Social Workers: Challenges and Contributions to Housing First Support Programmes
By Patricia Bezunartea Barrio, Assistant Director, RAIS Fundación.
One of the biggest challenges facing public and private organisations that work with homeless people is the need to go that extra mile and deliver lasting high-impact solutions as opposed to the ad hoc solutions being provided to respond to emergencies. The chronic use of resources is an ongoing subject of discussion in Europe, where there is broad consensus among the networks and organizations that work with the homeless –mirrored in important institutional and political statements by various European bodies– concerning the need to redefine care networks and provide other types of services that are better tailored to meet people’s requirements (and not vice versa), services that allow them to deal with the long term, guarantee their rights and live in the dignity they deserve as citizens.
In this sense, the Housing First methodology has been a major catalyst in terms of how to tackle the exclusion of the most vulnerable members of our society. Housing First programmes are based on the conviction that housing is a basic human right and they stem from the belief that people do not need to prove that they are “housing ready” or participate in various forms of treatment, demonstrate perfect personal hygiene or prove that they are sober in order to qualify for decent housing. Housing First allows those who are worse off –they may have mental health problems, addictions or disabilities in addition to being homeless– to obtain immediate access to housing straight from the street and become part of the community from then onwards. Once they are settled in, they can draw on a whole range of services and support tailored to their requirements, making it easier for them stay in the housing provided and speeding up their recovery process.
In this context, the key to enabling people to recover and take the reins of their own lives is other people, paid or voluntary workers who form part of the support teams. This is a basic and essential relationship; it is the key to guaranteeing the success of the project and ensuring that people’s needs are met instantly, as and when they arise. This relationship guarantees that the processes people embark on thereinafter will not end in another failure for many of them. And many of these team members are professional social workers.
The manual in which Sam Tsemberis systematises his Housing First methodology advocates the inclusion –generally speaking– of a social worker on the support team, in addition to the other specialists. The philosophy underlying this project is fully in line with the premises that have governed social work ever since its inception. At the same time, this working model raises a number of challenges that are liable to make us critically rethink the role of this profession, past and present. Mary Richmond claimed, way back in 1922, that the success of social casework lies in encouraging and stimulating the client, securing their broadest participation in all the projects concerning them. Richmond’s premise was that human beings are autonomous and independent and the art of the professional who is devoted to the service of individual cases is to gauge the individual’s requirements and then satisfy them. Another of her assertions is that each human being is unique and different from others, and people must take part in designing and executing the plans that are designed to enhance their wellbeing. Self-determination, allowing people to take decisions concerning their own lives, is the very essence of this profession.
Another of the basic tenets of Housing First is its community character. The community (along with housing) is one of the main areas of intervention and, far from acting as a barrier to the recovery process, it is a source of resources and opportunities for forging relationships, participation and exercising citizenship.
Social work has a clear-cut community dimension, even though this takes a back seat in social worker training plans. Authors such as Antonio López Peláez have drawn attention to the need to reinstate community social work as a speciality in our field and one that should recover its rightful place, particularly in the current climate of economic recession. López Peláez says it is necessary to recover the legitimacy of the community as a sphere for collective action insofar as social exclusion processes involve losses, breakups, situations of isolation and increasing vulnerability. The best way to address vulnerabilities is through mutual support, solidarity and forming links with others; these are the main resources available to us. The challenges posed by society must be tackled collectively.
Furthermore, the community is the space where people can really exercise their rights, hence the need for professionals to redefine social policies by empowering people in community dynamics. We need to incorporate this focus into our professional work, which still leans too heavily on managing state benefits and mitigating the undesirable effects of a society that engenders poverty and inequality.
In projects that involve strong interpersonal links, as in the case of Housing First, the social worker must also really concentrate on developing a series of personal and professional skills that are essential if homeless people are to be supported successfully.
But do the main pillars of the Housing First model really form part and parcel of our social work? My answer to this question is not always, not in a radical sense, not as an essential part of our daily practice and this, as far as I am concerned, is the most valuable contribution Housing First can make to this profession. As stated in the “Housing First Europe”7 project report (evaluating the introduction of the model in 10 European cities from August 2011 to July 2013), this approach involves a change in the balance of power between service providers and service users that is found in institutional accommodation. This means that in addition to guaranteeing permanent housing without conditions for homeless people with more complex needs, support teams need to provide measures oriented towards meeting the individual goals of programme participants and covering their needs and preferences.
What, then, are the issues a social worker participating in Housing First type programmes should explore? These are just some of the issues I consider to be most relevant:
1. Rights training: I have already mentioned that one of the cornerstones of Housing First programmes is to consider housing as a basic human right and the provision of support as a key element in terms of guaranteeing that this right is exercised. Professionals in Housing First teams should be familiar with the laws regarding people’s needs and wants such as housing, civil and fundamental rights, immigration and others, and their intervention should be geared towards guaranteeing the rights of rights-holders.
2. Professional skills and competence: In order to show warmth, respect and compassion for people, provide support without being judgemental, respect another person’s self-determination and be capable of establishing relationships based on trust, greater emphasis needs to be placed on developing specific professional skills and compe- tence. Among these, communicative and dialogic skills are all-important, as described by Jesús Hernández Aristu, i.e. the capacity to listen to oneself and to others.
3. Developing community-based social work: The community focus is all-important in the support processes proposed by Housing First and it is the basic anchor for a person in that context. Recovery and development processes simply cannot take place unless opportunities provided in the surrounding area are taken into account. Participation, collective action, personal and social mobilsation, relating with and meeting other people all take place within the community context, which is the main window of opportunity for people. As far as social work is concerned, however, community intervention has not been developed as it deserves to be. In the context of today’s society, this development is essential.
4. Skills for measuring the impact and evaluating and disseminating the results of our work: There is no doubt that the legitimacy of social work as a discipline basically lies in the fact that it is action-oriented. This, however, should not stop us from transforming this action into valid and proven models and methodologies that we can use to develop our profession. We should be capable of measuring the results of our work, of knowing exactly what functions and what does not, transferring successful experiences after demonstrating exactly what these consist of. And in this respect, we have learnt a great deal from Housing First, ever since the programme began.
5. Service quality training: It is those who are most vulnerable who need the best services. Their dignity, trampled upon all too often, and their commitment to their recovery process require a wholehearted commitment to quality from us. This is not merely a declaration of intent, it means really and truly understanding exactly what is required in order to provide good service, developing techniques to guarantee that certain standards will be adhered to, committing ourselves to continuously improving the services and support we provide, and obtaining the satisfaction of those they target.
In conclusion, and to cite Teresa Zamanillo and Lourdes Gaitán, there are initiatives linked with social work that we cannot afford to turn our backs on: “constantly increasing the professionalism of social workers, fostering critical thinking and the capacity for self-criticism at all levels of formal social work organi- sations, launching processes geared to promoting the self-sufficiency of those we are trying to help, avoiding relationships where they feel dependent on and inferior to the social worker, and opening the doors to the fertile winds of interdisciplinary focuses”.