Two-Year Post-Housing Outcomes for a Housing First Cohort in Aotearoa New Zealand

Background: Housing First (HF) is an approach that improves outcomes for people who have experienced homelessness. Housing provision in HF is immediate, non-conditional, and permanent, with open-ended wraparound support offered. This paper reports one-year and two-year post-housing outcomes for 387 people housed by the first HF programme in Aotearoa New Zealand (NZ). Methods: We linked the de-identified cohort to Statistics NZ’s (StatsNZ) Integrated Data Infrastructure (IDI). This database contains administrative data on services provided by the NZ Government. This paper reports on interactions with government services by the cohort both before and after being housed. We focus on the domains of health, justice, and income. Results: The cohort experienced a sizeable drop in healthcare service interactions. Average bed-nights in both mental health inpatient (-59%) and residential units (-50%) more than halved in year one and maintained the reduced average in year two (-41% and -51%). Outpatient events increased 15% in year one and 31% in year two. The average person in the HF cohort had almost $3,000 more in overall total income across benefits and wages/salaries in the two years after being housed. Conclusions: Our findings show promising early changes in mental health outcomes and income rates for those housed, demonstrating that the HF approach is likely to have had early positive impacts. In a dynamic policy context, support and coordination of services is still needed at two years post-housed. Funding: This paper was supported by funding from the Aotearoa NZ Ministry of Business, Innovation, and Employment Endeavour Fund. Declaration of Interest: Clare Aspinall has received compensation via a contract with Community Housing Aotearoa to advise on Covid-19 response, and is Vice-Chair of Dwell Housing Trust. Carole McMinn is a paid employee of The People’s Project/The Wise Group; Philippa Howden-Chapman is a Ministerial Appointment to the Board of Kāinga Ora: Homes and Communities; Julie Nelson is on the Governance Board of The People’s Project, and is the joint Chief Executive of The Wise Group; Kerry Hawkes is the paid Manager of The People’s Project. All other authors have no competing interests. Ethical Approval: Ethics approval was granted by the University of Otago Human Research Ethics Committee, reference number 16/049.