Country Review 187 Homelessness Research and Policy in Switzerland – A First Country Report Embedded in the UN and European Framework Matthias Dri l l ing, Esther Mühlethaler, Gosalya Iyadurai, Jörg Dittmann Institute for Social Planning, Organisational Change and Urban Development ISOS, School of Social Work, University of Applied Sciences Northwestern Switzerland ˆ Abstract_ Even today there is little knowledge about the extent of homeless- ness in Switzerland; there is no legally binding definition of homelessness, and statistics that can be used at national level for profiling this form of poverty are scarce. This paper is based on the “First National Report on Homelessness in Switzerland” (Drilling et al., 2020). The report was motivated by the desire to share currently successful social science based research projects by the authors (especial ly: f irst national count; comparabil i ty study between Switzerland and Croatia; analysis of politics against homelessness in federalist regimes). In this paper we present findings in order to contribute a sound Swiss perspective to the European landscape of homelessness research and to highlight important future challenges. ˆ Keywords_ Switzerland, homelessness, housing exclusion, country report ISSN 2030-2762 / ISSN 2030-3106 online 188 European Journal of Homelessness _ Volume 15, No. 1_ 2021 Introduction For a long time, Switzerland has been a blank spot on the European map of home- lessness research. But this does not mean that there has not been a discussion on the topic in the country. The Federal Bodies have discussed homelessness at national level since World War II, particularly in Parliament and the Federal Council, and since the 1970s various popular initiatives have been submitted to referendum on the subject of housing. In addition, Switzerland has a long tradition in reporting on housing provision to the UN institutions. And for more than 15 years, medical and psychiatric research has been investigating the living situation of people affected by homelessness who use drugs or who are suffering from infectious diseases. For social sciences and the structural causes of homelessness, the situation regarding insufficient research activities changed in 2017. Under the umbrella of the COST Action CA 15218 “Measuring Homelessness in Europe” the authors of this paper started a scientific project to collect data on users of services for people affected by homelessness in the city of Basel (Drilling et al., 2019) and carried out an in-depth exploration of the situation of people migrating under the terms of the Schengen visa into Switzerland, but who were ending up relying on support for the homeless (Temesvary, 2019). Currently, a survey is being prepared throughout Switzerland, the results of which will determine the number of people affected by homelessness in the country in 2021. Housing under Swiss legislation In the Federal Constitution, Switzerland provides for a basic right to assistance in emergencies (Federal Constitution of the Swiss Confederation Art. 12), which guar- antees an unrestricted minimum entitlement to food, clothing, emergency medical assistance and accommodation: “Anyone who finds himself in need and is unable to provide for himself is entitled to assistance and care, and to the means that are indispensable for a dignified existence” (Art. 12 Federal Constitution of the Swiss Confederation 2018). In practice, emergency aid is targeted at people who have no right to remain in Switzerland and who find themselves in an existential emergency. A universal and legal right to accommodation is not provided for in the Swiss Federal Constitution. Although the social objectives of the federal government define housing as a basic need and stipulate that people seeking housing are to be supported, they do not provide for individual entitlement to housing. In the corre- sponding Art. 41 of the Federal Constitution, the initiative of those seeking housing is emphasised. The planned state support for housing seekers is reflected in various housing promotion measures and housing assistance offers. These are based on the constitutionally regulated state promotion of housing construction Country Review 189 and home ownership (Federal Constitution Art. 108), which, among other things, also provides for the promotion of housing for economically and socially disadvan- taged groups. The enactment of regulations against abusive rents is also laid down as a constitutional mandate (Federal Constitution Art. 109). The primary imple- menting law is the Housing Promotion Act of 2003, which aims to promote housing for low-income households and access to property, taking into account in particular the interests of families, single parents, people with disabilities, the elderly in need and people in education and training (WFG Art. 1). According to the Swiss report of Switzerland at the UN Habitat III Conference in 2016 (Confederation Suisse, 2016) the Confederation, cantons and cities have been engaged in an intensive housing policy dialogue since 2013, in which housing market problems are discussed and housing policy measures coordinated at all levels of government in order to provide access to adequate housing for as many sections of the population as possible (Confederation Suisse, 2016, p.11). For some time now, various stakeholders have repeatedly called for greater federal commitment to the promotion of affordable housing and charitable housing construction. Such demands regularly appear in national, cantonal and communal political drafts and demands, and are expressed in position papers and proposals from civil society organisations. Caritas, for example, states in an analysis on ‘Housing and Poverty’ (Caritas, 2014) that precarious situations in the area of housing can also be attributed to the fact that with the introduction of the Housing Promotion Act (WFG) in 2003 there was a shift from subject-based help to object- based help. Whereas in the previously applicable Housing Construction and Property Promotion Act (WEG) the Federal Government supported people with low incomes and few assets with so-called additional reductions in the sense of subject financing, the WFG limits the Federal Government’s support to object assistance in non-profit housing construction (Caritas, 2014, p.6). In Switzerland, the cantons, cities and municipalities are responsible for imple- menting housing policy measures and providing housing for socially disadvantaged households. The Confederation defines the legal framework and provides imple- mentation assistance, such as the above-mentioned document, which is conceived as assistance for cantons, cities and municipalities. Possible financial guarantee models for landlords are analysed in the study ‘Securing and Improving Access to Housing for Socially Disadvantaged Households’ (Althaus et al., 2017), also carried out as part of the National Programme against Poverty (2018). In addition to financial contributions to housing costs as part of social assistance and supplementary benefits for old age and survivors’ insurance (AHV) and disa- bility insurance (IV), cantons, cities and municipalities are familiar with various other forms of housing assistance for socially disadvantaged households (Beck et al., 190 European Journal of Homelessness _ Volume 15, No. 1_ 2021 2013). In addition to such social policy measures, the public promotion of housing construction and home ownership envisages influencing the housing market at the housing policy level. The Department of Housing BWO has also published a document in this respect in which the possibilities for action by cities and munici- palities for the targeted creation of housing for socially disadvantaged households are presented (Beck et al., 2013). In the National Programme against Poverty (2018), much potential was still attributed to such support measures to facilitate access to and maintenance of suitable and affordable housing for low-income households. The report on the results of the