. Accordingly, addressing different purposes, we get different financial commitments. Concerning HF programmes, the fund contribution refers to half a million euro for

new structure approved by the last Council of Partners, with a Health axis and an axis of Housing and employability

Of the 28 partners, only two associations develop the housing first project, identified with bold red squares

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80 houses - project entirely financed by the Lisbon municipality.Soon, the Municipality will be announcing the renovation of the Municipal Programme for the Homelessness. the Municipal Programme main purposes are: - Decrease the number of homeless people in Lisbon;- Promote their integration by creating new answers that assure quality of life; - Create new responses and other models of transition and housing;- raise employment and autonomy.In fact, a local policy targeting homeless people should be based on three fundamental principles, being decisive for a new approach and for the eradication of all these situations, bringing to the city the true dimension of sharing and equity, such as:1- Social Rights versus Assistancethe principles inherent in the Social rights must overlap with the historical values linked to assistance, gaining ground an equal politics in the access to the rights, losing the pertinence of the concept - deserving or not deserving;2- Stop Managing Homeless - Poverty Must Be EradicatedSocial action, although financed by the Municipality of Lisbon, among other entities as “Santa Casa da Misericórdia de Lisboa”, is implemented and developed with the participation of a large number of associations. In this context and over the decades, we have seen the plain management of the homeless phenomenon and not so much the creation of solutions to take all people out of the street in a consistent and definitive way. It has been observed that during decades there has been a great investment addressing the problem but it does not produce significant results in modifying its reality. this is more due to the logic of the response worked, more directed to the first needs of the underman, less to the structuring of conditions for its solution, cutting with the deprivation, with the disease, with the absence of housing, with social isolation and that, as a general rule, it is based on conditions of poverty, even for those who have occupation.3 - Stop Working For… instead… Working Withan usual practice that we observe and, in our opinion, should also be altered is related to the fact that traditionally in a methodology inscribed in the perspective of assistance, change institutional behaviour: not work for... but to work with. this change giving voice to those who are never listened, and to offer options to those who never have a choice. Concluding, local and public policies for the homeless people must take into account the restitution of rights and good social practices considering each person as a whole being, ensuring the same full access as all other citizens.

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1 the responsibility of the Deputy Mayor for education and Social rights2 according to the national Strategy 2017 | 2023, a homeless person is considered to be one who, regardless of his or her nationality, age, sex, socioeconomic status and physical and mental health condition, is: without a roof - living in a public space, housed in a whereabouts in precarious places; without a home - being in temporary accommodation intended for the purpose.3 In Portugal, the presence of homeless people in the street is not punishable, so their departure depends only on their will, with the exception of cases of mental health according to the Portuguese Mental Health Law which provides compulsory hospitalisation in cases very specific and with a very strict procedure.

© Jose Gema, 2011, Gare do Oriente, Lisbon

© Jose Gema, 2011, Praça dos restauradores, Lisbon

© Jose Gema, 2011, Praça do Martim Moniz, Lisbon

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The unfairness of homelessness and the global economic crisisRoberto De Vogli PhD, MPH 1 2

1 Department of Social Psychology and Development, University of Padova, Padova, Italy2 Human Rights Centre, University of Padova, Padova, Italy

IntroductionHomelessness is a serious determinant of poor health. Homelessness is associated with a long risk of health problems including unintentional injuries, musculoskeletal disorders, hunger and nutritional-related deficiencies, cardiovascular diseases, respiratory diseases, infectious diseases and tuberculosis, skin problems, chronic stress, mental health problems, alcohol and drug abuse and of course, sleep deprivation. According to a report in the U.K., homeless people live on average between 30 and 40 years less than the general population. [1] the state of being homeless is not only a risk factor for poor health, but also a symptom of unfair societal arrangements and social injustice. according to Jon rawls, fairness is “…a moral principle that relates to social and/or distributive justice, or the perceived (and real) appropriateness of the distribution of goods, benefits and other outcomes in a society. [2] Yet, there is a discrepancy between the perception of the causes of homelessness in society among the general population: although people generally rank individual-level causes such as drug and alcohol abuse and mental illnesses as primary causes of homelessness, empirical research clearly indicates that, in reality, structural causes such as lack of affordable housing, and unemployment are even more important. Although several studies have assessed the effect of the 2008 global financial crisis on unemployment and foreclosures and health, there is a paucity of information on the specific effects of the crisis on homelessness.

