Housing First: A Solution to End Chronic Homelessness
Housing First is an innovative approach to ending chronic homelessness where people are provided rapid access to low-cost apartments, with vital medical, mental health and other support services available on site. It is a more humane, a more successful and a more cost-effective method than paying for these same individuals to cycle in and out of the emergency room, the sobering center or jail.
Seattle has taken a leadership role in funding Housing First programs. In just the past three years, Seattle has put 280 Housing First units into operation with another 289 expected to be online by 2011.
HOUSING FIRST: PROMISING RESULTS
NEW! 1811 Eastlake Study Released: Housing First Saves Lives and Money
The 1811 Eastlake project was the subject of a 3-year study funded by a $400,000 grant from the Robert Wood Johnson Foundation. The evaluation team included DESC and the Addictive Behavior Research Center at UW, which is part of the Department of Psychology. Mary E. Larimer PhD, professor of psychiatry and behavioral sciences and adjunct professor of psychology at UW, was lead author of the study. On March 31, 2009, the Journal of the American Medical Association published the study.
View the press release: Housing for homeless alcoholics can reduce costs to taxpayers (March 31, 2009)
View the study abstract: Health Care and Public Service Use and Costs Before and After Provision of Housing for Chronically Homeless Persons With Severe Alcohol Problems - The Journal of the American Medical Association (Vol. 301 No. 13, April 1, 2009)
City Releases Preliminary Findings
In January 2008, Mayor Nickels announced the findings of studies on one-year outcomes at two Housing First projects: 1811 Eastlake and Plymouth on Stewart. Separate studies revealed similar findings. Preliminary research shows an estimated cost avoidance of over $4 million* because of fewer visits by these formerly chronically homeless individuals to the Harborview Medical Center and the Dutch Schisler Sobering Center, as well as less use of other crisis-treatment services.
*This figure is updated from the original press release. At that time the figure had been estimated at $3.2 million.
What is Housing First? Housing First is an innovative approach to engage and rapidly house individuals who are homeless into permanent supportive housing then to provide intensive and flexible services to stabilize and support housing tenure.
- Everyone deserves safe, affordable housing
- People determine when they are ready to be housed, not the system (no housing “readiness” standard). People do need to accept responsibilities of being a tenant.
- It is cost effective to provide supportive housing as an alternative to individuals using some of our most intensive and expensive services (e.g. jail, hospital).
Housing First: Core Principles:
- It’s about changing the system, not the person. The major paradigm shift of this model is how services are provided. They are onsite at the apartment building versus expecting an individual to show up at an agency for services. Staff are constantly working to engage residents and are trained in evidence based practices that have been shown to be effective for hard to serve populations (motivational interviewing, assertive community treatment).
- Tenant choice on accepting clinical services. Services need to be readily available with staff continually working to engage and build a relationship with the tenants. No participation in clinical services is required in order to remain housed. Persons may be in early stages of recovery and chose to continue to use alcohol and other substances. Any direct knowledge of illicit drug use, especially drug dealing, would result in contact with law enforcement.
- Focus is on being a good tenant. The main emphasis is on safety with interventions on behaviors that negatively impact an individual or the community. Skill building is essential to help an individual learn the skills needed to be a successful tenant: managing finances (or obtaining a payee if needed); handling conflicts with other tenants; and managing the day to day responsibilities in their apartments.
- Eviction is a last resort. Clinical interventions are attempted to try to exhaust all other solutions prior to serving a tenant an eviction notice.
- Strength-based model with emphasis on building community. Some of the most effective PSH projects have designed their space to include community rooms where activities and shared meals can occur. Peer support and helping individuals feel connected to their community is an important part of recovery and housing stability.
The Substance Abuse and Mental Health Service Administration (SAMHSA) recognizes Assertive Community Treatment (ACT), peer mentors, and integrated treatment to be evidence based practices that have shown to be effective.