Figure 2b. Changes in service use from 12 months pre-VOICES, to 12 months in VOICES and 12 months of Housing First in those who were NOT housed (n=5)
4.1.4 Use of services during Housing First •
Housed vs. not housed
Figures 3a and 3b compare service use during the first 12 months of Housing First in those who were housed vs. not housed, in terms of actual numbers and numbers per customer. Outcomes for criminal justice system use were similar in those were and were not housed (Figure 3a). Given the different numbers in each group (11 housed, 5 not housed) we explored events per customer. This showed a pattern of demand being three times higher among those not housed compared with those who were housed (Figure 3b). For health service use outcomes, the overall numbers of A&E episodes were similar for each group, but hospital in-patient episodes were far higher in those who were housed (Figure 3a). Again, the patterns were different when exploring events per customer (Figure 3b). Compared with those who did get a Housing First tenancy, among those not housed: A&E episodes were 2.5 times more common, in-patient episodes were similar. Despite the limitations of small numbers, in which individual customers can distort between-group comparisons, these data do indicate a clear benefit of Housing First for reducing demands on the criminal justice system and A&E, but only if a tenancy is successfully started. This highlights the importance of referrals to Housing First and rapid securement of tenancies (see Recommendations). This pattern could also reflect a degree of self-selection bias, whereby those who are less complex and easier to house are housed first, leaving a waiting list of unhoused customers who have the most complex needs.
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