national programme and a fact sheet on housing published at the same time call for the expansion of financial and non-monetary assistance, the mixing of residential neighbourhoods and the creation of profes- sional interfaces between tenants and landlords in order to be able to contribute more effectively to mediation, counselling and support in terms of housing integra- tion. Further action is also seen to be needed to strengthen cooperation between social services and the real estate sector so that the range of services can be better adapted to the needs of the letting party and, conversely, to raise the awareness of the real estate sector regarding the need for adequate housing for disadvantaged groups (Federal Council, 2018, p.33). Homelessness appears in the housing policy regulations and recommendations mentioned above as a possible and preventable consequence of inadequate housing provision. Policies and measures that explicitly and primarily relate to dealing with and combating existing homelessness do not exist in Switzerland at the national level. Accordingly, most political debates and demands revolve around housing policy in general, such as demands for more affordable housing, and rarely around the phenomenon of homelessness itself. Approaching Numbers of Homelessness and Profiles through Housing Market Studies Neither the number of homeless people nor the number of people potentially affected by homelessness have been recorded throughout Switzerland to date (OECD, 2020). Estimations are therefore based on the analysis of the housing market. In general, the provision of housing via the Swiss housing market is assessed as sufficient and of high quality (see for example in the report on Switzerland on the occasion of the UN-Habitat III Conference in 2016, Confederation Suisse, 2016). However, although the housing needs of the Swiss population are largely satisfied, there are certain social groups who are disadvantaged in the private housing market – especially in cities and their agglomerations. In particular, Country Review 191 it is difficult for older people, people with disabilities and people living in modest financial circumstances to find accommodation and they are heavily burdened by housing costs (ibid., p.11). In their report on the implementation of Agenda 2030 in Switzerland, the Federal Office for Spatial Development and the Swiss Agency for Development and Cooperation (Confederation Suisse, 2018, p.37) state that in Switzerland almost 84 per cent of households affected by poverty and 57 per cent of households in precarious situations do not have adequate housing. The provision of housing is described similarly in the document ‘Housing Assistance for Socially Disadvantaged Households’ (Beck and Althaus, 2018). In this publication the authors refer to the study ‘Housing Provision in Switzerland: Survey of households of people living in poverty and in precarious circumstances’ (Bochsler et al., 2015) and state that housing costs account for more than 30 per cent of gross income for four out of five households affected by poverty. The Federal Departments of Housing and Social Security recognise not only a lack of affordable housing but also an access problem, as described as follows: “Access is generally difficult for people who have poor references due to debt collection, lack of payment discipline or conflicts in previous tenancies, regardless of the situation of the rental housing market. The same applies to people on welfare and/ or migrants who, because of their name or skin colour, experience implicit or explicit discrimination, even in more relaxed housing markets” (Althaus et al., 2016, p.VII). For a better understanding of the difficult situation of certain population groups in the housing market, it is worth taking a look at individual statistics regarding the Swiss housing market. Compared to other OECD countries, Switzerland has a much smaller proportion of people owning their own home (4.8 versus 48.8 per cent OECD average) and the highest proportion of all OECD countries (55.1 versus 22 per cent OECD average) of tenants paying rents at market prices (see Figure 1). According to Eurostat only 7.2 per cent of the total population benefited from subsi- dised housing in 2017. This situation is reflected in the distribution of owner types in Swiss rental apartments. Less than five per cent of all households are renting at reduced or subsidised prices. 192 European Journal of Homelessness _ Volume 15, No. 1_ 2021 Figure 1: Types of housing – Switzerland in the context of OECD countries. Source: OECD Affordable Housing Database http://www.oecd.org/housing/ data/affordable-housing-database/ (all data 2018) 100 90 80 70 60 50 40 30 20 10 0 ■ Own outright % ■ Own with mortgage % ■ Rent at market price on private rental market % ■ Rent at reduced/subsidised price % Switzerland OECD Australia Austria Belgium Bulgaria Canada Chile Croatia Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Italy Korea Latvia Lithuania Luxembourg Malta Mexico Netherlands Norway Poland Portugal Romania Slovak Republic Slovenia Spain Sweden United Kingdom United States Country Review 193 In addition there is a low average vacancy rate of 1.66 per cent in 2019 (Figure 2). Figure 2: Vacancy rate in Switzerland 2016 – 2019. Source: Federal Statistical Office 2020 Number of vacant… 2016 2017 2018 2019 … 1 bed room apartments 4 051 4 674 4 983 5 323 … 2 bed room apartments 8 303 9 781 11 199 11 961 … 3 bed room apartments 17 570 20 599 23 475 25 005 … 4 bed room apartments 17 173 19 150 21 451 21 935 … 5 bed room apartments 6 100 6 588 7 215 7 246 … 6+ bed room apartments 3 321 3 482 3 971 3 853 Total 56 518 64 272 72 294 75 323 Vacancy rate 1.3 1.45 1.62 1.66 The burden of housing costs varies considerably depending on disposable income. For the reference value ‘Housing costs of more than 40% of disposable income’, the Federal Statistical Office calculates on the basis of EU-SILC 2013 data that around 36 per cent of all low-income households are affected. In contrast, only 1.3 per cent of all high-income households spend more than 40 per cent of their disposable income on housing. Looking at social groups, the unemployed, single parents, indi- viduals and above all individuals aged 65 and over (around 40 per cent) are affected by housing costs that demand more than 40 per cent of their disposable income. The OECD also argues in this direction in its 2019 informal report on affordable housing (Plouin, 2019). Here Switzerland is assessed jointly with other OECD countries and it is established that its housing prices are those which have risen the most between 1996 and 2018 (compared with prices for education or health), and that they also place the greatest burden on low-income households out of all OECD countries. At the same time, the report points to a new group who is increas- ingly excluded from the housing market: young people (individuals and families) who are looking for a place to live. Here the costs and significance of these costs are particularly problematic in view of disposable income. Towards a Right to Housing? Swiss Restraint Reports on International Conventions Homelessness as an extreme form of poverty and social exclusion is interpreted as part of a broader legal framework of social welfare, poverty reduction and the right to adequate housing (European Commission, 2013). At various levels of political administration, having no shelter or no housing is defined as a situation to be prevented, and an attempt is made to combat it through international conven- 194 European Journal of Homelessness _ Volume 15, No. 1_ 2021 tions or national laws. The right to adequate housing is partially protected under constitutional law at the state level and is used in diverse jurisdictions, e.g. in connection with evictions, tenant internal protection or discrimination in housing. A right to housing derived from this, however, often exists only at the level of society as a whole and not at the level of the individual