Housing First: Revolutionizing Services for Homeless People in Italy

The Housing First (HF) approach originated in the United States during the 1990s within mental health services, inspired by the model for discharging patients from psychiatric hospitals called ‘Supported Housing’. Based on gaining immediate access to independent apartments with support from a team of health workers for chronically homeless people and groups assessed as at risk of homelessness, it spread from the Pathways to Housing model founded by psychologist Sam Tsemberis in New York in 1992. HF introduces some changes compared to other models. It reverses the institutional-clinical approach from both a health and a welfare perspective. The key element is the direct transition from the street to a home. Very quickly, therefore, HF has also proven an effective and potentially revolutionary intervention to address homelessness in different contexts, including in England, France, Finland, Portugal, Spain and other countries. In Italy, as we argue in the following pages, it has the potential to provide a new direction for homelessness policies in a context in which chronic homelessness has increased: the Italian Institute of Statistics (ISTAT) reveals that there are 50,724 homeless people (roofless and houseless people) in Italy (up 3,071 from 2011), and that 21.4% of those have lived on the street from more than four years (ISTAT, 2014). Since 2011, supply – the number of beds and meals provided by 768 organisations – has increased by 15%, despite a more or less stable number of homeless people. This means that the same person is using the same services more and more times in the same week (three times more for beds and five times more for meals in one week), with severe consequences for the welfare system and costs to local authorities, as well as for living conditions.