{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T12:13:12Z","timestamp":1768306392480,"version":"3.49.0"},"reference-count":73,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Women\u2019s Health"],"abstract":"<jats:p>\n                    This paper explores the use of Housing First services for women experiencing homelessness, focusing on those aged 35 and over, who have multiple and complex needs. The paper draws on an evidence review and the results of a five-year evaluation of a Housing First for Women pilot project (2015\u201320) and three-year longitudinal study of two further Housing First services for Women in the UK (2021\u201324), which centred on the lived experience of women using these services. Four main arguments are advanced. The first is that the original Housing First model from the US and the initial deployments of the Housing First approach in Europe and the UK used a model designed in a context in which the nature and extent of middle aged and older women's homelessness was poorly understood. High fidelity Housing First services were less likely to be fully effective because the original model did not properly account for the level of trauma associated with domestic abuse and violence against women in middle age and later life. The second argument is that there is, on current and emergent evidence, a clear case for developing Housing First that is designed, managed and run by women for women which includes safeguarding as one of its key operating principles. The third argument is that Housing First for Women, with its comprehensive co-productive support and intensive case management, may offer important advantages over Sanctuary Schemes\n                    <jats:xref>\n                      <jats:sup>1<\/jats:sup>\n                    <\/jats:xref>\n                    and other services that are designed to counteract middle aged and older women's homelessness that is associated with abuse, violence and multiple and complex needs. The paper concludes by arguing that in order to fully meet the needs of middle aged and older women experiencing long term and repeated homelessness with multiple and complex needs, an integrated and preventative strategy, including preventative approaches like Domestic Abuse Housing Alliance (DAHA) Accreditation and Housing First for Women must be developed. If Housing First for Women is to be effective, it must be situated within a wider integrated strategy to counteract women's homelessness to reach its full potential.\n                  <\/jats:p>","DOI":"10.3389\/fgwh.2025.1726756","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:32:47Z","timestamp":1768285967000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Housing first for middle aged and older women: the emerging case"],"prefix":"10.3389","volume":"6","author":[{"given":"Joanne","family":"Bretherton","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1177\/0002764294037004004","article-title":"Distorting tendencies in research on the homeless","volume":"37","author":"Snow","year":"1994","journal-title":"Am Behav Sci"},{"key":"B2","volume-title":"Rock Trust Housing First for Youth Pilot: Evaluation Report","author":"Blood","year":"2020"},{"key":"B3","volume-title":"Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction","author":"Tsemberis","year":"2010"},{"key":"B4","volume-title":"Housing First: Ending Homelessness, Transforming Systems and Changing Lives","author":"Padgett","year":"2016"},{"key":"B5","first-page":"17","article-title":"Service models and mental health problems: cost effectiveness and policy relevance","volume-title":"How to House the Homeless","author":"Rosenheck","year":"2010"},{"key":"B6","volume-title":"Effective Services for Substance Misuse and Homelessness in Scotland: Evidence from an International Review","author":"Pleace","year":"2008"},{"key":"B7","volume-title":"Housing First in Europe: An Overview of Implementation, Strategy and Fidelity","author":"Pleace","year":"2019"},{"key":"B8","volume-title":"The Picture of Housing First in England","year":"2020"},{"key":"B9","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1002\/jcop.21554","article-title":"Housing chronically homeless veterans: evaluating the efficacy of a housing first approach to HUD-VASH","volume":"41","author":"Montgomery","year":"2013","journal-title":"J Community Psychol"},{"key":"B10","first-page":"25","article-title":"A tale of two countries: a comparison of multi-site randomised controlled trials of pathways housing first conducted in Canada and France","volume":"15","author":"Aubry","year":"2021","journal-title":"Eur J Homelessness"},{"key":"B11","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.ijlp.2011.07.006","article-title":"The curious case of housing first: the limits of evidence based policy","volume":"32","author":"Stanhope","year":"2011","journal-title":"Int J Law Psychiatry"},{"key":"B12","first-page":"269","article-title":"Neoreaction and housing first. 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