and varies greatly in its enforceability and implementation depending on the political context. International conventions and legislation which are influencing Switzerland are: • Universal Declaration of Human Rights (1948): ratified by Switzerland • International Covenant on Economic, Social and Cultural Rights (UN Covenant I) 1968: ratified by Switzerland. • EU Social Charter of 1961/1999: not ratified by Switzerland • EU Social Investment Package: policy paper • European Pillar of Social Rights: policy paper • Agenda 2030: policy paper The International Declaration of Human Rights of 1948 (Art. 25) and the International Covenant on Economic, Social and Cultural Rights (ICESCR) of 1966 (Art. 11) recognise adequate housing as part of the right to an adequate standard of living. Other international human rights treaties (such as Antiracism Convention Art. 5, the Women’s Rights Convention Art. 14, the Children’s Rights Convention Art. 27, the Migrant Workers Convention Art. 43 or the Disability Rights Convention Art. 28) address the right to adequate housing or aspects thereof, such as the protection of one’s own home and privacy or protection against discrimination in access to housing. In addition, a right to housing is also described at the European level within the framework of the ‘EU Social Charter’ (Art. 31, EU Social Charter 1999) and the ‘European Pillar of Social Rights’ (Principle 19). The international right to decent housing was given additional international attention in 2000 with the creation of the mandate of Special Rapporteur on decent housing. With this mandate, the scope and content of the law could be clarified in greater detail and implementation requirements for signatory states could be specified, as UN Habitat states in a factsheet ‘The Right to Adequate Housing’ (UN Habitat, 2009, p.1). The right to adequate housing is also enshrined in the ‘Agenda 2030 for Sustainable Development’. Objective 11.1 on inclusive development of cities and settlements provides for “access to adequate, safe and affordable housing and basic services for all by 2030”. In a 2018 report, the Special Rapporteur on the Right to Adequate Housing called for an approach to nationally and locally adaptable, human rights-based housing strategies (UN Human Rights Council, 2018). This report distinguishes housing strategies from housing policy and understands strat- Country Review 195 egies not only as the provision of housing but also as action plans aimed at addressing gaps and inequalities in existing systems and at reviewing and modifying existing housing policies and programmes in order to challenge possible stigmati- sation, marginalisation and discrimination behind housing system failures (ibid., p.3). As a basis for such housing strategies, the recognition of the direct connection between inadequate housing and human rights violations is needed (ibid., p.4). A human rights-based housing strategy does not understand homeless people or people living in inadequate housing as recipients, beneficiaries or ‘objects’, as many housing programmes and policies do, but rather as rights holders and active people who are empowered to participate in decisions concerning their lives and the protection of their rights. Housing strategies should thus respond to the lived experience and promote the participation of the people concerned (ibid., p.4). Furthermore, various resolutions, strategies and measures at the operational level of the European Union can be identified for granting the right to housing and combating homelessness. These are based on the recognition of homelessness as one of the most extreme forms of poverty and deprivation under the ‘European Platform Against Poverty and Social Exclusion’ as part of the European Strategy 2020. In 2013, the European Commission published a working paper ‘Confronting Homelessness in the European Union’ as part of the Social Investment Package, in which it addressed the urgency of the homelessness problem and proposed specific policies and guidelines for the prevention and reduction of homelessness to the member states (European Commission, 2013). In the European Parliament, too, the increasing homelessness in most European countries has been the subject of repeated debate over the past decade. The ‘European Federation of National Organisations Working with the Homeless’, FEANTSA, has produced an overview entitled ‘The 2014-2019 European Parliament’s Record on Homelessness’, praising the broad, cross-party commitment to combating homelessness and social exclusion in the context of precarious housing (FEANTSA, 2018). In addition, resolu- tions have repeatedly been signed calling for an ‘EU strategy to combat homeless- ness’. It calls on the European Community and individual Member States to make significant progress towards ending homelessness and social inclusion through regional and national strategies (European Parliament, 2011). Switzerland is committed to respecting universal human rights and economic, social and cultural rights, as described in the ICESCR. It acceded to the ICESCR in 1992, but has not yet ratified the protocol. The EU Social Charter has not been ratified by Switzerland either, although this has been demanded by various actors for several years and the legal conditions for ratification have been fulfilled. At the same time, Switzerland participates neither in the form of statements nor through active contributions in the initiatives and resolutions of the European Union on ending homelessness mentioned above. 196 European Journal of Homelessness _ Volume 15, No. 1_ 2021 By signing the ICESCR, Switzerland has accepted the obligation to report regularly on the implementation of the agreement and thus also to demonstrate its consid- eration of the right to housing. After a delay, Switzerland submitted the first report to the UN Committee in 1998 and the combined second and third reports in 2008. The fourth report was published in February 2018 and discussed in the UN Committee in October 2019. The UN Committee addressed its recommendations to Switzerland in November 2019. The first Swiss report of 1998 discusses in detail the right to accommodation. In addition to the current housing situation in Switzerland – including that of disadvantaged groups – this report also provides a detailed explanation of Swiss legislation on housing. With regard to homelessness, it is noted that there is no official statistical data, either at national or cantonal level, that would allow an assessment of the situation of homeless people. Only a survey conducted as part of a report from Switzerland to the World Health Organisation (WHO) provided estimates of the number of homeless people in the five largest Swiss cities. These numbers of homeless people, which vary relatively strongly from about 40 people (Lausanne) to a total of about 500 people (Basel), are not further explained in the report. Thus, it remains unclear which definition of homelessness forms the basis of the estimate. Reports two and three, which were submitted to the UN Committee in 2008, also contain a chapter on the ‘Right to Housing’, which deals with housing conditions in Switzerland and corresponding federal measures. The housing situation of disad- vantaged groups is dealt with only marginally and with reference to Roma people and people with disabilities. In the fourth report of 2018, the term ‘right to accom- modation’ is no longer used. The ‘Housing’ chapter focuses on the federal govern- ment’s housing policy with a focus on the ‘Federal Act on the Promotion of Low-cost Housing’ and the ‘Housing Construction and Property Promotion Act’. In addition, a short section on national studies on homelessness appears in the same chapter. As in the first Swiss report in 1998, however, this reference to homelessness is also very brief. Reference is made without comment to a study on housing provision in Switzerland (Bochsler et al., 2015) and to the data on the burden of housing costs from the survey on income and living