Pitkäaikaisasunnottomuus ja Asunto ensin -periaatteen soveltaminen Suomessa (2011-2015)

This research project examined the practices and the experiences of the Finnish adaptations of the Housing first model. The idea of the HF model is to provide housing first, and then combine that housing with supportive treatment services in the areas of mental and physical health, substance abuse, education, and employment. The model is based on the premise that housing is a basic human need and civil right, not something that should be earned. Thus, it should not be tied to any prerequisites, such as undergoing psychiatric treatment or sobriety. The priority is on immediate access to independent housing. (Tsemberis 2010; Granfelt et al. 2015.)

The main objective of the study was to analyse how the ideas of the HF model are present and function in tackling and preventing long-term homelessness in local Finnish service contexts. The study focused on the standpoints of long-term homeless persons (including persons at risk of becoming long-term homeless) and practitioners in homelessness work, and on the interactions between these two groups. The rich data contain interviews with homeless people and practitioners, conversations between clients and practitioners in offices and home visits, case conferences and ethnographic observations. The data were gathered in five non-governmental organizations (NGOs) that offer housing related services for former homeless people, for (former) prisoners and for people with mental health and substance abuse problems. All NGOs are more or less committed to the ideas of the HF model.

The results of the study are presented in  publications  that mostly concentrate on the practices and experiences of an individual NGO. However, we found common themes in tackling long-term homelessness and in applying the ideas of the HF model. These themes are 1) choice, 2) home, and 3) community and integration. In addition to these themes the research shows how the HF model is mixed with other approaches, and how it also have deficiencies.  Furthermore, the research has produced texts that reflect and develop qualitative methods applied in the project (Juhila, Hall & Raitakari 2015; Nousiainen 2015; Raitakari & Juhila 2016; Granfelt forth.) In the analysis of data we have used and developed further the theory on housing pathways created by Clapham (2005) (Juhila & Kröger 2016).

Choice

The HF model emphasizes the choices of homeless people regarding their housing and services. Homeless people are defined as capable of doing their own choices, and a right to make choices is seen to increase their commitment to services and recovery, and to strengthen their responsibilities for risks related to choices. (Hansen Löfstrand and Juhila 2012.) This resonates with the dominant welfare discourses on user involvement, consumerism and personalisation. The research results show that the personal life pathways of homeless people often include traumatized events and the experiences of stigmatisation and exclusion from services (e.g. Granfelt 2016; Juhila et al. 2016; Nousiainen 2016). So, their opportunities to make individual choices regarding their housing or services have thus far been very limited. Instead they have been dependent on whether they have been chosen, i.e. have been defined eligible to certain services or housing. The practices of the studied NGO’s include coaching of homeless people or people in risk of becoming homeless to make ‘reasonable and right’ choices in their lives to avoid future risks and failures. Reflecting one’s own choices related to housing and the ways of living in own apartments as well as intensive psychosocial support for vulnerable and often traumatized people are in the core of preventive housing social work that has been studied and developed in the research project (Granfelt 2013, 2014, 2015). The research also demonstrates how housing and service choices are negotiated in case conferences and conversations between clients and practitioners (Raitakari & Juhila 2013; Juhila et al. 2015). Choices are made jointly among many stakeholders rather than as individual ‘consumer choices’. However, there are several structural issues that narrow choice making possibilities, among which the lack of small rental flats and limited service options available in municipal purchaser-provider models are the most serious ones (e.g. Juhila & Günther 2013; Granfelt 2016; Raitakari 2016).

