DESC: Sheltering the Most Vulnerable

Background

Seattle’s Downtown Emergency Service Center opened its doors in 1979 as a low-barrier shelter for people with behavioral health and substance use challenges. In 1994, DESC’s mission to provide shelter for vulnerable people expanded to include providing permanent supportive housing. Today, DESC is nationally recognized for providing over 1,200 units of permanent housing to people experiencing chronic homelessness — including adults affected by mental illness, chemical dependency, and multiple disabilities. Still, the agency continues to meet a critical need in the community by providing low-barrier shelter to 379 individuals nightly. DESC operates four shelters:

• The Main Shelter, a shelter for 220 men and women which is open 24 hours.
• Connections, a shelter for 38 men.
• Queen Anne Shelter for 100 men.
• Kerner-Scott House, shelter for 25 women suffering from mental illness.
• Navigation Center, shelter for 85 people

DESC provides a model for how to operate a low-barrier shelter for the most vulnerable residents in a community.

1. Remove Barriers to Accessing Shelter

DESC shelters do not exclude people from shelter because of intoxication or serious mental illness. DESC considers people with these challenges very vulnerable — and therefore prioritizes them for their limited shelter beds. Because DESC was originally founded to serve this population, they have decades of experience working with people with mental illness and addiction.

2. Prioritize Limited Shelter Beds

Since 2009, King County, Wash. has consistently counted more than 2,000 households sleeping outside or in places not meant for human habitation during the annual Point in Time Count. In November 2015, Seattle declared a state of emergency in response to the homelessness crisis, citing the tragic deaths of 45 people who died while unsheltered that year.

To help the most vulnerable in the community survive, DESC prioritizes their shelter beds by vulnerability, using a tool the agency developed called the Vulnerability Assessment Tool (VAT). The tool assesses who is most at risk from extended exposure to life on the street due to physical and behavioral health conditions, victimization, self-harm, and risks related to inability to take care of their basic needs.

When individuals first present at a DESC shelter, they are immediately assigned a shelter bed if one is available. During an initial short stay in shelter (typically a week), shelter staff conduct a VAT. If a person’s score indicates that they are among the most vulnerable seeking shelter, they will receive an extended stay.

3. Minimize Rule-Making

It can be difficult to strike a balance between maintaining safety in a sometimes-chaotic shelter and minimizing shelter rules. However, evaluating the need for — and purpose of — shelter rules and policies is an important exercise for DESC. An operating principle of effective low-barrier shelter is to keep the rules to a bare minimum, so that they don’t in themselves become barriers to people’s ability to enter or reside in shelter.

Rules are typically intended to ensure safety and consistency, but can quickly be used as consequences rather than a risk-management tool. Staff teams, especially those with less experience working with a high-needs population, may look to the rules to provide program structure. Staff may hope rules will reduce challenging behaviors that low-barrier shelters will, by design, encounter. Paradoxically, with a very high-needs client population, more rules can actually increase the number of problem behaviors that staff will need to manage. A low-barrier shelter must be low-barrier both in accessing shelter as well as participating in it once admitted. It is crucial that operators thoughtfully and intentionally reduce the number of rules to the greatest extent possible. Not only will this lower barriers to accessing shelter, it will provide optimal space for creative problem solving — a key component of successful service provision.

Some shelter rules make it difficult to stay in shelter or may interfere with activities like housing and job search. For example, rules that force clients to leave during the day can make it harder for them to to search for work: People may not present well to employers when carrying all their belongings with them or after having been out all day in harsh weather. Further, survivors of domestic violence in particular have reported that restrictive shelter rules can re-traumatize them. When considering the need for rules and discharging a client, the vulnerability of that client and their exposure to harm if unsheltered should be considered.

DESC went through a process they called “the role of the rules” to evaluate the need for their various rules and policies. The shelter manager reviewed past incidents that resulted in clients being barred from services for a day or more. He held meetings with shelter supervisors, staff, and clients to discuss changing the rules and to gather input. The final rules were pared down to only those directly related to safety. The new rules were posted 30 days before they took effect, and the shelter manager held frequent meetings with staff to discuss this shift. The focus of these conversations was preventing extremely vulnerable people from losing vital resources. The number of people barred from shelter decreased dramatically once the new rules were implemented.

4. Provide 24-Hour Access

In the 1990’s the business community near DESC’s main shelter, the Morrison, was concerned about an increasingly visible homeless population. In response, the city of Seattle increased the size of the contract for the shelter to allow it to remain open for 24 hours in order to give people a place to be during the day. DESC believes 24-hour shelter holds many benefits for their clients as well. They do not have to leave during inclement weather or move all of their belongings out daily. Additionally, this time allows staff increased contact with clients to engage them and help assist them in returning to permanent housing.

5. Re-House Long-Stayers

In 2012 a taskforce convened by the Committee to End Homelessness recommended increasing capacity in Seattle shelters by moving individuals that had stayed the longest in shelter into permanent housing. This would allow shelter beds to turn over more often and serve more people.

An analysis found that 26 percent of shelter users staying the longest utilized 74 percent of bed nights over the study period. A cohort of 277 individuals with stays over 180 days were prioritized for re-housing by homeless service agencies, including DESC. The collaborative was able to house 85 individuals, who represented the usage of at least 41 shelter beds for an entire year. Not only does this process help people return to housing who may not be able to exit homelessness on their own, it increases the capacity of the shelter system by creating “flow” through the system to housing. For example, if individuals stay in shelter an average of 30 days, 41 beds can serve 492 people over the course of a year.