conditions (SILC) conducted by the Federal Statistical Office (BFS) in 2013. Switzerland’s reporting on the implementation of the ICESCR repeatedly triggered fundamental criticism, not only from the UN Committee, but also from actors within Swiss civil society. In its recommendations to Switzerland in 2010, the UN Committee has expressed fundamental criticism of the binding nature of Switzerland’s economic, cultural and social rights. The Committee regretted that most of the provisions of the ICESCR in Switzerland are only programmatic and social objectives, not binding provisions. This means that some provisions cannot Country Review 197 be given effect and cannot be appealed to national courts (Economic and Social Council, 2010, p.2). Although the UN Committee does not specifically address the right to housing in this context, its criticism should also refer to this. The first report from Switzerland to the UN on the implementation of the ICESCR acknowledges that the Swiss Federal Constitution does not guarantee any right to housing as such and that a corresponding referendum (popular initiative ‘Right to housing and extension of family protection’) was rejected in 1970. The right to accommodation is only recognised under constitutional law in individual cantons. It is precisely this lack of a national, binding right to housing that forms part of the comprehensive criticism by Swiss non-governmental organisations (NGOs) of Switzerland’s first report on the implementation of the ICESCR (Kadima et al., 1998). In their commen- tary published in 1998, they noted the following shortcomings: “Although tenants are legally protected against eviction and excessive prices, there is no right to housing, i.e. a legal claim including the right of co-determination. Despite protection against eviction, it is now possible, for example, to evict an older, long-term tenant without offering an appropriate replacement and regardless of the psychosocial consequences. Renovations can be carried out at very short notice without the tenants having a say” (Kadima et al., 1998, p.30). The civil society actors demand a constitutional anchoring of the right to housing that goes further than Article 41 of the Federal Constitution, which only provides for the obligation of the state to ensure that housing seekers can find adequate housing through private initiative and personal responsibility (ibid., p.31). In November 2019, the Economic and Social Council of the UN responded to the fourth report on the implementation and status of the ICESCR of Switzerland. The topics of housing, shelter or precarious living are no longer included within it. A second debate is taking place in Switzerland regarding the non-ratification of the EU Social Charter by Switzerland. Although Switzerland signed the Social Charter in 1976, both attempts (1987 and 2004) to ratify it have so far failed. Switzerland is thus one of the few member states of the Council of Europe that have not ratified the Social Charter. Starting in 2007, a third attempt at ratification took place over more than ten years with the ‘Pro Social Charter’ campaign of the professional association Avenir Social. The first interim result presented by the Federal Council in 2014 was a report confirming that the legal situation in Switzerland meets the requirements for ratification (Federal Council, 2014). Since there has been no prospect of ratification due to the current political majorities, the campaign was discontinued in autumn 2018. Switzerland has not positioned itself in relation to the ‘European Pillar of Social Rights’, in relation to housing-specific demands in the European Strategy 2020 or in relation to resolutions on combating homelessness. Individual references can only be found in statements by actors such as political parties or trade unions. 198 European Journal of Homelessness _ Volume 15, No. 1_ 2021 Social democrats, for example, are in favour of agreements between Switzerland and the EU based on the ‘European Pillar of Social Rights’. The Swiss Confederation of Trade Unions is also committed to improving living and working conditions by ensuring that new EU social achievements, such as the ‘Pillar of Social Rights’, are adopted in Switzerland. However, specific references to housing or homelessness are not included in such statements. Oscillating Between Housing Market Failures and the Individual Fate of People Affected by Homelessness – A Chronology of Parliamentary Debates Towards the end of World War II the prevention of homelessness became an undis- puted urgency, as it made clear at its session of 29.03.1945: “The Federal Council has repeatedly taken the view that for reasons of state and social policy, the fight against homelessness must take precedence over all other considerations.”1 To underpin this urgency, various debates and decisions were taken in the post-war years to alleviate the housing shortage. Then the decision-making behaviour changed; in the following years there are several votes which have negative effects on the protection of tenants or special target groups: On 29.1.1950, the extension of the measures introduced in 1947 to promote housing construction was rejected by a referendum. And in the Federal Council meeting of 07.12.1951 it was decided not to continue the measures for the protection of tenants, as they were defined in 1941, 1944 and 1948 (in particular the extensions to relocation dates), beyond 31 December 1952. Homelessness is explicitly mentioned here: “The so-called housing shortage is today less a question of housing shortages and the danger of homelessness associated with them than a question of rental prices. However, the latter cannot be regulated by restrictions on termination and extensions given to relocation dates.” Also the right of official use of unused dwellings and the restric- tion of the dwelling was abolished. In 1955, the Federal Decree of 22.12.1954 on the popular initiative “for the protection of tenants and consumers (continuation of price control)” was narrowly accepted by the population, but rejected by the Council of States. This concludes a phase of closer political framing of housing supply and numerous target group-specific protection goals. Even some 15 years later, protection goals cannot be enforced at national level. The ‘Referendum for the Right to Housing and the Extension of Family Protection’ (1970) was rejected. The popular initiative called for a right to housing to be enshrined in 1 Note: All quotes are excerpts from the original documents. The sources can be found in Drilling et al. (2020). Country Review 199 the Constitution: “The Confederation recognises the right to housing and takes the necessary measures to safeguard it so that families and individuals can obtain housing that meets their needs and whose rent or costs do not exceed their financial capacity”. And where there is nevertheless a shortage of housing, “the Confederation, in agreement with the canton concerned, shall take the necessary temporary measures to protect families and individuals against unjustified termina- tion of tenancy agreements, against speculative rents and against all other abuses.” Although the volume of construction increased in the 1970s, the situation in resi- dential construction remained tense. The tensions between a capitalist-oriented housing industry, the liberal state organs and numerous critical Marxist university institutes made the question of interventionist measures by the state an object of debate. As a result, the wholesale company Denner supported a referendum to set up a housing fund (Denner Initiative). The plan was to initiate a housing fund “from which mortgage loans with low, socially graded interest rates for the construction of apartments and old people’s homes as well as contributions to the development of building land were to be paid”. But even this petition for a referendum was rejected in favour of a counter-proposal, which only spoke of “granting the federal government general competence to