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Discus Housing First

Silver 2019 | Netherlands

Outline

Adapting Housing First to reduce homelessness in Amsterdam

Cities across Europe face a growing homelessness problem. Homeless people can be vulnerable to violence, exploitation, drug and alcohol abuse, and mental health problems, which can make maintaining a tenancy difficult once rehoused. The usual approach when tackling homelessness is to address these issues first, before a permanent home is found.

Housing First turns this model on its head by providing clients with a safe and secure home first. In Amsterdam, Discus Housing First has taken this approach a step further to create an innovative, adaptive programme that puts clients in complete control of the process, allowing them to make fundamental decisions, including the home’s location and the type of support they receive. Clients also choose their caseworker to create a unique – but voluntary – support programme that evolves with their changing needs. Since April 2006, Discus has successfully housed more than 600 people using this highly tailored approach to social work.

The €10 million ($11.2 million USD) Discus programme is funded by the municipality of Amsterdam, which was so impressed by the results it adopted Housing First as official homelessness policy in 2017. The method has also been implemented in dozens of other Dutch and European cities, helping to transform the way homelessness is tackled across the Netherlands and beyond.

Full details

Homelessness is a growing problem across Europe. In Amsterdam, high private sector rents and a shortage of 70,000 homes has put the city’s affordable housing supply under extreme pressure. The average waiting time for one of Amsterdam’s 186,000 social homes is now 11-15 years. More people find themselves living in hostels or on the streets, where they are vulnerable to violence, exploitation, and drug and alcohol abuse.

Tackling homelessness requires the collaboration of several different agencies in the effort to make real and lasting change to the lives of people who often have multiple, complex needs. In the Netherlands, the ‘staircase model’ has been the dominant approach to tackling homelessness. This means ‘treatment first’ for homeless people, who need to progress through a series of stages before they are deemed to be ready to move into a more permanent home.

Discus Housing First is adapted from the American model of Housing First. This innovative housing programme aims to eradicate homelessness in Amsterdam by turning this traditional model on its head. Discus Housing First moves homeless people into permanent housing as quickly as possible and provides ongoing, flexible support for as long as it is needed, but on a voluntary basis. The approach empowers homeless people to instigate real positive change by focusing on their strengths, rather than their weaknesses.

The programme was the first of its kind in the Netherlands and started as a joint initiative between Jellinek Mentrum, Alliantie Amsterdam and the city council. In 2007 Discus became a department of HVO Querido. Jellinek Mentrum provides treatment and counselling for people with mental, psychiatric and addiction problems. Alliantie Amsterdam is a housing association and HVO Querido offers guidance and care to vulnerable people.

Discus began its Housing First programme in April 2006 with the goal of ending street homelessness, empowering people, respecting their choices, helping to modify harmful drug and alcohol use, and supporting them to participate in society again, in a way they choose to. Since then, more than 600 homeless people have been housed through the Discus programme. Early in 2019, HVO-Querido’s 1,000th Housing First home was created in Amsterdam.

The programme in practice

Discus starts the process by addressing an individual’s basic needs – a home, safety, and basic care – and then supports them to make decisions about how they wish to improve their lives. Clients are in control and have the power to make fundamental decisions, including who they want to work with and the type of support they wish to receive. This includes the location of their housing, activities, volunteering work, and the length, time and frequency of support sessions. With the client’s permission, Discus involves neighbours and family members in the process, as they can play a vital role in encouraging the client to rebuild their lives and participate in society as much as possible.

Discus believes having a secure home provides the foundation from which clients can work to overcome other challenges in their lives and achieve their goals. Through Discus, Housing First clients rent apartments provided by nine housing associations in Amsterdam. Clients are helped to maintain their home and offered other support, including psychological and social rehabilitation. Clients can decide for themselves how they wish to organise their lives, as long as they pay rent and do not act anti-socially.

At the start of the project, Discus housed people directly from the streets. Over the years the target group has expanded and they now house people from night shelters, 24-hour shelters and halfway houses. Clients are referred to Discus by De Veldtafel, a group of professionals from separate care organisations under the supervision of Amsterdam’s municipal health service.

The Discus approach is different to most Housing First models. Each client is assessed in order to identify the right caseworker to support them. Discus believes the success of the programme depends on this crucial relationship, with the client having a say in the caseworker they are matched with. It currently employs 85 caseworkers and recruitment focuses on finding people with the right personality and behavioural characteristics, rather than technical or academic skillsets.

