Wednesday, March 14, 2018

Homeless Response System Online Learning Clinic 2018 – Part I: From Managing to Ending Homelessness

Imagine We Could End Homelessness

There are many social ills of the past, that seemed intractable, that people would have said we would never get rid of, from slavery to segregation, from child labor to keeping children with special needs out of school. Imagine we could end homelessness. Not just help individuals. Not just manage homelessness. Imagine we could eradicate it. Imagine we could make this intractable social ill a thing of the past, too.

What do we mean by ending homelessness? We do not mean no one ever becomes homeless. It is a given that in a capitalist economy, there is economic churn, and that that cannot be fully prevented. This is why even Scandinavian social welfare states have some degree of homelessness. What we do mean is that homelessness rarely happens, when it does happen it is brief, and that it never happens to that person again. This is no pipe dream. Research[i] has shown that it is entirely doable.

Out with the Old – Managing Homelessness

The origins of the modern homelessness crisis begin in the late 1970s-early 1980s. It is difficult to narrow down one decisive cause for any social problem. However, roughly speaking, there are two major, somewhat technical, societal shifts that brought about this crisis. First, many persons with mental illness, were deinstitutionalized, and the hospitals they resided in were shut down. Second, a type of cheap housing, primarily for single underemployed, unskilled and/or disabled men, known as single resident occupancies (SROs) was largely discontinued. Many of those affected by these changes became homeless.

Though homelessness had existed before, it had not existed in the numbers akin to this crisis. Much in the way we deal with natural disasters, in the 1980s, our society attempted to deal with this problem through the use of emergency shelter. This did not solve the problem. In the 1990s, the Federal Government and related public and private entities decided through transitional housing programs, replete with myriad rules that the homeless needed to abide by, to help them address all their problems. The hope was that the homeless would graduate from these (often lengthy 24 month) programs “housing ready” and be able to move on their own into stable permanent housing. Unfortunately, only a minority of those who enrolled in these programs ever reached that goal. The Federal Government and local communities needed a viable alternative, but one did not seem evident.

In with the New – Ending Homelessness

Around the same time, a small program in New York City was being tested and was slowly gaining ground. This program/philosophy was called Housing First. The idea of Housing First was simple. Rather than trying to “fix” people, and then house them, these practitioners suggested standing the classic model on its head. House people, with two conditions only: They would need to abide by the terms of their leases, and meet periodically with a case manager. They would be offered wrap-around services to help them deal with their challenges, and they would be encouraged to use them. However, unlike in the traditional model, they would not be forced to do so. 

As opposed to the classical program that worked only for a minority of participants, the Housing First program worked for about 85%(!) of those enrolled in it. These 85% were able to achieve stable permanent housing. Though this program began with a small group of chronically homeless persons in New York City, these numbers held up in study after study, in community after community, in setting after setting. This led the consensus of scholars in the field to endorse Housing First, and the Federal Government to eventually follow suit, and mandate that all programs follow this philosophy[ii]. The message to all American communities was clear: The Federal Government would no longer fund the management of homelessness. It was time for the modern homelessness crisis to end.
As this was happening, in the 2000s-2010s, communities were developing more and more permanent supportive housing programs for the chronically homeless and others in need of a permanent setting with intense wrap around supports. And, during the Great Recession of the late Aughts, a related idea called Rapid Rehousing, for non-chronically homeless persons proved promising. The idea was that most of these individuals could be quickly housed, offered intense wrap around services for a limited time, and get back on their feet and move on in 90-180 days. As these settings gained ground, the Federal Government encouraged communities to shift their resources to these settings. Conversely, it began to discourage starting new transitional housing programs, due to their low success rate and high cost.

[ii] Randy Mayeux’s book synopsis of the above-mentioned book by Tsemberis and his colleagues is a great primer on the book and the issue. See

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