In my city, there was a man sitting on pieces of cardboard
at the entrance of a building, in front of a school.
His place of life, for years already,
it was there, it was the street.
And students, their parents, teachers
knew this gentleman and called him by his first name.
Today, we will call him Ted.
But one day, Ted disappeared and he never came back.
Everyone had worried about him.
Everyone was certainly right to worry about him,
because you have to know
that the life expectancy of a homeless person on the street
is 45 years old.
But I will not leave you with all that,
because, in fact, Ted is fine, he is doing very well.
He is in housing, today, for three years already,
and he impresses everyone.
Yet everything had been tried with him.
But he kept zoning from the street to the day reception, to the night shelter,
from street to day reception, to night shelter, for eight years.
Ted was a resident of the street.
Today, Ted lives in his home.
What made the difference this time?
The answer will amaze you with its simplicity,
because what made the difference was housing.
It seems pretty obvious to fight homelessness through housing.
But in fact, what really made the difference, this time,
it is to have dared to live immediately from the street
with someone as fragile as Ted.
A chronically homeless person,
presenting vulnerabilities in mental health and addictions.
It’s only rarely done so far.
From this accommodation,
a process of social integration could be started
thanks to the intensive support of a multidisciplinary team.
This is a social innovation,
called Housing First, or housing first.
But what makes its character more effective,
more efficient, more sustainable, more just?
That’s what I’m going to tell you.
So you and I meet homeless people on the street
and it can leave us with the impression that nothing is done for them.
This impression is absolutely false,
because today, at home,
a homeless person on the street can find an answer to his primary needs.
Thanks to the joint efforts of public and associative institutions,
a homeless person on the street can find a bed for the night
to be cared for, to be nurtured.
The problem of homelessness is managed in a humanitarian way.
And in winter, the resources allocated are reinforced.
The problem is managed seasonally.
The bulk of public subsidies go to this humanitarian management
and seasonal homelessness.
From this help, called social emergency, is then organized
and here I am going to force the line a bit – I concede it –
then organizes the help in the form of a staircase.
Different stages, different hosting solutions,
transitional, fixed-term,
preparing for the final stage of the insertion process:
housing.
This system works.
There are even people
who are very quickly accompanied to the accommodation.
But this system does not work for everyone.
And here we find people like Ted, homeless people,
chronic, weakened in the areas of mental health and addiction,
who fail to meet the access conditions
associated with each of these steps.
To project, to diminish, or even more often,
stop the use of drugs or alcohol,
to go into cure.
Some institutions have relaxed their access conditions.
But that’s not enough.
The vast majority of homeless people, the most vulnerable,
fail to begin this process of insertion, which has been imagined.
They stay years in the street, they start to live on the street,
they start living in emergency services,
they keep getting further and further away from individual housing
and they see their problem and their initial fragility worsen.
Current public policy in the fight against homelessness
is discriminating.
But there is good news,
I will share it today, with you,
it is that there is a solution.
With these homeless people the most distant housing,
cancel the intermediate steps, reverse the process.
First the housing, then the rest.
It’s the “Housing First” model, or housing first.
This model is characterized by three fundamental principles.
The first: the target audience;
the second: housing;
and the third: accompaniment.
Let’s start with the target audience.
You understand, we talk about homeless people
the farthest dwelling.
Those for which we have already tried everything.
Those that increase the fragilities in the field of mental health,
addiction.
Those that are considered as not being able,
or not fit, not ready to live.
Second characteristic of the model: housing.
This is the most classic accommodation possible,
from the public rental park, but also private.
The person signs his lease, like you and me.
There are no other conditions of access to housing.
This person pays his rent.
With what income?
With the income to which she is entitled.
And as a last resort,
it will be the income of social insertion
granted by the public center for social action,
who is in the territory frequented by the person,
even in her situation of homelessness, she is entitled to it too.
It is not easy, you doubt, to find housing
for this type of people with very modest incomes,
strongly stigmatized,
but it’s not impossible, we found some.
And we continue to try to impact housing policy.
Do you have an apartment to rent?
Or you ?
I think we’ll talk to each other afterwards.
But what are we going to talk about?
With what arguments can I come to you?
We find the third characteristic of the model: the accompaniment.
Housing is not enough.
With these fragile people,
you need a companion to meet their needs.
Accompaniment will therefore be intensive, multidisciplinary and mobile.
And he will aim for recovery.