Home

In the original HF model home as a concept was not used as such. It is, however, implicitly present for example in the principles of the scattered housing (own home in a normal neighbourhood) and services based on home visiting. So, instead of living in shelters, nursing homes or supported housing units, the emphasis is on own homes as a solution for homelessness. This is in line with the overall Western welfare policy where we have witnessed a turn of professional care and control from institutions to communities, and more recently to home-spaces. The research project produced results in regard to home from various angels. First, home is not necessarily synonymous to own house or flat. The home and the feeling of home include such features as safety, continuity and privacy. Creating the feeling of home is often a precondition to a successful housing, to a pathway away from homelessness. This can be a challenging pathway and demands supportive, security creating housing social work based on trust, since people with difficult life histories might not have previous experiences of a ‘real’ home. (Granfelt 2015, 2016; Nousiainen 2016.) Another angle to home and the HF model is, that since services supporting housing are increasingly provided in home-spaces, tensions between private and public are created. On the one hand there is a risk that homes become a new, controlling institutional form, but on the other hand when services are provided in clients’ own territories it both strengthens their self-determination and creates such safety that is necessary in securing the continuity of housing. (Juhila, Hall & Raitakari 2016; Haahtela & Juhila 2016.) Lastly, the research results indicate that the greatest risks for a successful housing and the strengthening of the feeling of home are temporary tenancies and service contracts that are still is use for instance in mental health (Juhila & Günther 2013).

Community and integration

The original HF model states that housing should be provided in apartments scattered throughout a community. This scattered site model fosters a sense of home and self-determination, and it helps the reintegration of (former) homeless into the community (Tsemberis 2010). Scattered housing and community integration are also argued to prevent the risk of becoming (again) homelessness. This principle fits well to the EU-driven policies emphasising social inclusion and the importance of ‘normal’ community networks in inclusion processes. It relies on the idea of ‘recovery in’ instead of ‘recovery from’ (Davidson & Roe 2007; Juhila, Hall & Raitakari 2016). Our research results demonstrate how step-by-step community integration work is done successfully during the course of home visits among people with mental health and substance abuse problems, although there are still big challenges in this: ‘normal’ neighbourhoods are not always inclusive by nature and there is a risk of becoming lonely and isolated instead of integrated (Raitakari, Haahtela & Juhila 2015; Raitakari & Permin Berger forth.). In addition we show how belonging to communities produce positive and negative identities; in telling their life stories (former) homeless people narrate both constructive and harming, even difficult experiences of communities (Haahtela 2013a; Nousiainen 2015, 2016). Getting rid of negatively experienced communities demand the processes of desistance, which also have been demonstrated in our study (Granfelt 2014, 2015). The Finnish adaptation of the HF model includes as a speciality so called community-based HF, which means that a whole block of flats has been targeted at homeless persons including individual flats with permanent tenancies, but also shared space for community activities. According to our research this solution suits for many, but some residents experience this kind of  a ‘forced’ community integration disturbing and therefore plan moving forward in the future (Kettunen 2013; Nousiainen 2015, 2016).

Mixed model of housing first and treatment first

In the HF literature the HF model is usually presented as a totally new solution to long-term homelessness and it is compared especially to the so called treatment first model (or a staircase model) that requires some results in recovery processes before housing is offered (Raitakari & Juhila 2014, 2015). Our hypothesis was that in the Finnish local adaptations these two models are however mixed. This hypothesis proved to be true in the close analysis of services practices (Haahtela 2013; Raitakari & Günther 2015).

Success story, but with some deficiences

The Finnish Government policy to reduce homelessness by applying the HF model has been a success story in many ways. However, the model also has deficiencies. It has not been able to solve for instance the homelessness of heavy drug users. Another big challenge is that without investments on small rental flats, new (groups) of people are threatened to become long-term homeless. (Pleace et al. 2016.) 

References:

Davidson, L. & Roe, D. (2007) Recovery from Versus Recovery in Serious Mental Illness: One Strategy for Lessening Confusion Plaguing Recovery. Journal of Mental Health 16(4), 459–470.

Clapham, D. (2005) The Meaning of Housing: A Pathways Approach. Policy Press.

Tsemberis, S. (2010) Housing First. The Pathways Model to End Homelessness for People with Mental Illness and Addiction. Hazelden.

