How ‘housing first’ is helping people leave rough sleeping behind

When Michael became homeless in Plymouth in 2022, he struggled to find the support he needed, and made what he describes as an “impulsive” decision to come to London.

For his first week in the capital, he slept on the pavement without even a sleeping bag. Then he overheard people talking about The Connection at St Martin-in-the-Fields, the homelessness charity next to the National Gallery, and decided to show up.

Michael moved between the streets and temporary accommodation before eventually securing a place through the UK government’s Rough Sleeping Accommodation Programme. But it was time limited, and as the end of his tenancy approached the uncertainty returned.

Then he heard about Solo Homes, The Connection’s version of a homelessness approach known as Housing First. Michael was assigned a support worker, Gen, and within weeks he had visited a flat and signed a tenancy agreement. Rent is paid using his benefits, while the charity covers the cost of his care needs, including mental health support. 

Gen helped him settle in and access mental health support, while Michael began making the place his own, even building some of his furniture. After years of uncertainty, he finally felt he had somewhere he could stay.

“Since then it’s just been amazing,” he says. He has not returned to the streets since.

Michael’s experience now sits within a much bigger change in how England is approaching rough sleeping. In August, the government announced a £442m rough sleeping programme, combining an immediate push to offer everyone sleeping rough a route off the streets before Christmas, with longer-term accommodation for people who have spent extended periods homeless.

More than 1,000 settled homes are expected to be provided over the next three years, alongside intensive support. The programme is broader than Housing First, but government guidance says its longer-term housing offer will build on Housing First principles.

Those principles reverse much of the conventional thinking about homelessness. Instead of expecting someone to progress through hostels and temporary accommodation, perhaps addressing addiction, poor mental health or other problems before they are considered ready for a permanent home, Housing First starts, as its name suggests, with housing.

People are offered a settled home of their own, while a support worker helps them access whatever services they need. Crucially, keeping that home is not conditional on accepting treatment or reaching particular milestones. Support can include mental healthcare, drug and alcohol treatment, benefits advice or help reconnecting with family and community.

The principle is that recovery becomes more achievable when someone is no longer worrying about where they are going to sleep.

Costanza Barbieri, a mental health practitioner, who has worked with people sleeping rough in London, says it reflects a broader shift in thinking about the relationship between someone’s surroundings and their wellbeing.

When stable housing is prioritised, we see reduced pressures on emergency services, A&E departments and the criminal justice system

“There’s a real shift in focus towards wellbeing these days, whereas in the past it wasn’t given much consideration – as if a person was capable of coping with their depression or stress by simply setting aside the environment in which they live, as if not having a home, sofa surfing, or living with a family of five in a studio flat could simply be brushed aside,” she says.

Evidence accumulated over several years suggests the approach can be particularly effective for people who have experienced long-term rough sleeping alongside mental health problems, substance dependency, trauma or contact with the criminal justice system.

Beginning in 2018, the government funded large Housing First pilots in Greater Manchester, Liverpool and the West Midlands, ultimately supporting more than 1,000 people.

Among the group followed by researchers for a year, 84% were living in long-term accommodation after six months, rising to 92% after 12 months. Before joining the programme, 86% had been living in precarious or unstable circumstances.

Researchers also recorded improvements in mental health and wellbeing. The proportion of participants describing themselves as often or always lonely fell from 35% to 16% during their first year, while GP registration rose from 60% to 92%. There were also reductions in reported antisocial behaviour and contact with the criminal justice system.

Stable housing did not instantly resolve every problem. After a year, researchers found no statistically significant reduction in overall drug use or alcohol dependency, while employment remained low. Several years into the programme, many participants were still receiving treatment for physical and mental health conditions.

That finding helps explain why Housing First is built around long-term support rather than the idea that handing someone a key will immediately undo years of trauma, ill health or addiction. Government researchers concluded that recovery could be slow and non-linear, particularly among people who had spent long periods on the streets.

In London, the homelessness charity Spear runs Housing First services across five boroughs. Elena Brooks, its assistant director of operations, and Carmen Jeffery, one of its Housing First team leaders, point to clients who have retained their homes for the full four years of a project despite previously spending long periods sleeping rough.

They also measure progress in less dramatic ways. Somebody attending a GP appointment, consistently turning up to addiction recovery meetings or simply starting to manage the routines of living independently can be a significant step.

Francesca Albanese, executive director of policy and social change at Crisis, another homelessness charity, says that stable housing can also reduce some of the repeated emergency interventions that accompany long-term homelessness.

“The results clearly show that when stable housing is prioritised, we see reduced pressures on emergency services, A&E departments and the criminal justice system. It’s also a far better way of spending money – directing it towards ending homelessness instead of managing it,” she says.

It’s a far better way of spending money – directing it towards ending homelessness instead of managing it

The need for a different approach remains considerable. Across England, an estimated 8,748 people slept rough at some point during June, with 3,253 classed as long-term rough sleepers.

London shows another part of the challenge. Between April and June, 3,959 people were recorded sleeping rough. Among those who had previously slept rough and moved into accommodation during the period, 80% entered temporary accommodation and only 20% moved into settled housing.

The Connection says that long-term rough sleeping has also been rising in the borough of Westminster. Its Solo Homes programme remains small, but the early results are striking. Since February 2025, the charity says it has supported eight long-term rough sleepers into their own tenancies through the scheme, and all eight have so far kept their homes.

Finding enough suitable homes remains one of the biggest obstacles to expanding programmes like it. Brooks and Jeffery say that housing shortages have already slowed Housing First schemes in London, while the government’s own evaluation identified housing availability, long-term funding and access to specialist mental health services among the main barriers.

The best thing about this is you’ve got someone to help you and you can feel stable

Responding to the government’s new programme, Cllr Anthony Okereke, London Councils’ executive member for housing and homelessness, welcomed the investment but added: “Alongside this welcome investment, we need a sustained focus on prevention and housing supply.”

The government has allocated £178m of the new programme specifically for settled accommodation, with councils able to acquire existing properties, bring empty homes back into use, convert buildings and, where possible, build new homes.

Housing First is not intended as the answer for everyone who becomes homeless. Some people may need short-term help after a sudden housing crisis, while others may prefer supported or shared accommodation. Its focus is on people whose homelessness has become entrenched and whose lives are often complicated by several overlapping problems.

For Michael, the change has been simpler to describe.

“After three years of uncertainty, it was just nice to know I don’t have to worry about it anymore. I’ve got stability now,” he says. “The best thing about this is you’ve got someone to help you and you can feel stable.”

After years spent wondering where he would sleep next, he has a front door, furniture he helped build himself and no deadline telling him when he has to leave.

Main image: iStock/insta_photos