Caseworkers follow a methodology created by Discus Housing First called ‘It-can-also-be-different’. This encourages a more creative approach to social work to achieve small successes. For example, when a client was not managing to live in a house, Discus worked with the municipality of Amsterdam to get a permit for him to live on a small boat. With this kind of adaptive support, many clients are able to overcome old negative patterns of behaviour. In addition, if a client feels their support programme is not working effectively, they can change it.

The annual budget for Discus Housing First is €10 million ($11.2 million USD). On average, Discus receives €22,000 ($24,810 USD) per client, per year, from the municipality of Amsterdam to cover support costs. The municipality also provides financial support to each client, who receive around €1,000 ($1,122 USD) per month, plus extra support for the rent (€300 / $337 USD).

The rental cost of each Housing First unit is €500-700 ($560-785 USD). A housing allowance subsidy reduces this cost by around €200 ($224 USD) per month, leaving clients to pay around €300-400 ($336-449 USD) per month. In contrast, social housing rents are around €700-800 ($785-897 USD) without extra financial support and private rents in Amsterdam are around €1,000 ($1,122 USD) per month.

Social and environmental impact

When it first started, the ‘staircase approach’ was the dominant method for tackling homelessness in Amsterdam. By involving the municipality in the programme’s development – including powerful presentations from clients – Discus has been able to demonstrate the effectiveness of the Housing First approach. This has led to the continuing expansion of the model across the city and to the adoption of Housing First as official local homelessness policy in 2017.

To date, Discus has housed 600 formerly homeless people. Research by Radboud University in 2013 showed an impressive 93% housing retention rate within a group of 100 Discus clients. Clients face complex and multiple issues when they are first housed. However, a 2013 European project to evaluate the effectiveness of Housing First, found almost all Discus clients experience improvements in their living situation (91%), general quality of life (89%), daytime activities (79%), and resilience (79%). A majority also experience an improvement in their physical condition (73%), mental condition (70%), reduction of substance abuse (71%), finances (70%), housekeeping and self-care (68%), and relationship with their children (67%).

Discus aims to have a similarly positive impact on the environment. Employees do not have a central office, instead they work around the city and are encouraged to use bikes and public transport as much as possible. Last year they introduced a project called ‘Stop wasting, start sharing’, which collected and distributed second-hand items among clients. Discus has also introduced energy-saving measures into Housing First homes, such as LED lighting, thermostatic valves, water-saving features and automatic light switches.

The future

The 2015 Social Support Act ensures the support costs of the Discus Housing First programme are covered by the municipality of Amsterdam, securing the future of the model and its continued growth.

Discus is supporting the implementation of the Housing First approach in other parts of the country through its professional training courses. More than 20 cities in the Netherlands have now adopted the Housing First model and Discus has contributed to training workers. This year an expertise centre was opened to offer training to care organisations. Discus is also playing a vital role in the growth of Housing First across Europe, sharing best practice with organisations including in the Czech Republic, Norway, Spain, Macedonia, England, Scotland and Belgium.

Through its innovative approach, Discus is transforming the way homelessness is tackled across Europe and helping hundreds of vulnerable people access – and keep – a secure and affordable home.

View the full project summary here

Resident stories

Tineke was born in 1957 in Gouda and grew up in Alphen aan de Rijn.

I come from a fairly strict Catholic family, conservative in every way. As a child I was very shy at first and I went along with everything. I was not happy, I had only a few friends. My mother never showed me any affection; only later did I understand that she was depressed. In my teens I rebelled, I was sometimes a bit extreme.

I failed in school and I never knew what I wanted to be. I didn’t think about my future, I went ‘with the wind’. Although I was not such a good student, after high school I gave up my aversion to studying and went to the social academy in Amsterdam. I had a very nice time there. The emphasis was not on learning things by heart. You could go your own way. I did a very nice internship at the community centre. But at the same time I had to deal with psychiatric problems – I had many emotions from being very happy to very sad. I also had many issues with my ADD (Attention Deficit Disorder) and I didn’t function properly.

I realised I had lost my friends, I became homeless and felt extremely lonely.

I remember when I received the key to my home with Discus Housing First. It was a great feeling to have a home but for sure, one of the best things is the support. I got lots of attention and that helped me enormously.