List of publications of the project:

Granfelt, Riitta (2013) Asumissosiaalinen työ läsnäolotyönä – kokemuksia naisten yhteisöstä [Housing related social work as being close by and available – experiences on a women’s community]. In Merja Laitinen & Asta Niskala (eds.) Asiakkaat toimijoina sosiaalityössä. Tampere: Vastapaino, 219-243.

Granfelt, Riitta (2013) Asumissosiaalinen työ rikosseuraamusalalla [Housing related social work in criminal justice]. In Susanna Hyväri & Sakari Kainulainen (eds.) Paikka asua ja elää? Näkökulmia asunnottomuuteen ja asumispalveluihin. Helsinki: Diakonia-ammattikorkeakoulu, A tutkimuksia 39, 209-228.

Granfelt, Riitta (2014) Asunto vai rikoksettomuus ensin? Asumissosiaalisen työn tuella irti asunnottomuudesta ja rikollisuudesta [Housing first or crimelessness first?]. In Henrik Lindeborg, Mari Suonio & Tytti Lassila (eds.) Sosiaalityö ja sosiaalinen tuki rikosseuraamusalalla. Helsinki: Rikosseuraamuslaitos, 255-274.

Granfelt, Riitta (2015) Asumissosiaalinen työ: Kotiin ja rikollisuudesta irti? [Housing social work: towards home and getting rid of criminality?] Helsinki: Y-Säätiö.

Granfelt, Riitta (2015) Kansainvälinen arvio valmistui: pitkäaikais(asunnottomasta) asukkaaksi? [An international evaluation has been completed: from a (long-term) homeless to a resident?] Asuminen ja Yhteiskunta 1/2015, 9.

Granfelt, Riitta (2015) Rikollisuudesta irti: kouluun ja kotiin [To break away from criminality: to school and home]. In Anne-Mari Jaakko, Viivi Lanne & Jarkko Rasinkangas (eds.) Eriarvoisuus ja sosiaalityö. Talentia-lehti & Sosiaalityön tutkimuksen seura: Tutkiva sosiaalityö, 29-32.

Granfelt, Riitta (2016) Vankilasta desistanssipolun kautta kotiin [The Pathway of Desistance from Prison to Home]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi, 60-84.

Granfelt, Riitta & Nousiainen, Kirsi & Haahtela, Riikka & Juhila, Kirsi & Raitakari, Suvi (2015) Oman oven avaajaksi: voiko asunnottomuudesta päästä eroon? [Towards own door and key; is it possible to get rid of homelessness?]. In Jouni Häkli, Risto Vilkko & Leena Vähäkylä (eds.) Kaikki kotona? Asumisen uudet tuulet. Helsinki: Gaudeamus, 71-81.

Haahtela, Riikka (2013) “Tehdä projektinsa tarpeelliseksi”: Työntekijöiden selonteot asunnottomille suunnatun Naisten keskuksen elinkaaresta [Making one’s project necessary: workers’ accounts on the life cycle of a of a homeless women’s coaching center]. Janus 3(21), 206-221.

Haahtela, Riikka (2013)Työntekijöiden ja asiakkaiden kohtaamisia asumisyksikössä [Encounters between workers and clients in a supported housing unit]. In Susanna Hyväri & Sakari Kainulainen (eds.) Paikka asua ja elää? Näkökulmia asunnottomuuteen ja asumispalveluihin. Helsinki: Diakonia-ammattikorkeakoulu, A tutkimuksia 39, 183-208.

Haahtela, Riikka (2014) Homeless Women’s Interpretations of Women-specific Social Work among the Homeless People. Nordic Social Work Research 4(1), 5-21.

Haahtela, Riikka (2015) Asiakkuuksien rakentuminen asunnottomille suunnatussa naistyössä [Constructing clienthoods in women-specific homelessness work]. Tampere: Acta Universitatis Tamperensis 2023 and Acta Electronica Universitatis Tamperensis 1512.

