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During the last decade, Houston, the nation’s fourth most populous city, has moved more than 25,000 homeless people directly into apartments and houses. The overwhelming majority of them have remained housed after two years. The number of people deemed homeless in the Houston region has been cut by 63 percent since 2011, according to the latest numbers from local officials. Even judging by the more modest metrics registered in a 2020 federal report, Houston did more than twice as well as the rest of the country at reducing homelessness over the previous decade. Ten years ago, homeless veterans, one of the categories that the federal government tracks, waited 720 days and had to navigate 76 bureaucratic steps to get from the street into permanent housing with support from social service counselors. Today, a streamlined process means the wait for housing is 32 days.
Houston has gotten this far by teaming with county agencies and persuading scores of local service providers, corporations and charitable nonprofits — organizations that often bicker and compete with one another — to row in unison. Together, they’ve gone all in on “housing first,” a practice, supported by decades of research, that moves the most vulnerable people straight from the streets into apartments, not into shelters, and without first requiring them to wean themselves off drugs or complete a 12-step program or find God or a job.
There are addiction recovery and religious conversion programs that succeed in getting people off the street. But housing first involves a different logic: When you’re drowning, it doesn’t help if your rescuer insists you learn to swim before returning you to shore. You can address your issues once you’re on land. Or not. Either way, you join the wider population of people battling demons behind closed doors.
Success, of course, relies on strong and coordinated leadership, which the City of Chicago and other smaller cities across the state simply have not had on this topic, except for one area.
* The Rockford area (Winnebago & Boone Counties) pulled it off…
As unemployment rates rose, so did homelessness. In 2014, roughly 700 of the city’s 147,000 residents were unhoused.
Rockford has been working to reverse that trend since partnering with Community Solutions, a New York City nonprofit dedicated to ending homelessness through a housing-first approach, in 2015. As a result, in 2017 Rockford became the first city in the nation to reach functional zero, effectively ending homelessness, for two of the city’s homeless populations: veterans and the chronically homeless.
Reaching functional zero homelessness doesn’t mean that no one in Rockford experiences homelessness. But it does mean that there are more people getting housed than there are people becoming homeless. And that when homelessness does occur, it’s rare and brief.
Developed in large part by the social scientist Sam Tsemberis and the longtime federal administrator Philip Mangano, Housing First has been tried in a growing number of American cities. It still requires cooperative landlords and often employs case managers and other Continuum of Care strategies, but the housing itself comes before anything else. Some of the communities that have tried it have reported remarkable results. Utah County, which includes the city of Provo, has reported that 87 percent of Housing First clients were maintaining their housing for at least a year and that chronic homelessness had declined by 50 percent over several years.
But it’s not an end in itself.
* From a Maine newspaper called the Sun Journal…
A recent study found that Housing First programs decreased homelessness by 88% and improved housing stability by 41%, compared to Treatment First programs.
Jack Tsai, campus dean and professor at the University of Texas Health Science Center at Houston, writing in the American Journal of Public Health in 2020 stated, “Studies have found that Housing First results in greater improvements in housing outcomes for homeless adults in North America. Housing First may lead to greater reductions in inpatient and emergency health care services but may have limited effects on clinical and social outcomes.” […]
[Jeff Olivet, executive director of the U.S. Interagency Council on Homelessness, said] “We know that Housing First is not a panacea. Housing First was designed to end homelessness at the individual level — not to solve the structural causes of homelessness, such as the severe lack of affordable housing, ongoing impacts of structural racism, and lack of access to mental health care and drug and alcohol treatment on demand. Blaming Housing First for the ongoing homelessness crisis is like blaming cancer treatments for cancer. It doesn’t cure every person, and we have much more to learn, but we are saving lives on a daily basis.”
* From that aforementioned study…
Results: Twenty-six studies in the United States and Canada met inclusion criteria. Compared with Treatment First, Housing First programs decreased homelessness by 88% and improved housing stability by 41%. For clients living with HIV infection, Housing First programs reduced homelessness by 37%, viral load by 22%, depression by 13%, emergency departments use by 41%, hospitalization by 36%, and mortality by 37%.
Conclusions: Housing First programs improved housing stability and reduced homelessness more effectively than Treatment First programs. In addition, Housing First programs showed health benefits and reduced health services use. Health care systems that serve homeless patients may promote their health and well-being by linking them with effective housing services.
