Dr Beth Watts argues that the growing focus on innovative responses to homelessness must be balanced with a commitment to approaches we already know work.

In the current ‘cold climate’, after years of policy change increasing the risk of homelessness faced by those already struggling, perhaps a glimmer of positivity can be seen in the increasing profile of the issue in the mainstream media and expression of concern amongst people wanting to do something to help.

Innovative solutions to homelessness are springing up across the country – old buses converted into mobile emergency shelters, ‘tiny houses’ and ‘homeless villages’ using novel building techniques to provide low cost accommodation. These ventures seem to offer a compelling practical solution to a visible social ill, and thus garner widespread public support, and even celebrity endorsement.

There are however good reasons to be cautious about innovation. Innovative programmes are not necessarily ‘better’, as is often implied: they are only as good as the outcomes they achieve. Interventions that work best at achieving positive outcomes are the ones that should be championed, whether they accord with traditional longstanding ways of working, or present radically new ones.

Of course, to establish an evidence base on ‘what works’, new approaches have to be tried and given a chance. But we are not starting from a blank slate. An array of existing evidence identifies the kinds of interventions that work well in tackling homelessness. Innovations that go with the grain of these insights should hold more appeal and receive more support than those that cut against them.

In a recent synthesis of evidence (here, see chapter 9), Suzanne Fitzpatrick and I identify five principles that should underpin approaches for groups facing poverty combined with complex needs. These are:

Personalisation: support should be open-ended, persistent, flexible and co-ordinated, and work with the ‘whole-person’ and/or ‘whole-family’; responses must take into account the underlying causes of complex needs and the challenging behaviours that can be associated with them.

Deinstitutionalisation: as far as possible, people should have the option of staying in mainstream housing, rather than specific, separate institutions.

Reintegration: the focus should be on enabling people to access mainstream employment opportunities and engage in other ‘ordinary’ social settings.

Asset-based: interventions should focus on people’s strengths, enabling them to build a meaningful and fulfilling life in the face of ongoing challenges and realise their potential.

Poverty-informed: the financial and material hardship that people face should be directly addressed, rather than only focusing on their social or personal needs or behavioural issues.

Some of the innovative solutions currently emerging arguably depart from these principles. In particular, several seem to be a retrograde step in that they explicitly seek to create homeless-people specific communities or institutions, separated off from mainstream residential areas and working environments, and bringing those experiencing homelessness into ‘alternative’ forms of accommodation (that most of us would surely not choose over more orthodox housing).

Pursuing innovative responses in isolation from existing evidence runs the risk of reinventing the wheel, wasting time and resources learning lessons that have been learnt many times before. It may lead to avoidable mistakes and fail to help those targeted in ways we know are possible, and at worst risk making their situation worse. Congregate accommodation solutions, however innovative, will concentrate highly vulnerable people together, just like traditional hostels have done for decades, and evidence suggests that this can impede their recovery from poor mental health or addiction.

Housing First, developed in New York in the 1990s, turned traditional models on their head. Instead of requiring rough sleepers to navigate stages of transitional accommodation before ‘graduating’ into mainstream accommodation, it takes rough sleepers directly from the street to mainstream, scatter site, permanent accommodation. The effectiveness of the model in enabling a very high-needs and chaotic group to sustain accommodation is now very well established. Rolling out and adding value to such evidence-based models should emphatically be the priority, and though progress is being made, it is disappointing that uptake in the UK has been relatively slow.

Efforts to find practical solutions to homelessness are certainly to be welcomed, but with a note of caution that good intentions and new ideas are not enough – indeed, they can lead us astray. Innovation provides one route to finding new effective responses, but it is not risk free. The priority should be to push forward solutions underpinned by principles that we already know are effective.