Haahtela, Riikka (2015) Naisten asunnottomuus [Women’s homelessness]. Tampereen yliopisto. Alusta 17.3.2015. http://alusta.uta.fi/artikkelit/2015/03/17/naisten-asunnottomuus.html

Haahtela, Riikka & Juhila, Kirsi (2016) Arjen valinnat ja neuvot kotikuntoutuksen kohtaamisissa [Everyday Choices and Advice-giving in the Encounters of Home Rehabilitation]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi, 192-214.

Hansen Löfstrand, Cecilia & Juhila, Kirsi (2012) The Discourse of Consumer Choice in the Pathways Housing First Model. European Journal of Homelessness 6(2), 47-68

Hansen Löfstrand, Cecilia & Juhila, Kirsi (2017) Housing First as a Moral Tale and a Travelling Idea. In Björn Andesson, Frida Pettersson & Aanette Skåner (eds.) Den motsspänstiga akademikern, festskrift till Ingrid Sahlin. Malmö: Égalité, 15-37

Juhila, Kirsi & Günther, Kirsi (2013) Kunnan, järjestöjen ja asiakkaiden oikeudet ja velvollisuudet tilaaja-tuottajamallissa: tutkimus asumispalvelujen tarjouspyyntöasiakirjoista [Rights and Responsibilities of the Municipality, Non-governmental Organizations and Service Users in the Purchaser-Provider Model], Janus 21(4), 298-313.

Juhila Kirsi & Hall Christopher & Günther Kirsi & Raitakari Suvi & Saario Sirpa (2015) Accepting and Negotiating Service Users’ Choices in Mental Health Transition Meetings. Social Policy & Administration 49(5), 612-630.

Juhila, Kirsi & Hall, Christopher & Raitakari, Suvi (2016) Interaction During Mental Health Floating Support Home Visits: Managing Host-Guest and Professional-Client Identities in Home-spaces. Social and Cultural Geography 17(1), 101–119.

Juhila, Kirsi & Jolanki, Outi & Vilkko, Anni (2016) Siirtymät ja valinnat vanhojen ihmisten ja asunnottomien asumispoluilla [Transitions and Choices in the Housing Pathways of Old People and Homeless People]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi, 11-39.

Juhila, Kirsi & Kröger, Teppo (eds.) (2016) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi. http://urn.fi/URN:ISBN:978-951-39-6664-5

Juhila, Kirsi & Kröger, Teppo (2016) Asumispoluista elämisen polkuihin [From Housing Pathways to Life Pathways]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi, 215-224.

Juhila, Kirsi & Raitakari, Suvi (2016) Pieni aika sosiaali- ja mielenterveystyössä [Small Time in Social and Mental Health Work]. In Sirpa Kannasoja, Marjo Kuronen & Tytti Poikolainen (eds.) Sosiaalityön aika. Talentia-lehti ja Sosiaalityön tutkimuksen seura.

Kettunen, Marko (2013) Asunto ensin: malli Yhdysvalloista ja soveltaminen Suomessa [Housing First: Model from USA and applications in Finland]. Yhteiskuntapolitiikka 5/2013.

Nousiainen, Kirsi (2015) Narratiivinen haastattelu performanssina tuetun asumisen yksikössä: kun päihdeongelma ja mielen sairaus ovat osallisina näyttämöllä [Narrative intreview as performance in a supporting housing unit: substance abuse and mental health problems as participants at stage]. In Sanna Aaltonen & Riitta Högback (eds.) Umpikujasta oivallukseen. Refleksiivisyys empiirisessä tutkimuksessa. Nuorisotutkimusverkosto/Nuorisotutkimusseura, julkaisuja 164. Tampere: Nuorisotutkimusseura ry. and Tampere University Press.

Nousiainen, Kirsi (2015) Reflecting Narrative Interview Context as Performance: Inteviews with former Homeless Persons with Intoxication and Mental Health Problems. Nordic Social Work Research 5(2), 129-142.