We are not talking about healing here.
We do not talk here
to stop the use of drugs or alcohol immediately.
We are talking about recovery.
The recovery of his life as an actor, as a citizen.
From his own resources and at his own pace.
The team will be there for as long as necessary.
The model “Housing First” is an American model,
which was initiated in the early 90’s in New York.
It took a bit of time before crossing the Atlantic,
but he arrived in Europe.
And in all the countries of Europe
in which there is a policy to fight against homelessness,
it has been implemented.
Each time, with impressive success.
At least 80% of these people as far from home as they are
are still in housing, two years later.
Otherwise,
this practice can significantly reduce
public costs for nights in night shelters,
social emergency
and also in hospitalization.
So, it was time to test this model in Belgium.
With the support of the Secretary of State for the fight against poverty,
in the national lottery contest,
field institutions, public and associative,
from which I come,
have initiated a two-year test phase.
In the cities of Antwerp, Ghent, Hasselt, Brussels, Molenbeek-Saint-Jean,
Liège, Charleroi and Namur.
This experiment was called “Housing First Belgium”.
And I coordinated it from the Federal Public Service Social Integration.
So, support teams, multidisciplinary, intensive,
have been engaged to accompany immediately into housing
nearly 200 homeless people very chronic.
They spent, on average, five years of their lives on the streets and very weakened
in the areas of mental health and addiction.
An evaluation team has been engaged across the three regions
and followed the evolution of this audience,
some of these tenants, Housing First,
during two years,
meeting them every six months.
This experimental group, the tenants “Housing First”,
has been compared –
The evolution of this experimental group
has been compared to the evolution of a control group
Homeless people with the same profiles.
Just as fragile,
just as chronicled in their homelessness.
Two years later –
yes obviously, in this group control,
they are people who have continued to patronize the traditional aid system.
Two years later, where are these people?
What have become of them?
Two years later,
93% of the homeless, chronic, fragile,
accompanied by the Housing First teams,
are still in housing.
These fragile people, the most distant from housing,
we demonstrate their ability to live.
They appropriate their home,
they pay their rent,
they invite us to deconstruct stereotypes
that we had them.
By comparison, it takes two years for only 48% of people
who continued to patronize classical help system
access to housing.
The “Housing First” practice appears from
as the fastest solution to get out of the street.
And the solution that allows the most sustainable street exit.
Another element that I wish to show you on this graph.
At the far end, on the right, you have a column,
which represents the control group,
those who have continued to patronize conventional aid systems.
Two years later, there is a whole series of colors.
What are they referring to?
We do not find in the experimental group
tenants “Housing First”.
These colors refer to different residential statuses.
We have people who are in housing, 48%.
We have people who are always on the street,
but there are also people who are hospitalized,
who are in prison,
without perspective of housing at their exit.
Others, who are in substandard housing
and who at any time could be expelled.
These data emphasize the need for preventive measures.
Beyond
this maintenance in housing, which is already an incredible result,
we have a whole series of data that show
that these Housing First tenants see their self-esteem increased.
They gain in empowerment.
They are also people
who begin to take charge of their health,
they start a journey of care,
This reduces hospitalization costs by 46%.
So from this data,
what should be done to effectively fight homelessness?
Increase the number of beds in shelters-nights?
Multiply subsidies in winter?
No.
These data invite us to think differently
the fight against homelessness.
Ted’s story is not an isolated story as an exception.
Ted’s story, and all the other stories,
demonstrate the driving role of housing in social integration,
including for the people furthest from the accommodation.
Let’s base our public policies on this evidence.
Dare housing with the individual accompaniment adapted.
And I’m not talking here about putting huge new resources on the table.
No, I am talking about using public money efficiently.
A link between the costs and the impact on the medium and long terms.
That’s the efficiency.
Something I have to tell you before you leave.
An accompanying day in the “Housing First” model
costs three times less than a night in a night shelter,
seven times cheaper than a night in prison.
Without talking to you about psychiatric emergencies,
17 times cheaper.
Let’s take a look at the shortest route out of the street,
avoid installation in emergency structures,
which are not meant for that.
Allow these emergency structures to refocus on their primary mission,
because we continue to need it.
From a humanitarian and seasonal management of homelessness,
let’s move to a fight against homelessness.
And let’s be ambitious, while being absolutely realistic.
Let’s win this fight against homelessness.
Thank you.
(Applause)
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