You cannot solve the homeless problem until you put people into housing. That won’t end the problem, but it has to be done first. Temporary shelter beds are barely even a bandaid, let alone a solution.
posted by Rich Miller
Monday, May 8, 23 @ 9:05 am
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== Houston, the nation’s fourth most populous city, has moved more than 25,000 homeless people directly into apartments and houses.==
But I have been assured that Texas is being overrun and must ship people, like chattel, to other states just to get by.
It’s always heartening to me to see success stories like this, especially ones with such an easy-to-comprehend main idea. But I suspect getting all those activist groups on the same page is much harder than these articles indicate, and it’s not like these articles treat it like a nothing-burger.
Comment by Arsenal Monday, May 8, 23 @ 9:13 am
There are tons of things that have lots of evidentiary support, but Americans still recoil from. Housing first is one. Comprehensive sex ed reducing teen pregnancy and abortions is another. Pretty much everything about how the US handles crime and punishment as well.
Some significant portion of the US population’s first reaction to evidence based solutions is to plug their ears and cover their eyes.
Comment by Homebody Monday, May 8, 23 @ 9:23 am
–Temporary shelter beds are barely even a bandaid, let alone a solution.–
Unfortunately, some charities work to perpetuate the condition they claim to want to solve. For the simple reason that if they ever actually solved the problem, they wouldn’t be able to show how much they ‘help’ people.
Rockford has correctly identified the problem, and has worked around it.
Comment by TheInvisibleMan Monday, May 8, 23 @ 9:24 am
” 720 days and had to navigate 76 bureaucratic steps”
that is scary. Think about the average “normal” person trying to navigate anything to do with local government, now apply that to someone sleeping in a tent. No wonder they never got through it.
Comment by Ron - In Texas Monday, May 8, 23 @ 9:40 am
“But I have been assured that Texas is being overrun and must ship people, like chattel, to other states just to get by.”
Different groups, different location. Try any of the border towns. El Paso looks like a natural disaster in places.
Comment by Ron - In Texas Monday, May 8, 23 @ 9:42 am
=But I have been assured that Texas is being overrun and must ship people, like chattel, to other states just to get by.=
Maybe it is time we start considering what problems we can ship to texas?
Get caught with a gun committing a crime, get sent to texas as an alternative to jail. Get caught stealing a Hyundai, get sent to florida as an alternative to jail. Same with carjacking.
I assume they would be ok with that.
Comment by JS Mill Monday, May 8, 23 @ 9:56 am
Housing First works. Full stop. It’s about the political will to get the money and coordination in place for it to have an impact at scale over time. Maybe the Johnson administration is the opportunity Chicago needs to put the money and coordination in place.
Comment by Montrose Monday, May 8, 23 @ 10:07 am
People, this post isn’t about asylum seekers. It’s about the very real homeless problem that existed before the asylum seekers and will be with us after the surge ends.
Please stick to the topic. Final warning.
Comment by Rich Miller Monday, May 8, 23 @ 10:11 am
Houston is unusual for big cities. They don’t have traditional zoning which means it’s way easier to build housing. Plus, Houston is a massive area of land.
Comment by Steve Monday, May 8, 23 @ 10:31 am
===Houston is unusual for big cities===
Whatever. Where there’s a will, there’s always a way.
Also, Rockford.
Comment by Rich Miller Monday, May 8, 23 @ 10:38 am
==Houston is unusual for big cities. They don’t have traditional zoning which means it’s way easier to build housing.==
And that’s something we actually can learn from Texas (or at least Houston).
==Plus, Houston is a massive area of land.==
That, of course…isn’t. You either have land or you don’t.
Comment by Arsenal Monday, May 8, 23 @ 10:39 am
Housing First is an area where Johnson’s campaign rhetoric could match concrete action. It’ll require finding the money, both in the city and in Springfield. I wonder if this is a way to get a real estate transfer tax through, since some of that money would go back to landlords to house the homeless.
Comment by ChicagoVinny Monday, May 8, 23 @ 10:42 am
The key word seems to be “coordination” of public, non-profit and corporate will to get something done. Use that and create and implement a plan Chicago (and Illinois). The feds seem to be AWOL on this.
