Reconciling recovery, personalisation and Housing First: integrating practice and outcome in the field of multiple exclusion homelessness.

'Recovery' is a key concept in the organisation and delivery of interdisciplinary support for people experiencing multiple exclusion homelessness (MEH, that is, situations where homelessness overlaps with a range of other complex problems such as mental health issues and drug and alcohol dependencies). At the level of individual support planning, practitioners are expected to 'work together' to motivate service users to make positive changes to their lives and to secure outcomes (results) such as employment and permanent accommodation. Drawing on the accounts of 34 (n = 34) people with first-hand experience of MEH in England, we outline some of the limitations of 'recovery-orientated practices', namely the exclusion of people with unresolved needs and the implications this may have for continuity of provision. To address this issue, we argue that there is a need for a more personalised and inclusive practice model, which can accommodate 'recovery' (change outcomes) alongside those for maintenance and prevention. In proposing one such model, we show how this might also take forward the principles of 'Housing First' (a US blueprint for tackling entrenched homelessness), which has already begun to challenge the orthodox view that permanent accommodation should be provided only when recovery has been achieved.