promote housing construction and the acquisi- tion of residential property and house ownership”. However, the intention to keep the development of rents in the focus of social policy led to another popular initiative in 1977. Here, too, the focus is on the protection of tenants, with a controlled increase in rents and making terminations of tenancy agreements more complex. But this popular initiative ‘for an effective tenant protection’ was also rejected, just like the counter-proposal (of 25.03.1977) on 25.09.1977. A National Council meeting took place between the two referendums, during which homelessness was addressed directly. As agenda item ‘Narcotics. Change’ on 02.10.1974, member of Parliament Bratschi introduced the situation of an emergency shelter and opened the debate on the link between drug consumption and home- lessness that continued in Switzerland until the 1990s: “An emergency shelter, called ‘Sleep-in’, also accommodates 30 young people night after night. For them, the ‘sleep-in’ should not be the final destination; it is, however, because there are no corresponding cantonal institutions that could take over this care task. We can only be dismayed and simply state: the drug wave has overrun us.” Since the 1980s, parliamentary tasks, debates and popular initiatives have alter- nated on a regular basis in the areas of low-cost housing, protection of tenants, homelessness on the one hand, and drug consumption problems, homelessness and support on the other. The success of initiatives in the area of rent protection remain low. On 21.03.1986 the popular initiative ‘For an effective tenant protection’ was rejected, in 1999 the federal initiative ‘Home ownership for all’, in 2003 the popular initiative ‘Yes to fair rents’ and on 23.12.2012 the popular initiative ‘Secure 200 European Journal of Homelessness _ Volume 15, No. 1_ 2021 living in old age’ failed. Another popular initiative is planned for the coming years: ‘More affordable housing’ demands in the medium term that the Confederation, “in cooperation with the cantons, together strive for a steady increase in the share of housing owned by non-profit housing developers in the total housing stock. In cooperation with the cantons, it ensures that at least 10 percent of newly built dwellings throughout Switzerland are owned by these institutions.” The issue of homelessness in these years is primarily tackled as a matter of indi- vidual pathology rather than a structural issue, as in previous years. This is the understanding of the cost estimate in the National Council meeting of 18 June 1992 in which parliamentarian Leemann reads the 3.1 million Swiss francs demanded for preventive measures in the field of drugs, an argument of conformity with home- lessness support and with simultaneous distribution of tasks between the Confederation and the cantons, in which he demands: “The Confederation should make the social services possible; the operation of the contact points, day rooms or emergency sleeping places, etc. should, on the other hand, remain with the cantons and communes in accordance with the statutory mandate.” Parliamentarian Plattner’s idea about the help for the homeless in the field of drug prevention is similarly located when, on 03.10.1994, he addressed the urgent interpellation of member of parliamentarian Weber on the drug problem: “In Basel we now have three drug consuming rooms, one of which – I don’t know if this is already the case today – will even be paid for by a neighbouring canton, although it is in our city. We have several emergency sleeping places. We have a street kitchen. We have day rooms and shelters.” On the occasion of the popular initiatives ‘Youth Without Drugs’ and ‘For a Sensible Drug Policy’ (Droleg-Initiative), parliamentarian Gysin links the topic of homelessness even more clearly with drug policy in the National Council on 21 March 1996: “We have a viable, integrated four-pillar model, as it is on the table at the Federal Government. We’ve been living this in Basel for six to seven years. We have well-developed, functioning survival support with three drug consuming rooms, emergency sleeping places, soup kitchens, day structures and other institutions….”. And in the late summer of the same year, Plattner renewed his idea in the Upper Chamber (17.09.1996) on the occasion of a debate on the two popular initiatives, that drug prevention was above all also effective in the offers of help to the homeless: “This policy, the four-pillar policy, is also based on a pillar that is repressive. Repression is important, but it never has the weight that it has in the minds of some representatives of the hard line. We do not primarily send police and investigators onto the streets to clear up the problem, but we concentrate our efforts and resources – including financial ones – on drug consuming rooms, on setting up emergency sleeping places, on street kitchens, on day centres, on shelters for young drug-dependent prostitutes, on advice centres on withdrawal possibilities, on outpatient and inpatient drug withdrawal centres and much more Country Review 201 besides.” In this context two documents are relevant which refer to the accom- modation of homeless people with an addiction illness (Motion Bischof of 03.06.1992 and Motion Dormann of 6.12.1993). Only two documents show that in the time of the narrow definition that homeless- ness is mainly related to drug consumption, the National Council argued for a further thrust on the topic of homelessness: the motion Leutenegger Oberholzer for the ‘Federal Housing Decree’ of March 21, 1991 and the motion De Dardel of March 9, 1993. Leutenegger Oberholzer pleads for “fifteen percent of this to be used specifically for the housing supply for socially disadvantaged population groups and their specific housing needs”. According to the applicant, the “housing problem has worsened for everyone. For the fringe groups of society, however, the situation has become dramatic in recent times. This is shown by the many homeless people in the cities. The Housing and Property Promotion Act promotes traditional forms of housing. It is a support programme aimed at people with medium to low incomes. It is clear that the socially most disadvantaged groups cannot benefit from this. These are the groups that do not appear at all on the traditional housing market. I am thinking of the homeless, whose numbers are also rising sharply in Switzerland. There are already many people in large cities today who do not have apartments and that are dependent on emergency shelters. Emergency accom- modation may include, for example, emergency sleeping shelters, containers, etc.” Leutenegger Oberholzer refers to the report ‘Disadvantaged Groups in the Housing Market’ by the Housing Research Commission of 1990: “I therefore request that part of the framework credits that we are approving today be used specifically to finance such alternative forms of housing for the socially most disadvantaged population groups in Switzerland. (…) Some of the low-interest loans to umbrella organisations of non-profit housing construction for the accumulation of Fonds de Roulement (an instrument for low-interest loans) are to be used specifically for the creation of housing for socially disadvantaged groups. This would then also allow the federal government to co-finance, for example, containers, emergency sleeping facilities and the like.” The applicant withdrew the application after a debate, but was able to add the issue of homelessness back to the housing supply for public discussion. The motion de Dardel, which was submitted to the National Council on 09.12.1993, was also not processed any further because it was rejected after two years. Under the title ‘People without Permanent Residence and the Right to Housing’, de Dardel asked the Federal Council to include the right to housing as a political objective and to enshrine it in the Federal Constitution. This was especially important for people who live in very precarious housing conditions and for those who no longer have their own living space. 