Housing First and PIEs in the US and the UK

Housing First and PIEs 

The term "Housing First" (often abbreviated to "HF") describes an approach developed initially in the United States, which took the view that it was more effective to fast-track re-house homeless people with multiple problems such as substance abuse, trauma and mental illness, and then offer them treatment in and from their own homes, on a purely voluntary basis.

This is in contrast to what they termed "staircase" models, which expected people to pass through a number of rehab projects and programmes, as part of their recovery, before eventually being deemed ‘ready’ to be independently housed. Typical of such compliance-based housing would be the 'dry' households of recovering alcoholics. (For a discussion of the ‘staircase’ concept, see Johnsen & Teixeria; also Strnad & Masat)

There is some debate currently as to how far the HF and PIEs approaches should be seen as different parts of the same spectrum. The HF model was originally developed and described by a psychologist, Sam Tsemberis and it has some very sound social psychology at its heart, especially around questions of empowerment and choice, and the negative effects of institutionalisation.  

Clearly the HF approach, despite a strong rights-based emphasis, has its roots in psychology; and at a stretch, it would be possible to see singleton accommodation in an ordinary flat as being 'psychologically informed', at least in so far as it may meet profound psychological and emotional needs for the individual - and make it more possible to then address other needs. 

However with the release of the revised 'PIEs 2.0' model, with its greater range and in particular the concept of a 'PIE of pathways' and a clearer role for wider system change issues,  there is now a clearer place for even scattered site housing within the expanded scope of the PIEs approach.

PIEs and Permanent Supported Housing 

The principal contribution of the PIEs framework, however, may lie not in the general principles of HF, but in their particular application in the Permanent Supported Housing that HF proposes, as a constructive alternative to both the shelter system, and short-term “half-way” or “Transitional Housing”.

The permanent housing which HF expects may come in either of two forms – “scattered sites’ and ‘congregated sites”, and the latter can take the form of several dozen or more individuals living, each with independent tenancies and some degree of shared facilities, in the same building.  This appears to be the fastest growing version of Housing First; yet there has been so far little discussion of positive practice, or the nature of the social environment that is created there.

PIEs and Recovery - Transitional and/or compliance-based Supported Housing 

Little is discussed, and perhaps little is known, about the optimum running of transitional supportive housing, or long-term/permanent, but still compliance-based, accommodation.  This seems the form of housing closest in outline to the operation of the UK 'hostels' (see elsewhere on this site, and especially the dedicated page on Recovery Housing).

But there has been little exchange of research or views, probably principally because there has been relatively little formal published research on this in the academic press, using this terminology. 

Divided by a common language

Nevertheless, what published research there may be is still largely hidden from research searches by the terminology. Few service provider looking for models, or research or policy stakeholders looking for evidence, will be aware that in the UK the term 'shelter' is now rarely used; and the term 'hostel', which IS the common term is the UK, would not be used in a search.  Until recently, US research and policy has been - quite literally - blind to the developments in the UK in improving hostel environments.


Recommended reading/viewing/listening

PIEs, 'scattered site' and 'networked' housing (PIElink page) HERE

'Recovery Housing' in the US and the UK HERE

An interview with Sam Tsemberis (You tube link)

Framing Housing First (video

'Staircases, Elevators and the Cycle of Change' (article)

Exploring Effective Systems Responses to Homelessness HERE 

Packed with questions HERE

They do things differently there HERE

Red Herrings and Real Achievements HERE

Further reading/viewing/listening

Tsemberis et al: Selected works (website).