Due to disturbances with the neighbours, noise or people visiting at night, and a few fights with friends, I lost the house. But Discus worked with the housing company to give me another chance.

Now I live in a different area and the people from Discus are always there to support me. For sure, having your own house means you can build a perspective on life.

I am afraid of loneliness, and that is the dark side of life – but I am rarely alone. Friends assist me, people often visit me. But I don’t like that about myself, I think I should do more things alone. I have to learn that, I have to work on it, because it is better to be independent. I have had many periods of loneliness, I find it so difficult that I have periods where I stay in bed and avoid contact. I don’t answer the phone, it can go really fast, such a downward spiral.

Now, luckily, I am getting better and better. I really like that I can say that now.

What helps against loneliness is very simple: contact with people. At Discus, for example, they have organised solitude meetings where you meet people who you can have a chat with. What also helps are outings, just fun things with other people. Fortunately, they are regularly organised.

What doesn’t work is coercion. Since childhood I have developed great reluctance to it. People say: go play cards! But you must be interested in playing cards. I’d rather play chess. But the point is that you have to have the guts to join a group. That is often a threshold. I have trouble with everything I have to do alone, but in practice I am rarely completely alone. I have friends and acquaintances, I am pretty good at creating a cosy atmosphere, if I can say that about myself, I can connect people well.

On the other hand, I try to train myself in being alone, so that I can handle it better.

If you come from the street, or from the shelter, and you get a house, then you suddenly sit alone on the couch. That is why it is good that attention has been paid to the subject of loneliness. It is not just homeless people, there are so many lonely people. Sometimes you drink or use more drugs when you are lonely, because what does it matter?

It is also nice to go around the neighbourhood with someone from Discus, so we can look together, for example, where the community centre is. When I am with someone, I feel more at ease.

Your own home gives you the necessary peace and the strength to work on what matters in life.

Joyce was homeless for many years before she received support from Discus.

I used to be a happy girl when I was little. After my son’s birth, I started all day to hear voices – pregnancy psychosis. Most people have bad voices, I had good voices: my grandmother, my niece and brother of my father, all of them passed away. My voices wanted to help me.

I had never talked to anyone about the abuse, I thought I imagined it and it could not be true. It happened for years.

After the birth of my son, when all these voices started, many things happened and I kept having flashbacks. I couldn’t sleep at home anymore and went with my child to my mother’s house. But also there I ‘saw’ him standing in dark corners.

After six weeks I could no longer sleep in any house, not at my mother’s, not with my nieces, not with my friends. I decided to move onto the streets as I was less afraid there.

But life on the street was not easy. I found a little corner where I had boxes and a blanket. My little corner was not too far from my parents’. But the quality of life and my sense of dignity soon diminished. I could hear the sound of mice, rats, or people walking their dog. But I was lying there invisible.

Only one time I got scared. There was thick fog and I couldn’t see anything. I woke up and didn’t even know where I was – I lost a place where I could belong to. I was so busy in my head, I spoke to the spirits. I didn’t understand myself – I was hearing voices all the time and taking medication, but nothing helped. Those horrible voices didn’t allow me to do anything, the positive feeling of those voices that I had at the beginning weren’t there anymore.

I walked around for fifteen years with my psychoses, from mental health institution to another health institution. There was a time when I was taking 50 pills a day, of all colours – purple, green, pink, red, yellow, blue. All of them tranquillisers.

20 years ago the mental health centre didn’t know so much about all of this. I was suffering and my son was living with my parents. I felt guilty but didn’t see the way out. I found a few shelters and slept a while with the Salvation Army.

Finally the doctor gave me a new pill as an experiment, just a tiny pill. I had no side effects and it helped!

Then I got a room at a project called Vrijburg, a residential facility from HVO-Querido. I remember calling my mother and asking her for clothes. She came and gave me many second-hand clothes – I was so happy.

A year later in 2011, I got a Housing First home from the Discus project of HVO-Querido, my own house. I belonged somewhere and was a part of society again. After some time I could function very well and didn’t need so much support. I decided to move into social housing where the name of the contract would be my own.

I felt so proud to have a house in my own name.

My family supported me with all the furniture and I regularly see my son. He still lives with my mum but we all live close by and life is way easier now. I have a nice partner and still take my pills. Once every three months I see a psychologist and soon it will be once every six months.