202 European Journal of Homelessness _ Volume 15, No. 1_ 2021 It would be a further 10 years before the issue of homelessness would be more widely discussed in the National Council again. On 23.09.2014 parliamentarian Marra submits an interpellation on ‘Emergency Shelters for the Homeless in Switzerland’. With its questions to the Federal Council, it catapults the issue of homelessness back to the institutional level, in particular the division of tasks between the Confederation and the cantons; it sees the people concerned as being torn between the levels. She thus addresses the following issue: “There are, however, great differences between the cities in terms of policy in this area. Some do not shy away from ‘sending’ their homeless to other cantons where emergency shelter places might be offered. In most cases, this depends on the social policy of the city or canton. Article 12 of the Federal Constitution, however, states: ‘Anyone who finds himself in need and is unable to take care of himself is entitled to assis- tance and care and to the means which are indispensable for a decent existence.’ Marra asks whether it is ‘normal’ for ‘certain cities to fulfil their duty by taking on this task as their responsibility, while others simply sit back and rely on the existing offer?’” In its reply, the Federal Council rejects any responsibility. It plays down the problem by writing that “the homeless are part of the reality of Swiss cities” and admits that it has “no overall view of the situation in the cities” and “therefore cannot comment on the practice of referring to other cities”. The Federal Council also does not consider the lack of national data to be a reason for a survey and hopes that the “Conference of Cantonal Social Directors (SODK) will deal with the subject”. On 12.12.2014 the motion was archived as completed. Two years later Marra passes a postulate to the same topic under ‘emergency sleeping places’. She wanted to know from the Federal Council how the SODK or other bodies of federal social policy had dealt with this issue. In its reply, the Federal Council makes it clear and replies that no need for action has been identified in the context of the National Dialogue on Swiss Social Policy. In the following years, there are two more interpellations: On 15.12.2016 parliamen- tarian Addor asks if “asylum seekers are preferred to our homeless.” The Federal Council replies that due to the lack of figures on homelessness, it is not possible to answer this question. And the interpellation of parliamentarian Schneeberger of 31.05.2018 under the title “The commander of the border guard needs clear political instructions. Uncertainty and dissatisfaction among the population are growing” points out that, on the one hand, the border guard is increasingly taking on police tasks such as “routine checks of the homeless”, but on the other hand the direction of the interpellation is focusing on measures to clarify the tasks of the border guard. Country Review 203 Homelessness as a Result of Abuse and Individual Decent Processes – A State of the Art in Swiss Research Health issues shape research on homelessness in Switzerland. The reason for this bias is not clear. At best, Switzerland reveals what Benjaminsen and Bastholm Andrade (2015) have shown for welfare states: “that countries with more extensive welfare systems and lower levels of poverty have lower levels of homelessness, mainly amongst those with complex support needs.” (ibid., p.858). The Swiss studies illustrate the serious consequences of living as a homeless person. According to the publications many homeless people are dependent on alcohol, drugs are frequently consumed and a very high proportion of homeless people are in poor psychological and medical (especially infectious) health, with all of this also being of social origin (poor hygienic conditions, poverty). Homelessness is thus an expression of high levels of health and mental vulnerability combined with social exclusion (Grazioli et al., 2015). The studies that focus on Switzerland and are listed in international databases can be sorted according to the three topics ‘schizophrenia, psychoses and trauma’, ‘alcohol and substance abuse’ and ‘tuber- culosis and other infectious diseases’. Mental health studies In 2005, the first Swiss-related articles in international journals began to address the interface between homelessness and psychiatry. This was prompted by a series of investigations into psychiatric hospitals and programmes. Lauber et al. (2005) develop a profile of homeless people on the basis of a dossier analysis of around 16 000 patients (16 per cent of all patients were homeless in the dataset) and conclude: “The homeless as compared to other psychiatric inpatients had higher rates of substance use disorders, equal rates of psychotic and personality disorders, but lower rates of organic and affective disorders. Homeless people were more often admitted compulsorily or as an emergency. General practitioners (GPs) were less involved in the admission. The homeless had a shorter inpatient stay and their health status did not equally improve as it did in other patients. Risk factors of being homeless at psychiatric admission were: young age, male gender, single, low education level, urban residence, abuse of illicit drugs, especially multiple substance use, and having a dual diagnosis.” (ibid., p.50). One year later, the team of authors presents another study (Lauber et al., 2006). This time they analysed around 28 000 patient dossiers from psychiatric clinics in Switzerland, among which they identified around 1 per cent of the patients were homeless people. This study focuses more on the housing situation when entering the clinics, and the following risk factors for homelessness were identified as a result: “being homeless at admission, not living in a relationship, presenting multiple 204 European Journal of Homelessness _ Volume 15, No. 1_ 2021 substance abuse or a dual diagnosis, low clinical improvement during inpatient treatment and discharge against medical advice”. (ibid., p.138). Finally, a third study by the team (Lay et al., 2006) gives a view of the length of stay in psychiatric hospitals as a function of homelessness. The researchers separated a cohort of 424 patients from a group of around 2 500 hospital admissions and interviewed them regularly over a period of 5 years. Patients with a diagnosed psychosis spent the longest time in the clinics, at the same time they belonged to the group that was least often an inpatient in the clinics (in contrast to the diagnoses ‘schizophrenia’ and ‘other psychiatric abnormalities’). In this study, homelessness was significantly associated with a longer stay in hospital over the observation period. A higher probability of having a diagnosis of ‘psychosis’ or ‘schizophrenia’ as a homeless person than for people in other housing situations in the study group could not be established. In conclusion, the authors point to social policy to cover the need of homeless people for sheltered and accompanied accommodation and safe housing: “This fits recent findings indicating that the homeless use more in-patient and emergency type services and fewer outpatient-type services which can be regarded to a certain extent as an expression of the homeless seeking shelter, but furthermore as an expression of the inability of the social system to find appropriate accommodation for them. “(ibid., p.407). Jaeger et al. (2015) change the perspective in their study; psychiatric clinics are no longer the focus of attention, but rather institutions offering supported housing in the city of Zurich that are provided for the homeless. They ask how the situation of people diagnosed with schizophrenia has changed as a result of the restructuring of Swiss health care (‘outpatient before inpatient’ and thus processes of deinstitu- tionalisation). The authors conclude: “Individuals with schizophrenia in sheltered