researching system level change towards housing first

9th European Research Conference

Homelessness in Times of Crisis

Warsaw, Friday 19th September 2014

Researching System Level

Change Towards Housing First

José Ornelas

ISPA – Instituto Universitário




Defining system Set of actors, activities, and settings that are

directly or indirectly perceived to have influence

in or be affected by a given problem situation. (Foster-Fishman, Nowell, & Yang, 2007)

Two or more entities, joined by some

commonality, to form a organized structure

which operates according to rules set out to

address a higher order purpose, including

concepts, polices, agents and institutions. (Peirson, Boydell, Ferguson, & Ferris, 2011)




System Change

Efforts that strive to shift the underlying infrastructure within a community or target context to support a desire outcome, including shifting existing policies, programs and practices, resource allocations, relational structures, theories norms and values that guide system behavior.

(Foster-Fishman & Behrens, 2007)




System Change Dimensions

Purpose: what is the goal of change

Degree: incremental or transformative

Scope: what/who will it affect

Substance: what needs to be altered

Intensity: how much effort will it take

Duration: how much time will it take

Permanency: how sustainable is the change

(Peirson, Boydell, Ferguson, & Ferris, 2011)




Ecological Principles

Kelly (2006) proposed the use of four

ecological principles as a guide for analyzing

social systems:

Interdependence

Cycling of resources

Adaptation

Succession




Traditional Housing Readiness System

Homeless

Shelter placement

Transitional housing

Permanent housing

Treatment compliance + psychiatric stability + abstinence




Homeless

Shelter placement

Transitional housing

Permanent housing

Ongoing, flexible support

Housing First Model

Transformative change: involves

a paradigm shift in how problems

are perceived and what strategies

are used to address them




Why Change? Effectiveness of Housing First Approach

Numerous studies in USA, Canada and

Europe have demonstrated the

effectiveness and cost efficiency of

housing First approach

(Busch-Geertsema, 2013; Gaetz, 2012; Goering et al.,

2014, Pleace, 2012; Tsemberis et al., 2004)




The Study

Purpose:

To evaluate how the implementation of

an housing first program in Lisboa

contribute for a transformative and

sustainable system change (theories

and values, policies, resources, and

practices)




"Casas Primeiro" program:

started in October 2009

for homeless people with mental health problems

initial Protocol was signed between:

o Social Security Institute (funder) o AEIPS, a non-profit organization (project operator) o ISPA – University Institute (project evaluation) o Sam Tsemberis & Marybeth Shinn (consultants)

Impetus for change Housing First in Lisboa




Research Questions Interdependence What elements made up the existing system and how do they

related?

What were the factors, including in the external environment, that have influenced the direction of system change?

Cycling of Resources What were the quantity and quality of available resources and

how were they distributed and used across the system?

Are the quantity and flow of resources into, out of, or within the system altered through the process of change? Are new resources mobilized or created?




Research Questions Adaptation

How do the system and its elements/stakeholders (norms,

policies, agents, institutions,) respond to change?

Are system stakeholders comfortable or resistant with the

prospect of change? And why?

Succession

How does the system evolve?

Do internal system dynamics and/or external factors

support sustainability of the change effort?




Study Methods

Content analyses (reports, policy documents, organizations vision declarations and documents)

Interviews with key system agents/institutions (policy makers, program managers and professionals)

Interviews with participants




HF at a city polices level

Participation in Lisboa Platform of organizations that

work with homelessness to reorganize the city’s

services for homeless people: inclusion of Housing

First approach in the final proposal.

Participation in Lisboa Strategy for Europe Strategy

2020: proposal to upscale the housing first approach

in Lisboa (to support 400 homeless people) which

was included in the final official document.




HF Funding Resources

Negotiation with different funding partners:

Institute of Social Affairs

City Hall

SCML

Foundations and private sector




HF Scaling Up

In October 2012, AEIPS has started another Housing First project in the city of Cascais, funded by the local city hall.

In April 2013, AEIPS has helped another organization in Lisboa to start an housing first project for homeless people with substance misuse, and has been working as a consultant of this project.

HF National Partnership with organizations from the cities of Lisboa, Aveiro, Amadora, Braga, Cascais, Coimbra, Gaia, Setúbal, Porto, Faro that are already delivered or are interested in implementing Housing First programs in their territory.




HF International Networks

European Network

Italy, France, Norway, Spain, Scotland

International Network

Europe, Canada, EUA

researching system level change towards housing first

Government & Nonprofit