What is Housing First?
“Housing First” is an approach, according to HUD’s notice for the annual competition for homelessness grants, “to quickly and successfully connect individuals and families experiencing homelessness to permanent housing without preconditions and barriers to entry, such as sobriety, treatment or service participation requirements. Supportive services are offered to maximize housing stability and prevent returns to homelessness as opposed to addressing predetermined treatment goals prior to permanent housing entry.” Under “Housing First”, an individual or family is offered both housing and services, not just housing.
Why does Housing First not require services to be accepted?
The client is not required to take Housing First services, but the provider is required to continue to offer guidance to the client on avoiding risky behaviors and come back, again and again and again, to the client with offers of services. People with sobriety and substance use issues seek and accept help in different ways and at different speeds. It’s up to the Housing First provider to design a program that serves the unique needs and interests of each client being served, rather than impose a one-size-fits-all rule which denies help to a client or requires disqualification of a client if that client, for example, fails to eschew all drugs and alcohol.
So why is it called “Housing First”?
It’s understood that if we first get a person experiencing homelessness into housing, they’ll be more capable of taking advantage of services. Everything’s easier when one has a home (instead of a shelter bed or a place on the streets)—from having a secure place to keep medications and schoolbooks to a quiet place to sleep in order to be ready for work to a safe space to avoid bad influences. Provision of housing satisfies a basic human need of the client, builds trust between the client and the provider, and makes it possible for the client to take advantage of services.
When did Housing First start?
Housing First was adopted as federal policy during the George W. Bush Administration, replacing a wasteful, one-size-fits-all approach of denying housing and services to anyone who failed to comply with strict sobriety and substance abuse requirements. Most people suffering from mental illness and / or substance use disorders are incapable of overcoming their problems without failures and setbacks. It’s wasteful and cruel to deny clients housing and services or kick them out of programs for those failures and setbacks, especially as their problems will only become worse out on the streets.
Is Housing First used only by HUD?
Housing First is also followed by the Department of Veterans Affairs (VA) in its two most famous homelessness programs—Supportive Services for Veteran Families (SSVF) and HUD-Veterans Affairs Supportive Housing (HUD-VASH). Under SSVF regulations, for example, it is noted that “re-housing assistance is offered without preconditions (such as employment, income, absence of criminal record, or sobriety) and the resources and services provided are typically tailored to the unique needs of the household.” Those two VA homelessness programs, considered to be the gold standard for homelessness programs both here and abroad, have been instrumental in reducing veteran homelessness by 50% over the last dozen years. The big differences between the HUD homelessness program and the HUD-VASH and SSVF homelessness programs are that the VA programs are much better funded per capita and are both integrated into the world-class VA health care network.
Why is the Housing First approach so widely embraced?
Housing First is particularly effective at housing people who have experienced homelessness for long periods and suffer from one of more morbidities (problems with physical health, mental health, and substance use disorders). This subpopulation is often very expensive to communities for costs associated with police, corrections, and emergency health care. Helping these people into housing and providing them with services as well in order to keep them housed allows local communities to avoid significant costs while improving the health and well-being of their populations.
Does Housing First discriminate against faith-based organizations?
Faith-based organizations play vital roles in local homelessness systems, establishing and operating shelters as well as rapid re-housing and permanent supportive housing programs, consistent with Housing First. The principles which animate Housing First—upholding the dignity and autonomy of the client being served; building services around the client’s needs and interests, rather than the organization’s; and understanding that the client may fail, perhaps repeatedly, but is still deserving of help—find favor with many creeds and faiths.
What about someone who wants to enter a program that, contrary to Housing First, imposes preconditions and barriers to entry, such as sobriety?
People who want a sober lifestyle can be accommodated with single rental units or in shared housing with others who also want to live that lifestyle.
Is Housing First a treatment program for people with mental illness or substance abuse disorders?
No, Housing First is an approach used by HUD and VA to house and provide services to people experiencing homelessness, one which has the ultimate objective of keeping them safely and securely housed. It is not a treatment program, like those under the jurisdiction of the Department of Health and Human Services. Many people have issues with sobriety or experience substance use disorders but remain safely and securely housed; they may need treatment programs but they don’t need housing programs. Housing First, through the provision of housing and services, helps people experiencing homelessness to become housed; in getting them out of shelters and off the streets, they will be in a much better position to address the issues that caused them to become homeless—whether it be financial or familial issues, or issues related to poor physical health, mental illness, or substance use disorder—so they can remain housed. Once safely and securely housed, beneficiaries of Housing First can seek treatment programs for more extensive help for sobriety and substance use issues—and thanks to Housing First they will be in a much better position to take advantage of those treatment programs.
If Housing First is so great, why do we still have so much homelessness?
Local homelessness systems don’t have the resources to provide Housing First to everyone who needs it; they serve only fractions of the people who are eligible for help. With resources in short supply, it makes sense to use them in support of cost-effective strategies like Housing First. Moreover, local homelessness systems can be easily overwhelmed by the homelessness caused by the enduring, national shortage of affordable housing units and the inadequacy of federal programs to provide housing, mental health treatment, or substance abuse treatment for everyone who needs them.
Efforts to limit or weaken Housing First are strongly opposed by the Alliance. Housing First helps communities avoid significant costs by helping people get into permanent housing, particularly the chronically homeless. Housing First is housing and wrap-around services that help people to addressing underlying reasons for their homelessness. Federal resources to fight homelessness are limited, far from what’s needed to address the problem. Therefore, it is imperative that these resources be used on high-performing programs that are successfully helping people stay safely and securely housed.