Nousiainen, Kirsi (2015) Yhteisöt pitkäaikaisasunnottomien elämänkuluissa ja emansipatorisessa identiteettityössä [Communities in the life courses of long-term homeless people and in empancipatory social work]. In Sanna Väyrynen, Kaisa Kostamo-Pääkkö & Pekka Ojaniemi (eds.) Sosiaalityön yhteisöllisyyttä etsimässä. EU: United Press Global, 79-105.

Nousiainen, Kirsi (2016) Oma ovi yhteisössä: pitkäaikaisasunnottominen asumispolut ja asumiseen liittyvät valinnat [Own Door in a Community: The Housing Pathways and Housing Choices of Long-term Homeless People]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi, 163-191,

Pleace, Nicholas & Culhane, Dennis & Granfelt, Riitta & Knutagård, Marcus (2015) The Finnish Homelessness Strategy: An Internationa Review. Helsinki: Reports of the Ministry of the Environment 3en. https://helda.helsinki.fi/handle/10138/153258

Pleace, Nicholas & Knutagård, Marcus & Culhane, Dennis & Granfelt, Riitta (2016) The Strategic Response to Homelessness in Finland: Exploring Innovation & Coordination within a National Plan to Reduce & Prevent Homelessness. In Naomi Nichols & Carey Doberstein (eds.) Exploring Effective Systems Responses to Homelessness. Toronto: The Homeless Hub, 425-440.

Raitakari, Suvi (2016) Neuvottelut mielenterveys- ja päihdeasiakkaiden asumisen siirtymistä: toiveita, haasteita ja toimijuutta [Negotiating the Housing Transitions of Clients in Mental Health and Substance Abuse Services: Hopes, Challenges and Agency]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi. 108-133.

Raitakari, Suvi & Günther, Kirsi (2015) Mielenterveysasiakkaan asema portaikkomallin ja Asunto Ensin -mallin asumispoluilla [Mental health clients’ position in the staircase and Housing First pathways. Janus 23(1), 66-82.

Raitakari, Suvi & Haahtela, Riikka & Juhila, Kirsi (2015) Tackling Community Integration in Mental Health Home Visit Integration in Finland. Health and Social Care in the Community. doi: 10.1111/hsc.12246

Raitakari, Suvi & Juhila, Kirsi (2012) Asunto ensin -mallin ja portaikkomallin jännitteet mielenterveys- ja päihdekuntoutujien asumisratkaisuissa [The tensions between Housing First and Staircase models in the housing arrangement of people suffering from mental health and substance abuse problems]. Suuntaaja 2, 18-22.

Raitakari, Suvi & Juhila, Kirsi (2013) Kuluttajuusdiskurssit ja palveluvalinnat mielenterveyskuntoutuksen asiakaspalavereissa [Consumer discourses and service choices in mental health rehabilitation meetings]. In Merja Laitinen & Asta Niskala (eds.) Asiakkaat toimijoina sosiaalityössä. Tampere: Vastapaino, 167-195.

Raitakari, Suvi & Juhila, Kirsi (2014) Asunto ensin -julkaisujen suuntaukset, pääargumentit ja käytännöllis-poliittiset tavoitteet [Housing First literature: different orientations and political-practical arguments]. Yhteiskuntapolitiikka 79(2), 185-196.

Raitakari, Suvi & Juhila, Kirsi (2015) Housing First Literature: Different Orientations and Political-Practical Arguments. European Journal of Homelessness Research 9(1), 145-189.

Raitakari, Suvi & Juhila, Kirsi (2016) Asumispolkujen tutkimisen lähtökohdat ja menetelmät [The Premises and Methods of Studying Housing Pathways]. In Kirsi Juhila & Teppo Kröger (eds.) Siirtymät ja valinnat asumispoluilla [Transitions and Choices in Housing Pathways]. Jyväskylä: SoPhi. 40-59.