Evidence on what works to end homelessness is growing. Evidence also highlights that some forms of help are harmful and should be de-implemented. The ability to abandon low-functioning interventions is considered essential to improve conditions for homeless people. It is common for challenges to be encountered when evidence exists claiming that alternative approaches are more effective and/or cost-effective. This is particularly true in the context of the problematic staircase model and the highly effective Housing First. In this study, the aim was to collect published articles on the process of abandoning established methods with low scientific support. This scoping review explores evidence on de-implementation that may clarify why it can be difficult to introduce interventions like Housing First despite having strong scientific evidence. The call for a shift toward greater provision of Housing First in Sweden underlines the timeliness of this problem. Forty-one articles published between 2014 and 2020 were included. The review found no articles focusing on the de-implementation of homelessness services. Findings from other fields show that the important first step is to identify what needs to be phased out. Together with organized demands from users and favorable financial effects, scientific evidence can constitute driving mechanisms for de-implementation. We found a lack of practical frameworks and theoretical explanations that could support successful phasing out of unnecessary interventions in the homelessness field. It is suggested that to support the implementation of new ways of working that better benefit homeless people, we must pay attention to established ways of working. This requires a developed theory of de-implementation of homelessness interventions and calls for more robust research.

Research shows that resistance to change might occur in organisations that implement new evidence‐based practices (EBP). Formal and informal structures may work to retain traditional interventions, potentially counteracting the implementation process. Little is known about the de‐implementation of traditional practices to leave room for and enhance the implementation of EBPs. This study uses implementation structures as a theoretical framework with the aim of analysing implementation and de‐implementation factors among Swedish municipalities that provide support to vulnerable clients through the Housing First (HF) or Individual Placement and Support (IPS) interventional programmes. This cross‐sectional study is based on a digital survey and collects descriptive and qualitative data from three organisational levels in each responding municipality in Sweden. The descriptive statistics and qualitative texts were analysed using content analysis. The results show the incidence of HF and IPS, if and to what extent the interventions are going to be developed further, and partially, describe the organisational settings of HF and IPS. Organisational factors shown to have a negative impact on the implementation of HF and IPS were identified. The mapping of professional experiences from the intersection between HF or IPS and organisations such as the Swedish Health Insurance Office, the social services, and other similar welfare organisations, indicates that the realisation of HF and IPS requires expanded collaboration, which raises the consideration as to whether it is necessary to de‐implement broader frameworks and guidelines in these organisations to provide the prerequisites that enable the implementation of EBPs.

In recent decades, Sweden has seen extensive change in its housing policy, with emphasis shifting from “good housing for all” to marketisation and the supposed benefits of private ownership (Bengtsson, 2013; Grander, 2018). Consequently, Swedish society is now facing increasing homelessness rates, including whole new groups of social service clients due to housing shortages and people’s difficulties accessing the housing market. This article examines the complexities emerging from diverging institutional frames and points specifically to a dividing line between those who can access housing independently and those who need support from the social services. The article describes how such a categorical division/dividing line is institutionalised in the organisation of the social services’ work with homelessness and points to causes and effects of this situation. The case study is based on interviews and documents. The interviewees are staff from the municipal social services and the municipal public housing company. Our theoretical point of departure is Tilly’s (1999) “categorical inequality,” using exploitation, opportunity hoarding, emulation, and adaptation to explain how homelessness is (created and) maintained in our case study. The results show the dependency of social services on external actors and demonstrate the problematic consequences both for those referred to social services and for the practical work within them, including a requirement to stringently control clients. The results further show how it is possible for the social services to maintain collaboration with (public) housing companies at the same time as the most vulnerable clients are permanently denied housing.

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