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Housing first

This problem has a solution, and it has already been tested

Housing First inverts the traditional logic: instead of asking people to prove they are ready for a home, it hands over the home first and builds everything else from there. It is not a gamble. It is a methodology with thirty years of practice and results measured in a randomised trial.

What Housing First is

Housing First starts from a simple idea: housing is a right, not a reward. A person experiencing homelessness gets immediate access to their own home, with a contract and a key, without first having to stop using substances, accept psychiatric treatment, or work through a queue of shelters.

Support comes afterwards and lasts as long as it needs to: regular visits, coordination with health and social services, help rebuilding family ties and finding income. The housing is not conditional on progress in that support. A person can turn down a service and keep their home.

That separation between housing and treatment is the heart of the method, and it is exactly what the traditional model does not do.

How it differs from the traditional model

The traditional model is known as the "staircase model": the person climbs steps until they deserve a home. Housing First starts with the home.

Traditional model (staircase)

  1. 1Person experiencing homelessness
  2. 2Emergency shelter, with rules and curfews
  3. 3Shared shelter or transitional housing
  4. 4Prove abstinence and treatment compliance
  5. 5Only then, a home of their own

Every step is a point where someone can fail and go back to the street. People with the most complex situations, precisely those who need it most, are the ones who fail the entry criteria.

Housing First

  1. 1Person experiencing homelessness
  2. 2Their own home, immediately, with a contract
  3. 3Individualised, continuous support
  4. 4Rebuilding ties, health and income, at the person's own pace

Housing stability becomes the foundation for everything else, rather than the prize at the end. There is no step at which someone can fail and lose the roof over their head.

The principles behind the method

Where it came from

The method was born in New York in 1992, with psychologist Sam Tsemberis and the organisation Pathways to Housing. The proposal was radical for its time: take people living on the street with serious mental illness and place them directly into their own apartments, scattered across the city, with support delivered after the key rather than demanded before it. [1]

In its first five years, 88% of the people in the programme were still housed, against 47% in New York's traditional residential treatment system. The method has since spread across the United States, Canada and Europe. [1]

What the evidence shows

Housing First is one of the few social policies tested in a randomised controlled trial, the same design used to evaluate medicines. Below are the two most cited bodies of evidence.

Canada

At Home/Chez Soi, the largest trial ever run

Between 2009 and 2011, 950 people experiencing homelessness with serious mental illness were recruited across five Canadian cities and randomly assigned to Housing First or treatment as usual. Follow-up ran for up to 24 months. [2]

People in the Housing First arm spent on average 151 more days in stable housing over the two years. And 69% of the cost of the intervention came back as savings in other services, mainly emergency shelters, leaving a net cost of around CAD$ 6,311 per person per year. [2]

+151

more days of stable housing over two years

Compared with treatment as usual, in the Canadian trial.

Finland

The country that made it national policy

Finland has run Housing First as state policy since 2008. Homelessness has fallen by around 80% since 1986, and long-term homelessness fell by roughly 70% between 2008 and 2023. In 2023 the country counted 3,429 people living alone in homelessness, 1,018 of them long-term. [3]

The other side is worth recording: Finnish numbers have risen again in the most recent surveys, reaching around 4,579 people. This is not a method that solves the problem once and for all. It is a policy that needs continuous maintenance and funding. [4]

~70%

fall in long-term homelessness

Finland, between 2008 and 2023.

And in Brazil?

The scale of the Brazilian problem is different. In December 2025 there were 365,822 people experiencing homelessness registered in the federal social registry, against roughly 328,000 a year earlier. Seven in ten are Black, and 61% are in the Southeast. [5]

Housing First is still rarely applied in the country. The Opening Doors programme, run by Instituto Se Mudando, is one of the Brazilian experiments in adapting the method, in São Carlos, in the interior of São Paulo state. We publish our full documentation precisely so that other organisations can repeat what worked and avoid what did not.

We are available to talk and exchange experiences with anyone who wants to implement something similar.

See the Opening Doors programme

Supporting one person costs on average R$1,000.00 per month. That is what stands between someone and a return to the street.

Together we can! Shall we?

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