ObjectivesThe objectives of this article are to: a) examine the effects of the 2008 global financial crisis and related policy responses on homelessness; b) critically discuss the policy recommendations to end homelessness.

Methodsa critical review of the literature on the following topics: the health effects of homelessness, the concept of fairness and its application to being homeless, an analysis of perceived vs. actual causes of homelessness in the general population and the effects of the global financial crisis on structural determinants of homelessness such as job loss and foreclosures. Results

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In the following years after the outbreak of the 2008 global financial crisis, unemployment increased significantly worldwide with a global job loss of about 28.4 million. There is no reliable data on the impact of the crisis on global foreclosures. In the United States only, it has been estimated that about 7.7 million families lost their homes throughout the entire foreclosure crisis [3]. although there is no reliable data on the effects of the crisis on homeless either, a report indicates that nearly 3 out of 4 people in the eU believe that homelessness has increased in their country since the onset of the crisis. this perception was particularly high in countries severely affected by the crisis such as Spain and in Greece. [4] a recent study that focussed on cities showed that after the crisis, homelessness increased in London, Vienna, Berlin and Stockholm and Madrid, while it remained stable or decreased in new York, Seoul, and toronto. an interesting study by Homeless Monitor in englans (2015) clearly showed that structural, rather than individual-level, factors were the primary determinants of the increase of households made homeless between 2008/9 and 2013/4 end of private tenancy on top of the list. [5]not only the crisis exerted a negative toll on the lives of homeless people, but budget cuts too. Austerity policies have significantly decreased public health spending in the OCED nations and social interventions for homeless people. the european Federation of national Organizations Working with Homeless People (FeantSa) found that 60% of homelessness organizations experienced cuts in 2011. In Ireland, the capital social housing budgets have been reduced since 2008 by 67%, from €1.38bn to €450m. In Greece, half of the services for the homeless were closed down and many of the staff have been fired [6] in order to comply with the austerity policies imposed by the Troika (IMF, eC and eC). another study investigating trends in mean homelessness claim rates across 323 local authorities in england from 2004 to 2012, showed that austerity policies clearly increased the number of total claims. [7]

ConclusionsIn spite of the paucity of data, the global financial crisis seems having considerably increased homelessness. evidence also indicates that the effects of the crisis on vulnerable social groups were exacerbated by the way governments responded to the downturn. While strong social protection mitigates the health effects of the crisis, most governments have applied austerity policies adding additional unfairness to the already unfair condition of being homeless. After the outbreak of the financial crisis, government policies have mainly consisted in bailing out the failing banks who contributed to cause the crisis with very little help for those who lost their jobs and houses because of the crisis. according to the european Commission State aid Scoreboard [8] between October 2008 and October 2012, the Commission approved aid to the financial sector totaling 5,058.9 billion Euros (40.3% of EU Gross Domestic Product (GDP). Large bailouts were provided to US banks as well: Goldman Sachs that was found guilty of securities

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fraud, and took $10 billion in bailout money in 2008, still paid out $111million in bonuses a few years after. [9] the right to housing is recognized in a number of international human right treaties. article 25 of the Universal Declaration of Human rights recognizes the right of housing as a part of the right to an adequate standard of living. Yet, current neoliberal ideology would view social programs to increase access and affordability of housing as a sheer violation of market forces. Clearly, in order to end homelessness we need to end austerity policies and move beyond existing policies of neoliberalism and privileged protection for the financial sector to embrace new principles and policies promoting human rights and social justice. as nobel Prize in Literature in 1938, Pearl Buck once wrote, “the test of a civilization is in the way that it cares for its helpless members;” the lack of policies and political will to end homelessness in a society of unprecedented wealth clearly indicates we are failing the test. ReferencesThomas B. Homeless: A Silent Killer. A research briefing on mortality among homeless people.

