A bed made of cardboard boxes, worn-out clothes, a bottle of cheap wine; several stereotypes that come to mind when talking about homelessness. Walking the streets in Czech cities, one might think that only a few people face homelessness – lost souls who have not been lucky enough in their lives.
However, the term homelessness does not only include those without a roof over their head. The European Typology of Homelessness and Housing Exclusion, also used by Czech authorities, identifies four types of living situations (roofless, houseless, insecure, inadequate) considered as homelessness. According to this typology, people living in women’s shelters, in accommodation for immigrants, in insecure housing or in extreme over-crowding are perceived as homeless as well.
Most Czech homeless people are hidden from sight in temporary facilities with extremely poor living conditions. For instance, it was reported that in a collective housing facility in Karvina, 13 families had to share one shower and one toilet and adults slept on the floor.
The Czech paradox: More people in need of accommodation despite economic growth
The Czech economy is currently in excellent condition. Moreover, the percentage of people at risk of poverty or social exclusion in the Czech Republic is the lowest among EU member states (12.2 per cent in 2017 comparing to the EU average of 22.5 per cent), and the unemployment rate has not been lower in 22 years. In spite of the current period of prosperity, 200 000 individuals do not have stable housing. This is approximately two per cent of the Czech population and includes 20 000 children.
To make matters worse, the number of homeless people is growing in the Czech Republic. The main cause is that there is no law on social housing and bad living conditions for people in financial distress. Since the Czech government acts too slowly, many municipalities have decided to tackle the situation themselves, declaring war on homelessness. A promising project called Housing First, introduced in many cities across the globe, has proven to be a powerful tool to fight homelessness. Recent results from the City of Brno, the first Czech city to implement Housing First, showed that its results in local conditions are also undoubtfully positive.
What is Housing First about?
Housing First is an innovative tool designed for people who need significant help to enable them to leave homelessness. It was developed by Dr Sam Tsemberis in New York in the early 1990s. Since then the concept has been successfully implemented in several countries in North America and Europe. Its success rates are high; it has been shown that the model ends homelessness in at least eight out of every ten cases.
Contrary to more traditional approaches, in Housing First, homeless people are offered housing as soon as they enter the programme, regardless of their situation. The project is based on the idea that housing is not only a human right, but also the essential first step to solving all problems related to homelessness, such as drug abuse, health problems, and money problems. When participants have moved into the new house, aid workers do whatever it takes to keep them living there. Only then, the next step is focused on improving their health, well-being and social situation.
This approach is different from traditional homelessness services, which often require a person in need to follow social competency training and to commit to a long-term cooperation with NGOs or national authorities before housing is provided. In Housing First, accommodation is offered unconditionally. The assumption is that only when someone has formed a home base, has he the ability to tackle other personal problems.
The first pioneer in the Czech Republic
The City of Brno (population 380 000) which owns and controls access to 29 000 flats, approved a strategy to end family homelessness: to make it rare, short and non-recurring. Since 2016 various traditional and experimental approaches have been tested for outcomes. The Housing First approach has been one of them. Thus, Brno has become the first Czech city to experiment with the tool.
Before the trial run of the Housing First project was launched, a family homelessness registry was conducted in April 2016. The results showed that there are 421 homeless families in Brno, and two-thirds of them are Roma. Once homeless, these families are often considered unfit as tenants by both private and public landlords and have little access to housing.
Between September 2016 and June 2017, 50 of these 421 families were randomly assigned to the Housing First program through a lottery organised by City Council for Health and Social Affairs. To be able to measure the impact of the Housing First approach, the project was accompanied by a randomised control trial lead by the University of Ostrava. Consequently, other 100 families were randomly assigned as a control group. Both intervention and control groups were surveyed at baseline, and after six and twelve months several preselected indicators were registered and compared.
Promising but not surprising results
The trial period ended in June 2018, and the final report was published by the University of Ostrava in December 2018. So far, the results of the project are promising.
One year after the start of the program, 96 per cent of families still lived in the house they were assigned. During this first year, families who were not selected for the Housing First programme were on average homeless for roughly nine months, while this was only 0.16 months (less than 5 days) for families who benefited from the program. Overall, families participating in the program had 5.6 m2 more living space per person.
Unsurprisingly, the Housing First intervention did not only improve housing circumstances. It also had a positive effect on health and well-being. It was found that the health conditions of participants in the program improved, whereas the condition of the control families worsened. Stress levels were significantly lower in participants, especially in mothers. And both parents and children in the intervention slept better and longer.
Moreover, participating mothers were 4.5 times less likely to have high levels of psychological distress than mothers in the control group, and had a lower incidence of depression. The use of antibiotics was 2.23 times lower in people that participated in the program. In the intervention group, fewer children were placed in institutional care and foster care. Children spent more time with their families and were more likely to be happy in school.
The program was financially viable as well. The cost-benefit analysis showed that the housing first program could save public money. In fact, it was estimated that 106 emergency room visits, 51 emergency service calls and 39 cases of hospitalisation were prevented thanks to this intervention.
Although the results of the Housing First trial are promising, the intervention is not a quick fix for all problems. Life satisfaction, for example, improved significantly during the first six months of the program but was still lower than in the general population. And, while the financial situation of families in the program got better, most of them were still not able to cover their basic needs. Of course, many of the problems causing and stemming for homelessness need time and professional help in order to be solved. It is therefore essential that help remains available for a substantial period of time after participants have moved into their new house.
Brno’s success inspires other Czech cities
The project results demonstrate that the Housing First approach can thrive in Czech conditions and can be a useful tool to reduce (family) homelessness. The concept implementation was closely watched by media, elected officials and experts from all over the country. Inspired by Brno’s success, several Czech municipalities, such as Liberec and Ostrava, have already launched their own Housing First projects.
Dominik is from the Czech Republic. He studied French and mechanical engineering and is interested in architecture and social issues.