housing (25% of the residents) have significantly more problems concerning substance use, physical illness, psychopathological symptoms other than psychosis and depression, and relationships, daily activities and occupation than patients with schizophrenia at intake on an acute psychiatric ward.” They interpret this as a contradiction, because supported housing is basically designed to prevent homelessness, but de facto “serves as housing facilities for individuals with schizo- phrenia and other severe mental illness. Only 25% had seen a psychiatrist within the last 6 months although 51% stated that they had a permanent mental health problem.” (ibid., p.416) The study was part of a larger study on the prevalence of people with mental health issues in adult housing in the city of Zurich (“WOPP study”) from 2013 (Baumgartner-Nietlisbach and Briner, 2014). The reason for this study was the observation by psychiatrists that there was an increase in “severely mentally ill and inadequately treated people” (ibid., p.4). Since in Switzerland there was a lack of data on the mental health status of people without their own housing, the scholars interviewed 338 people (out of a total of 460 people in the residential Country Review 205 facilities) from four supported living facilities and the emergency sleeping facilities of the city of Zurich. The study is the only analysis to date of the objective and subjective mental health status of adults (categories covered by ICD-10, HoNOS-D, GAF ranges) affected by rooflessness and houselessness in Switzerland. The central results are therefore (ibid., p.5): • “96% of all interviewees fulfilled the criteria for at least one psychiatric diagnosis. If addictions are not counted, 61% of those surveyed were still affected by at least one psychiatric disease. • Subjectively, 70% of the participants had a permanent health problem, with 40% of all respondents feeling good or very good and 20% feeling bad or very bad. • According to the body mass index, 30% of the participants were overweight, 20% obese and around 7% underweight. • 90% of all interviewees had consulted a medical professional in the last six months, 50% had consulted a family doctor and 20% a psychiatrist. • 73% of all interviewees regularly took psychotropic drugs at the time of the study.” Although it should be noted that 259 of the 338 interviewees were from a supervised institution for socially disintegrated, mentally and physically impaired people suffering addiction, and that addiction was therefore highly likely to play a role in the objective state of health, the authors conclude for the practice that the state of health is very important for new clients in the institutions and should be regularly addressed in interdisciplinary cooperation. Morandi et al. (2017) make it clear that this cooperative approach should be put together in a permanent team and that this team should visit the people in the (supervised or supported) accommodation or even carry out patrols in public space. Their study, in which 30 people partici- pated, showed that a combination of outreach medical, psychiatric, social work (as part of the assertive community treatment) and inpatient intervention periods is particularly effective in preventing emergency situations among homeless people. In another contribution to the practice, the authors propose multidisciplinary “Intensive Case Management” teams, a “Clinical Case Management” (Silini et al., 2016) for the inpatient sector and a prioritisation of housing, especially in the form of ‘Housing First’ (Garcia Gonzales de Ara et al., 2017, see also Schmid and Bonsack, 2018). Stalder’s approach, which set up mobile outreach teams for community medicine in Geneva’s university hospitals, also fits in with this under- standing (Stalder, 2003). Stutz et al. (2017) argue in favour of a model of ‘night clinics’ such as that of the city of Zurich and come to the conclusion that this form of clinic offers an alternative for inpatient stays because it fulfils a “rehabilitative task for homeless people with primarily psychotic illnesses” and thus “contributes to the avoidance or shortening of fully inpatient hospital stays” (ibid., p.187). Di Bella 206 European Journal of Homelessness _ Volume 15, No. 1_ 2021 et al. (2017) take a more fundamental approach with regard to Switzerland’s health policy. They evaluate initiatives between 2014 and 2016 to introduce dental treatment into compulsory health insurance in Switzerland and locate a gap in the provision of dental care. For adults, dental treatment is only covered by the basic insurance in the case of accidents and serious dental diseases. Routine dental treatment must be financed by the patient. People who do not have enough money to pay for dental treatment often suffer from toothache. This affects children, the elderly, people on low incomes and homeless people (ibid., p.576). Studies on alcohol and substance abuse Grazioli et al. (2017) investigated the consumption habits of 85 homeless people in French-speaking Switzerland who regularly visit a contact point to consume their drugs and alcoholic beverages. The authors noted that the mere presence in the institutions contributed to a 7 per cent decrease in consumption. They conclude that shelters for the homeless are an effective intervention measure. Klingemann and Klingemann (2017) also conclude that programmes for homeless alcoholics in Switzerland have led to a reduction in dependence. They interviewed key people from eight providers of the ‘Drinking Under Control/DUCPs’ programme in Switzerland. However, they also drew attention to a contradiction, since the successes of the programmes are countered by the reluctance of the municipalities to offer such programmes because they fear that they will have a pulling effect on alcohol-dependent homeless people. Stohler and Gehrig (2015), on the other hand, focus on young adults in a hostel. The home offers accommodation for 28 women and men aged between 18 and 24 who cannot live with their families or indepen- dently. They have hardly any daily structures, often have debts, are mentally unstable and consume marihuana or alcohol. The caregiver in the home primarily advises the person concerned, while the social worker in charge receives more responsibility for decisions and sanctions (ibid., p.485). Over twelve months, long-term solutions are sought for the young adults, their social and personal skills strengthened and an attempt is made to stabilise their current situation. The authors conclude that the offer is suitable for people who already have a daily structure and are willing to change their situation. For young adults who do not wish to change their situation, do not cooperate, have psychological diagnoses or suffer from substance abuse problems, the length of time is insufficient. Longer-term solutions are needed that go far beyond the twelve months (ibid., p.486). Kübler and Wälti (2001) discuss these issues on the national level and highlight the attractiveness of Western European cities in the context of drug policy. They explain the effects of measures against drug-related problems in Switzerland, which led to the establishment of facilities for drug addicts at the end of the 1980s. They also compare the successes in reducing drug and alcohol consumption with the stig- Country Review 207 matising effects of the environment: complaints from the neighbourhood, the need to protect the living environment of contact points, etc. Swiss cities, they conclude, are still confronted today with the need for protection of the inhabitants, the needs of the consumers and the need of the city to reduce damage. Studies on infectious diseases The Swiss studies published in international journals show the social causes of infectious diseases such as diphtheria and tuberculosis in homeless people. Gruner et al. (1994) point out that in Zurich homeless people who also consume drugs are infected with diphtheria mainly because of their low socio-economic status. The