Comment by levivotedforjudy Monday, May 8, 23 @ 10:46 am
Great information and thank you for posting it, Rich. It was refreshing to read that there is actually an avenue that appears to be working. I am around hundreds of alcoholics and addicts weekly. Very few will seek treatment but that doesn’t make it any less necessary for them to have a place to live. Get them secure and maybe the people in the 12-step community can talk them into seeking help for their other problems. My hat is off to you for posting this.
Comment by Tom Monday, May 8, 23 @ 11:13 am
I’m a big fan of housing first. I have read of Finland’s program. In their case, they build the housing and its owned by the nation because they figured out that subsidies just increased the cost of housing for everyone while increasing the amount of housing was the actual answer.
Steve is right that zoning is a problem when it comes to adding a lot of housing quickly. On the other hand most of us can accept the idea that changing important aspects of a neighborhood can be unpleasant for the neighbors, so there is a balancing act.
Comment by cermak_rd Monday, May 8, 23 @ 11:26 am
- Steve is right that zoning is a problem -
That’s an artificial problem, easily fixed if our elected officials show up and do their jobs.
Comment by Excitable Boy Monday, May 8, 23 @ 11:39 am
I lived in Houston before moving to Chicago and I’ve had a number of talks with former Houston Mayor Annise Parker about homelessness and the work they did to produce their successes. She told me the very first thing they did was to create a goal for reducing chronic homelessness, and it was constantly reviewed to keep it focused on outcome measures of getting people housed within a specified amount of time. The most difficult piece was getting the coordination and collaboration of all the different social services, and focusing on interactions with a consistent team when interventions are provided in order to create needed trust. When too many people interact with an individual who’s been living on the streets, it actually slows down progress because it delays the development of needed trust. I see great things happening with the work done by having All Chicago at the helm. They recently received a $60M HUD grant focused on outcomes of reducing homelessness by 25% by January 2025. The federal government is rightly pushing a housing first model, but there’s not enough affordable housing and building it is 2 to 3 times more expensive than market-rate housing; the same is true all over the U.S. Everyone is going to have their own idea about what works, and what doesn’t. The same occurred in Houston, but it’s the focus on adhering to outcome measures of getting people housed within a specified time and tweaking interventions to make that happen that’s key.
Comment by James Cappleman Monday, May 8, 23 @ 12:01 pm
The St. Louis metro region has obstacles to housing first that you won’t see in Rockford. Any housing first solution would have to include Missouri as the homeless will migrate to the areas with the best services. Trying to set up a bi-state solution would, in my view, multiply the challenges in bringing people together. Not to say that it can’t be done. I would like to see a model that included multiple states, municipalities, etc.
Comment by Southern IL Bob Too Monday, May 8, 23 @ 12:20 pm
–maybe the people in the 12-step community can talk them into seeking help–
Or even better they can use a non-sectarian approach, because the 12-step programs are specifically identified as a hinderance and not a benefit for this issue.
Telling people to “give up control” of their life circumstances is the exact opposite message that should be provided to people trying to gain more control of their lives. It’s why when those programs get out of the way, there is success taking place, instead of perpetuating the situation to keep people coming to meetings(which more often than not, are in a church).
Comment by TheInvisibleMan Monday, May 8, 23 @ 12:41 pm
I remember before Rahm the situation wasn’t terrible. Did he not cut mental health resourcing by 50% as mayor? I thought he had…
Most homeless folks are just plan nuts and unless they get help basically forced into them, nothing will change.
Comment by Someone Monday, May 8, 23 @ 12:48 pm
“Most homeless folks are just plan nuts and unless they get help basically forced into them, nothing will change.”
There are so many things wrong with this take, I don’t know where to begin.
Comment by Montrose Monday, May 8, 23 @ 1:26 pm
- Most homeless folks are just plan nuts and unless they get help basically forced into them, nothing will change. -
One day you may find yourself far from your big fine house…singing a different tune.
Life can change faster than the swish of a horse’s tail…even for you.
Comment by Dotnonymous Monday, May 8, 23 @ 3:19 pm
Someone, I just checked your IP address and you really should be ashamed of yourself.
Comment by Rich Miller Monday, May 8, 23 @ 3:22 pm
“Most homeless folks are just plan nuts and unless they get help basically forced into them, nothing will change.”
Absolutely false and you know it.
Comment by btowntruth from forgottonia Monday, May 8, 23 @ 5:11 pm