Why use a ‘Housing First’ approach?

Posted: July 19, 2010 in Goals, Homeless Shelters, Homelessness, Housing, Money

Anyone familiar with me, or this blog, already knows that I am a strong proponent of a "Housing First" approach for solving homelessness. They also know that I do not believe that the traditional homeless support services (HSS) methodology has been – or will ever be – successful at reducing homeless by offering service which are primarily based on "a meal and a bed" mindset.

Homelessness is an intricately complex issue which can be solved only through helping the homeless become housed – and not just temporarily "sheltered."  

In response to my post, The ‘System’ isn’t broken…, one reader asked,

"To what degree do you believe that HSS should be focusing on the provision of housing as a solution to homelessness? I have met many individuals who have been provided with housing but, for one reason or another – usually lack of maturity and independent living knowledge and skills, the tenancy breaks down."

While I am not absolutely certain about it, I suspect that question may have been asked in part because I had written,

"However, unless HSS groups undergo a drastic metamorphosis and begin focusing on actually empowering the homeless to acquire housing and achieve some measure of self-sustainability, I question the prudence of continuing to finance an industry that has, thus far, proven itself to be unsuccessful at reducing homelessness."

The short answer to the reader’s question is:

Homeless support services (HSS) should be focusing 100 percent of their efforts toward helping the homeless become housed. Then, after the person is re-housed, they can – and should – be directed to whatever additional services are required to help them remain housed.

Quite obviously, my "short answer" is somewhat of an over simplification. Nonetheless, solving homelessness requires getting the homeless back into stable housing.

Please understand, I am not advocating simply providing housing to the homeless in an indiscriminate manner, or just for the sake of getting the homeless off the streets. Such an approach is a recipe for failure and would be equally as unsuccessful at reducing homelessness as the traditional HSS methodologies are.

However, housing is the necessary first step in reducing homelessness – that’s why the phrase is "Housing First."

Make note: Housing First, not "Housing Only."

A successful Housing First approach begins by placing an individual or family into housing. From there, it provides the necessary secondary services to help them remain permanently housed.

Those secondary services could be anything from learning how to manage their finances; job retraining; furthering their educational needs; mental health services; and yes, even drug and/or alcohol rehabilitation.

Among those communities in the U.S. which have used this approach, there has been a large rate of success and a low rate of recidivism.

In short: the Housing First strategy works when coupled with the appropriate "follow-up" services. Moreover, it is the only approach that has been shown to yield reproducible results.

In sharp contrast, the HSS industry has used an opposite approach. It has required the homeless to be "rehabilitated" before directing them toward housing. As a result, the numbers of persons becoming homeless for their first time is vastly outpacing the numbers of persons who are being "rehabbed" and then re-housed.

There is an additional benefit of using a Housing First approach: it is cost effective. And the savings, when compared to the traditional HSS method, are substantial.

There have been numerous studies, including one released this past March by the U.S. Department of Housing and Urban Development (HUD), comparing the costs of housing the homeless versus the cost of sheltering them. All the studies have shown the cost effectiveness of utilizing a Housing First approach.

Sadly, although approximately 300 communities nationwide have "adopted" a 10-year Plan to End Homelessness – which is based on the Housing First model – only a small number have actually implemented them.

Yet, based on data contained in HUD’s most recent Annual Homeless Assessment Report (AHAR), because of those communities which are using a Housing First approach; since 2006 there has been a total reduction in the numbers of chronically homeless persons by about 30 percent.

That’s a remarkable number (of which I will be writing about in an upcoming post).

In the meanwhile, let me leave you with this final thought about the Housing First approach.

Regarding the housing (versus the sheltering) of the homeless, Professor Dennis P. Culhane (University of Pennsylvania) wrote in an Op-Ed piece in The New York Times:

"All these changes would be expensive initially. But the current shelter-based approach is hugely wasteful, and savings would eventually be realized as we lowered the cost of homelessness to the health care, child welfare and criminal justice systems.

During the debate over health care reform, it has been convincingly argued that replacing institutional care with community services would be more effective and less expensive. Why should our approaches to fighting homelessness be any different?"

Interestingly enough, Professor Culhane penned those words back in December of 1993.

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Comments
  1. Rev. Cynthia says:

    Michael, thank you so very much for writing about “Housing First” with the required follow-up services in a way that is clearly understandable. I think it would be helpful if you could provide a list of services that would ideally be provided from the time someone knew they were about to land on the streets. Perhaps two scenarios: one for a family, who is about to become homeless, and one for a family, who has already lost their housing.

    Right now, with 3800+ people already unhoused in San Luis Obispo, something needs to happen immediately. It would seem that federally subsidized housing (like Section 8) needs to re-open in a large way.

  2. Thanks for the post Michael, it certainly has given me some food for thought and it’s interesting to see the findings of those studies. Is there any reason why this initiative has not been more widely adopted?

    It would be interesting to know more about how and why services are delivered in the way that they are today here in England and whether much consideration goes into rehauling services in the way which your Housing First idea suggests – presumably current services have steadily evolved from the “bed and a meal mindset” to which you refer, increasing and diversifying services to address identified needs as they go along.

    Just one thing to mention that springs to mind from my current research though. Many people, both residents and workers in hostels speak about the negative side of staying in a hostel. But on the other hand, it does seem to foster a sense of community and belonging among some individuals, even though these may be in small cliques. Part of their problem in becoming homeless was needing to get away from people and groups that were a threat to their desire to live a legitimate lifestyle – to be free from gangs, drug dealers etc. Being in a hostel offers a transition from this ‘old’ life and gives them the chance to meet new people who may share similar aspirations and goals. A lot of young people have talked about “getting my life sorted” and it seems as though a new, empathetic social circle is instrumental in this in many cases. Is there a way in which the Housing First approach could cater for this transition too?

    • michael says:

      SG,

      Actually, the HSS industry has not evolved beyond the “meal and a bed” mindset. In those cities here in the U.S. that have implemented a “Housing First” approach, the infrastructure for Housing First has been built from the “ground up” – and is, for the most part, administered separate from HSS.

      Here in the U.S. hostels are not used as part of the Housing First approach since they mimic the dormitory style of living offered by the shelter-based approach. Instead, folks who are helped via HF, are provided with genuine “single-residency” housing of their own, which is subsidized by government funding, until such a time when they are able to maintain themselves.

  3. Is it possible then that in some cities there is both the hostels and the HF approach, albeit run by separate institutions? I’m wondering then in those cases if homeless people have a choice of which they would use, if they are made aware of it, and how they would make that decision?

    • michael says:

      SG,

      I became aware of the HF approach shortly after I began authoring this blog and have been researching it ever since. As far as I have been able to ascertain, it is based on helping folks into single residency housing of their own. In certain instances, they are those who are placed into “group homes” (if their personal situations warrants it), but even then, it is far from a dormitory style environment – the purpose being to try and re-instill a sense of individuality in the person.

      Admittedly, there may be some “homeless hostels” here in the U.S. – although, at present, I am not aware of any. Nor, have I ever seen any reference to any.

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