long-term study on tuberculosis in the canton of Bern, which analysed data from individuals over 21 years, identified two thirds of those affected as homeless (Stucki et al., 2015). Janssens et al. (2017) interviewed those staying at the Geneva Municipal Emergency Service in 2015 and referred them to the Municipal Hospital in case of suspicion of tuberculosis. A total of 726 of the 832 homeless people surveyed completed the questionnaire with a positive analysis and took advantage of the hospital examination. The shorter the phase of homelessness, the greater the willingness to undergo an inpatient examination. Arguments for Change In Europe, Switzerland is widely perceived as a country in which homelessness is not relevant in economic, political and social policy fields. In the light of the facts and processes presented here, this does not correspond to reality. The state of research on homelessness and the absence of policies regarding homelessness is largely a problem of the lack of a comprehensive overview. At this point it becomes relevant to ask why this needs to change. From the documents presented so far, three lines of argument can be elaborated: 1. In accordance with its federal structure, the political constitution of Switzerland delegates the responsibility for combating homelessness to the cantons. Although the Federal Constitution recognises a right to housing, this is not legally binding. For their part, the cantons do not incorporate this right into the cantonal constitutions, but instead hand over responsibility to the municipalities. The municipalities, in turn, address homelessness through their social assis- tance practice, which is also dealt with at municipal level by the social services. This results in completely different assessments of the problem, with serious consequences for the people affected. In Switzerland, social assistance is targeted to individuals and people, and people are paid a fixed amount for housing, regardless of whether or not they can rent a place to live for this amount. Other communities also question the eligibility of the people concerned for 208 European Journal of Homelessness _ Volume 15, No. 1_ 2021 housing assistance. In particular, if the applicants for support have moved there from another municipality, they are advised that they ought to return to their place of origin. And communities on the outskirts of larger cities also do not hesitate to suggest that they might relocate to the cities, because the infrastruc- ture there is better for people affected by homelessness. These attitudes are reinforced by the discussions that take place in the national parliament, where debates are regularly avoided or where the Swiss Confederation defines itself as not having competence due to federalism. As a consequence of the state’s withdrawal from this task, civil society organisations fill this vacuum, but with all the weaknesses that this entails: discontinuity due to relying on the work of volunteers, lack of conceptual consistency, no professional development of services and dependence on donations or subsidies. 2. The social costs of homelessness are shouldered by the cities in Switzerland and by the NGOs working with the people affected. In Geneva, Zurich and Basel, but also Lausanne and Bern, the NGOs that take on responsibility for supporting the people affected by homelessness have reached the limits of their capacity. The widespread lack of professional standards in working with homeless people hinders the development of a common view of the problem. While some NGOs explicitly address all people affected by homelessness, others define their services as being for citizens of the canton. In addition, local policy institutions define themselves as working in the social work sector, but also take on disci- plinary tasks in their contact with the people affected by homelessness. This fragmentation of the social work profession has the effect of de-politicising the issue. Individual organisations that, for example, want to place the blame on the housing market for the situation cannot find allies. Other organisations that want to criticise the way social assistance is handled meet with resistance from their own ranks because they fear that subsidies will be cut. There is hardly any support from the scientific community, as there are not enough studies that critically examine these issues. Instead, biographical studies are used to indi- vidualise the problems; the focus on the problems in the housing market is then replaced by the demand that the homeless must have sufficient skills in housing; instead of defining uniform conditions of access to municipal services, a policy of admission requirements and a pricing policy for the provision of services is promoted. And instead of fundamentally problematising the existence of home- lessness in a rich society, health care costs (e.g. for stays in psychiatric institu- tions) are being transferred to the municipal social services without providing adequate financing models. 3. It is becoming increasingly clear that housing is being given a new meaning at international level. From a purely functional view, housing is becoming seen as a human right. Such a demand needs to be discussed at national level, and Country Review 209 legally binding guidelines need to be formulated, which will then have an impact right down to the level of the local municipality. The demand of the UN Human Rights Council to take a closer look at this perspective is above all a challenge to the social sciences in Switzerland. After all, in the context of applied research, it is precisely such focuses that are of societal relevance. Through broader research, the scientific community could also be given the task of supporting politicians, who tend to consider reporting to international bodies more as an obligatory exercise rather than an opportunity for reflection, while at the same time increasing the pressure to act. Such emphasis on the social sciences would in turn promote a more supportive climate for studies focusing on the extent of homelessness and housing exclusion and the profile of the people affected. The availability of figures and profiles at all three levels of government (Confederation, cantons, municipalities) would then become more important for reporting purposes. In this respect, the social sciences could also work towards networking the levels of governance, thereby strengthening professionalism in dealing with and preventing homelessness in Switzerland. Conclusion This paper was intended to fill a gap in European country-specific homelessness research: the absence of Switzerland. In order to provide a state-of-the-art view, different sources were used to illustrate the formats in which homelessness is discussed in Switzerland. It was found that the topic is certainly present, but is rather dealt with through analyses of the housing market on the one hand and “classical forms” of poverty research (e.g. poverty and housing) on the other. The issue of homelessness is repeatedly included on the agenda of political debate as well. But Switzerland’s federal system means this topic is consistently passed on to the cantons and municipalities, where there is far less common ground. In this respect, the opinion that Switzerland has no policy regarding homelessness is sometimes reasonably justified. The situation is quite different in the field of research, where Switzerland contributes significantly to the international research community – albeit limited to medical, psychological or psychiatric issues. One of the aims of this paper was therefore to open up the field of social science issues for Switzerland itself and to provide information on which future projects could build. 210 European Journal of Homelessness _ Volume 15, No. 1_ 2021 ˆ References Althaus, E., Schmidt, M. and Glaser, M. (2016) Nicht-monetäre Dienstleistungen im Bereich Wohnen für armutsbetroffene und -gefährdete Menschen. 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