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Housing First: ‘It felt like I’d discovered the vaccine for homelessness’

When Sam Tsemberis tried a new approach to helping people out of homelessness in '90s New York he had no idea the impact it would have.
Sam Tsemberis in New York in 2019. Image credit: Pathways Housing First

If 2020 was the year that thousands of people were brought off the streets then 2021 will be about keeping them in homes. And not just people forced to sleep rough, but anyone at risk of falling into homelessness.

Leaders around the UK will be looking to a new approach with rapidly rising popularity to achieve this: Housing First. The much-admired model has been hailed as the solution to ending rough sleeping once and for all and has famously seen remarkable success in tackling street homelessness in Finland.

The idea is simple: rather than making people who are sleeping rough answer personal questions, hit certain criteria and jump through hoops to get a home, they are simply given one. The housing comes first, and is followed by personal support for as long as people might need to help them adapt to independent life and conquer their demons.

The approach is the brainchild of Sam Tsemberis, a clinical psychologist who took a fresh perspective on solving spiralling homelessness in early-Nineties New York City.

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Tsemberis, now 71, could see that full communal shelters were not translating into more people being housed. So he developed the Housing First model and started tracking its success, initially housing one person a week. The proportion of people who managed to keep their new home over the first year sat at more than 80 per cent, compared to the 30 per cent through the traditional system.

It has become a blueprint for tackling homelessness all over the world and Tsemberis has proven to be a charismatic advocate for the model as well as an advisor and sounding board for countries wanting to adopt it. He knew the idea was a good one from the start, he says, but didn’t realise it would have such global impact.

“The idea came from the fact that the number of people who were homeless and living on the street was growing and the system to address it was based on the belief that this thing would just go away some time soon, we just need something quick to get people off the street right now,” Tsemberis tells The Big Issue.

“With our model we quickly understood that we were on to something here, it was extraordinary. But it became a matter of why aren’t people doing more of this? We’re in Covid right now and Housing First felt like we had discovered a vaccine for chronic homelessness and I’m trying to tell people: use the vaccine!”

The response to homelessness during the Covid-19 pandemic has been characterised by a Housing First-style approach. While projects have been developing in the UK for several years, the efforts to move homeless people into hotels and other emergency accommodation removed the barriers associated with housing at unprecedented speed, albeit not in a sustainable way.

The barriers placed in front of homeless people to access housing have traditionally been higher than for the rest of the population, says Tsemberis, in a move that breaches human rights.

“For the people who are the poorest, we have created a system in which they have to jump through more hoops than the rest of us,” he says. “If we can show that we can pay the rent and the deposit and are creditworthy then we can rent an apartment. No one is asking you and me how much we drink, or how often we drink or if we smoke weed or whether we’re taking medication for our problems.

“That’s where the rights violation comes in, we are holding a bar much higher for people who are disenfranchised more than ourselves. “

Now Housing First is well on the way to becoming the default response to rough sleeping in Scotland.

And leaders in Westminster are using lessons learned in Housing First pilots across Greater Manchester, Merseyside and the West Midlands to inform how rough sleepers protected from the pandemic are moved into permanent accommodation. 

In Wales, 2020 saw the first Housing First in Wales accreditation given to projects in Cowny and Denbighshire with more locations queuing up to increase the use of the model throughout the country.

It’s a sign of a culture shift that Tsemberis has been calling for over the last three decades.


There are currently around 2,000 Big Issue sellers working hard on the streets each week.

“I think there is a sea change now,” he says. “In a strange way this virus has made the point that I have been trying to make for years so much better and so effectively. People need their own place to live.

“20 years I’ve been pushing uphill and this little virus comes along and there are 15,000 people being swooped up off the streets to put up in a room of their own. It was like YES!”

But the question as we kick off 2021 remains the same: can the progress made in 2020 be sustained long-term?

Tsemberis believes it will determine whether his model delivers on its promise in the UK. 

“The money spent this year is emergency money – what happens next year?” he says. “That’s what worries me, not for people in hotels who are homeless, but people hanging on to jobs. 

“There is a looming after-effect of the economic disaster that this virus has taken. It’s hard to ponder the magnitude of it. The job is not finished.”