# Housing first for middle aged and older women: the emerging case

**Authors:** Joanne Bretherton

PMC · DOI: 10.3389/fgwh.2025.1726756 · 2026-01-13

## TL;DR

This paper argues that the Housing First model needs to be adapted for middle-aged and older women experiencing homelessness due to trauma and complex needs.

## Contribution

The paper introduces a specialized Housing First model for women, emphasizing trauma-informed care and female-led services.

## Key findings

- Original Housing First models were less effective for women due to unaddressed trauma from abuse and violence.
- Housing First for Women with co-productive support and case management shows advantages over existing services.
- An integrated and preventative strategy is needed to address homelessness in middle-aged and older women effectively.

## Abstract

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 (2015–20) and three-year longitudinal study of two further Housing First services for Women in the UK (2021–24), 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
1 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.

## Full-text entities

- **Diseases:** trauma (MESH:D014947), Domestic Abuse (MESH:D019966)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC12835368