A review by Dr Sarah Johnsen at the University of York and the charity Crisis on the effectiveness of housing models has directly shaped development of the 'Housing First' pilot project in the UK.


  • Findings from the review and the accompanying 40-page report Staircases, elevators and cycles of change are currently feeding directly into policy debate and the development of projects aimed at this vulnerable client group.
  • The review has played a key role in shaping the development of the UK's first 'Housing First' pilot project, which is currently underway among 19 formerly homeless people in Glasgow. Evaluation of this pilot is providing crucial evidence regarding the model's effectiveness.
  • Findings have led directly into current debates, particularly by the Mayor of London's Delivery Board, on interventions aimed at London's most entrenched rough sleepers (the so-called '205' group).
  • Dr Johnsen and Professor Suzanne Fitzpatrick are now taking part in a European-wide study of the 'Housing First' model.

About the research

Homeless people with complex support needs – such as alcohol, drug or mental health problems – have become a policy priority in the UK because they are disproportionately failed by or resistant to existing interventions. Dr Sarah Johnsen at the University of York and Crisis, the national charity for single homeless people, reviewed the evidence regarding orthodox and innovative housing models.

Unlike the prevailing 'Treatment First' philosophy – where homeless people only are placed into 'normal' housing when they show they can live on their own – the 'Housing First' model places them directly from the street into independent tenancies with tailored support. This model has proved successful in the US.

"The linear model does not always work well for homeless people with complex needs," explains Dr Johnsen. "They are often unable to progress through the stages required to be considered 'housing ready', and become stuck in a damaging spiral of repeat homelessness and substance misuse. The evidence we found clearly challenges some of the assumptions underpinning resistance to the Housing First model held by some stakeholders within the homelessness sector."

The review has rejuvenated debate amongst policymakers and practitioners regarding the strengths and weaknesses of different housing models for homeless people with complex support needs in the UK.