The Centre for Homelessness Impact created two comprehensive maps of existing evidence on homelessness by extensively searching for, and including in their maps, all relevant studies on homelessness. You can find out more about these Evidence and Gap Maps here: https://www.homelessnessimpact.org/gap-maps. The studies included in the maps tell us what works to improve outcomes for people who have already, or might in the future, experience homelessness and what helps or hinders the implementation of effective homelessness services.
In May 2019 the research team identified 223 unique studies across 551 articles from CHI’s effectiveness Evidence and Gap Map. We checked all of these studies to see which ones studied the effect of accommodation-based interventions. It looked like 69 were relevant so we checked these in more detail.
We assigned each intervention (that was evaluated by the studies in our review) to one of the seven intervention categories described at the beginning of this infographic. This allowed us to directly compare which types of intervention are most effective in improving housing stability. Head-to-head comparisons were only conducted between those categories for which there was sufficient data from the included studies.
We were able to conduct a network meta-analysis to compare the effect of different accommodation-based interventions, as described by the typology, on housing stability.
Giving people free or discounted housing for an extended period of time, in addition to active and individualised support, leads to greater housing stability compared to any other approach.
Housing stability outcomes are worse for those receiving basic unconditional accommodation compared to all other interventions, including those who are receiving no intervention (the control group).
With the exception of basic, unconditional accommodation, all other accommodation-based services were better for housing stability compared to doing nothing.
As well as looking at what interventions work, and work best, the review also explored how interventions work, and what contextual factors are important when implementing accommodation-based services.
Finding accommodation for those who need it can be hindered by supply and affordability in the housing market. State support for people who are homeless varies globally. If the support systems in place are not adequate, it can influence some of the public prejudice and stigma surrounding homelessness.
Clear identification of suitable users, referral routes and approaches to prioritisation
Effective and meaningful engagement with users and involving people in decisions about their housing and support, was a factor in outcomes and user satisfaction.
Many of the features of a person-centred and holistic approach including flexibility in support work, a non-judgemental approach and excellent communication.
The time and knowledge to assist with navigating systems, like those used to secure accommodation, for example, were also identified as enablers to housing stability.
Collaboration with other agencies is useful but difficult to achieve. Everyone needs to start on the same page and sing from the same hymn sheet to avoid confusion, misunderstanding and wasting resources.
Programme staff have a critical role to play. They need robust training and to be able to share in the vision of the intervention. This secures buy in and confidence in their ability to improve outcomes.