London: Crisis, 2011.

rawls J. a theory of Justice. Belknap, 1971.

Core Logic. United States residential Foreclosure Crisis: 10 Years Later, 2017.

european Commission. Poverty and Social exclusion report. Special eurobarometer 355. Brussells December, 2010.

Fitzpatrick S et al. the Homeless Monitor: england 2015. Institute for Social Policy Housing, environment and real estate, Centre for Housing Policy, University of York, City Future research Centre, University of new South Wales.

FeantSa. Impact of anti-crisis austerity measures on homeless services across the eU. Feanta Policy Paper, 2011.

Loopstra r et al. the impact of economic downturns and budget cuts on homelessness claim rates across 323 local authorities in england, 2004–12. J Public Health (Oxf). 2016;38(3):417-425.

european Commission. State aid Scoreboard. report on stated aid granted by the eU Member States. Brussels, 2012.

Daniel Bates. Goldman Sachs pay out $111 million in bonuses despite taking billions in bailout money. Daily Mail, 16 December, 2010.

Robles R., Deputy Mayor for Education, Health, Social Rights and Citizenship ofthe Municiaplity of Lisboa“Social policies and local choices in Lisbon”Nalin M., Assessor for integration and social inclusion, participation, genderpolicies and equal opportunities, Municipality of Padova“Local administration and homelessness”

15.30-15.45 Break

15.45-16.30 Round Table. “Media communication, social policy and practice”Chair: Bernad R., RAIS Fondacion, MadridPerea L., RAIS Fondacion, Madrid“Homelessness and communication. How to change the narrative?”Vecchiato T., Zancan foundation, Padova“Helping poor or condemn them to chronic care?”

16.30-17.00Closing sessionRonni GreenwoodSantinello M., University of PadovaGreetings and Farwell

17.30-18.30Italian EventCasa del Pellegrino, Via M. Cesarotti 21, PadovaPresentazione del volume Prima la casa. La sperimentazione Housing Firstin Italia pubblicato dalla Collana “Povertà e Percorsi di InnovazioneSociale” (Franco Angeli Editore).Curatori: Paolo Molinari, Anna Zenarolla

9.15-11.00Preliminary results of HOME_EU projectChair: Sandrine Loubiere (Aix-Marseille University)Discussants: Mary Beth Shinn (Vanderbilt University), Paul Toro(Wayne State University)De Vogli R., University of Padova“Homelessness as unfairness”Vargas-Moniz M., ISPA, Lisbon“Introduction to Home-EU project. Theory and methodologies”Petit J., Aix-Marseille University“European’s opinion about homelessness: preliminary results from a HOME-EUcitizen survey”

10.45-11.00

11.00-12.30 Greenwood R., University of Limerick“Traditional vs Housing First services: the user’s perspectives”Gaboardi M., “What works in homeless services: the point of view of service providers”Van Loenen T. & Wolf J., Impuls“The social policies within the EU”

12.30-12.45 Discussion

13.00-14.30 Light Lunch

14.30-15.30 Round Table: “European policies and local choices”Chair: Ornelas J., ISPA LisbonTangorra R., Director-Genaral for Inclusion and Social Policy, Ministry of Labourand Social Policy, Rome“How to use European Guidelines in national policy”

Program

[email protected].

The international seminar aims to

present the preliminary results of the project HOME_EU: “Homelessness as

unfainess” with the involvement of politicians, practioners and

services users

International SeminarHomelessness as

unfairness: an ecological perspective

20th june 2018Orto Botanico

Padova

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this project has received fundingfrom the european Union’sHorizon 2020 research andinnovation programme undergrant agreement no 726997

Documents

InterIM SeMInar Homelessness as unfairness: an ecological ...€¦ · of presenting “Science with and for Society” (european Commission, 2017) related to reversing Homelessness,