Research using the North American experiences
Le 08 avril 2012 | Actualités -
Launched in late 2010 by the Ministry of Sustainable Development, within the Housing First program, Housing First experiment ("A home firt" in French) is scheduled at 4 sites: Lille, Marseille, Toulouse and Paris.
In the capital, 100 units will be offered for 3 years, in the form of leases rolling, to homeless people with severe mental disorders, addictions, and / or leaving prison. If the program meets a real need, this is first a medical research before becoming a hosting solution or housing. Thus, 24 months, a team of researchers visit participants in their apartment in the experiment. Conducted in 2009 in Canada and the United States earlier in the year 90, the experiment shown in North American cities a strong self-sufficiency of the residents and a proven stabilization as 70 to 80% of people were still in their housing after 4 years.
A special public marginalized
The program targets homeless people with severe mental illness and addiction (schizophrenia, bipolar disorder), because these people are « too difficult to manage » in classical shelters. The today solutions are not adapted.
"These people are in a situation that all indications and all the cons-indications access to conventional structures," explains Jean-Marc Antoine, Project Aurore on experimentation.
He says: "Being homeless, the person would be entitled to accommodation in CHRS. But his mental disorder excludes this type of structure, which contains collective life rules, which usually can not handle his condition, and could not manage any outbreak of violence or decompensation. Similarly, the hospital just to support the most excluded mentally handicapped or drug addicts, for whom the instability of the street from following proper treatment and to comply with hospital regulations ".
The study Samenta, conducted by the Observatory of the Samu Social, 1/3 of homeless people in Ile-de-France suffer from psychological disorders. Housing First may be a response to their specific situation.
Reverse logic: housing as an integration tool
It was possible to create new specialized type of CHRS, complemented by a strong partnership with the health sector, and that it would welcome public disorders. But with the introduction of Housing Comes First, the bet has been launched to reverse the logic of care. Today, when a person begins a troubled integration path, it must begin with finding accommodation, places of care (outpatient or hospital) to move progressively towards temporary housing, and durable, making it a objective in itself.
With Housing First, housing is a prerequisite for inclusion and it is in housing that is done and care integration. Rather than requiring beneficiaries to enter the "boxes", to meet the admission criteria of a structure, it is the professionals who adapt, in each case, to his situation. To do this, follow the social and health will not happen, as usual, referring to the office of office or the hospital professionals will visit the person's home at 3 visits per week. Doctors, psychologists, special educators are a kind of guardrail, ramp support, and perhaps a launching pad towards autonomy.
The key to the experiment: to the person
Housing First project intends to place the individual at the heart of its management, have it participate in all stages of the accompaniment. First, the recipients will be informed of the experimental nature of home first. Several appointments prior to entry into the device have been made with the person responsible for validating the orientation-in this case, one of the researchers working on the program for the beneficiary to take an informed decision cause. Do with the person means to do with all its difficulties. Therefore, no separate criterion-inadequate to conventional-not interfere in its admission. Consumers of psychotropic assets will be, for example, able to participate in the Housing First program.
Finally, the recipient will have the choice between two to three different studios in different parts of the city. "This choice is important. A person who made the race for years before the subway or shopping, do not wish to live in the district. Choices for people, it's also start support for the refusal must be motivated and their arguments will be tools to better understand them, "says Jean-Marc Antoine. The furniture will also be chosen with the user and provides an opportunity to prioritize equipment (washing machine, bedding, fridge, stove, microwave ...). These choices will begin work on "know live" (sleep in his bed, aerate the slot, namely maintenance, ...).
Finally, beneficiaries will be fully integrated to support, so it will be possible to discuss the medication if any. Compared to existing structures, the principle of user participation, which places them in the organization of the device itself, is an innovation.
Dawn and "A Home First" program in Paris
The joint association of Aurore and the Public Institution of Health White House has been selected by the DRIHL for the establishment of the experiment in Paris. This is actually a temporary company grouping (GME), coordinated by Dawn and PSE White House who will manage the homes and followed the social and medical people. It brings together the Association of Cities of Catholic Relief Association Charonne Falret the work and the Centre for Social Action of the City of Paris.
The choice of the group thus makes it available to the public hosted the experiences and expertise of each structure, to make this experiment a success. The institutions that fight against exclusion expect a lot from this program: access to housing in the first step, the articulation of social support and care around the person, are working up new perspectives that could meet the needs of those excluded among the excluded.