Implementations of Housing First in Europe: Successes and Challenges in Maintaining Model Fidelity

Abstract

To describe and evaluate the fidelity of Housing First (HF) initiatives in six European countries to the Pathways HF (PHF) model and examine the larger social, historical, and political factors that may foster or impede model fidelity. Key stakeholders representing six European HF initiatives completed semi-structured phone interviews. Interviews were thematically analyzed according to five key fidelity domains and updated with interim results of a recent European research project (Housing First Europe). Dissatisfaction with the status quo was often cited as the catalyst driving searches for system change. PHF's evidence base, consumer-driven philosophy, recovery-oriented services, and view of housing as a basic right swayed local decisions to implement HF programs. Interviews yielded stronger evidence of fidelity on no housing readiness requirements, separation of housing and services, a harm reduction approach, consumer choice in services, and weaker evidence of fidelity on scatter-site housing, choice ...