This briefing is based on a systematic review that looks at the evidence on the wellbeing impact of housing interventions for people who are at risk of homelessness, unstable housing or loss of their home adults (also known as housing-vulnerable).
We also looked at the cost effectiveness of one of the key interventions, Housing First. This intervention provides immediate, unconditional, access to housing for people with complex needs, with intensive support. In spite of its high profile, there is little evidence about its cost-effectiveness.
Who is ‘housing–vulnerable’?
Housing-vulnerable groups include adults who are at risk of homelessness, unstable housing or loss of their home. This includes people who are homeless or had a history of homelessness; people with a history of mental illness; people with a learning disability; people fleeing domestic violence; substance misusers; refugees and asylum seekers; recent immigrants; young people leaving care; ex-prisoners; Gypsies and Travellers; people with a long-term disability; people with complex needs and multiple disadvantage; and people living in severe overcrowding or with short-term tenancies.
A lot of people are living in awful housing. That has a knock on effect on everything else.
What are the key findings?
Where you see the following symbols it indicates:
We can be confident that the evidence can be used to inform decisions.
We have moderate confidence. Decision makers may wish to incorporate further information to inform decisions.
We have low confidence. Decision makers may wish to incorporate further information to inform decisions.
Housing First can improve housing stability and physical health in the short-term.
Positive Effects of Integration into the Neighbourhood
There are positive effects on personal wellbeing, mental health and locality-related wellbeing – such as housing quality, satisfaction and integration into the neighbourhood.
Effects on personal finance and community wellbeing
There was no effect found on personal finance, and community wellbeing.
Impact on other outcomes (work, training, skills, relationships) was rated as initial.
Housing First: cost effectiveness
There was little of evidence on the cost-effectiveness of the interventions investigated. Only a small number of economic evaluations were included and their relevance to the UK varied.
Based on a two-year model that includes the costs of housing, support, health care and criminal justice, we found that each additional day of being stably housed using a Housing First approach, on average, costs an additional £9.
The evidence suggests that Housing First programmes can lead to an increase in life satisfaction, and the best estimates from our model show that each addition point on a 0-10 scale from unsatisfied to fully satisfied with life costs an additional £4,000.
However, there is lots of uncertainty around these estimates, particularly around the cost of Housing First and the appropriate case load for Intensive Case Management.