Housing First Or Homelessness Prevention? Stop! You’re Both Right

eight people painting a mural of gears on a waist high wall
Teeth and Grooves photo by New York City Department of Transportation is licensed under CC BY-NC-ND 2.0
Ending homelessness is an interlocking puzzle with many parts. System-wide coordination will help to ensure access to the wide range of supports that have a role.

There are plenty of media reports that homelessness is growing. Point in time counts document the rise in the number of people who are living outdoors or emergency shelters or provisionally housed.1

For people who are living outdoors, the prescribed solution is Housing First, which is a program that is proven to assist people who are living outdoors to move to permanent housing. Studies show that Housing First is most effective with homeless people who are living with a mental illness and/or addiction, predominantly single people who are living outside or at an emergency shelter.

With people who are provisionally housed, services aim to help them avoid becoming homeless. Compared with Housing First clients, service users are more likely to include children, single parents and women. Typical situations include very high housing payments, unsafe living conditions, crowding and couch surfing. The article linked to this post describes the full scope of homelessness prevention programming. Some examples include landlord tenant mediation, emergency financial assistance, legal advice and representation, employment programs, training assistance, system navigation and peer supports.

All fine and good, but the number of people who would benefit from these services is far larger than the amount of funding available to provide them. Policy makers, program managers and politicians are forced by scare resources to make difficult choices.

Some argue that Housing First, being a demonstrated best practice, should get priority. Others think it’s important to prevent people from becoming homeless in the first place. It’s a tricky debate because it’s been difficult to demonstrate that homelessness prevention programs are effective. Right now, decision making is tipped in favour of Housing First programs. Many funders require service providers to dedicate the majority of their funding to Housing First.

Here’s a new article that tackles the issue of choosing. It uses system modelling. A practical analogy (draining a bathtub while filling it at the same time), explains how systems modelling works. The researchers modelled three approaches to ending homelessness: Housing First only, prevention programs only, and a coordinated service that combines the two. They used a computer simulation to investigate the outcomes of each approach.

The modelling demonstrates that small investments in prevention and a coordinated system will have a significant effect in stabilizing the situations of people who are precariously housed. The researchers conclude that a coordinated program of Housing First as well as homelessness prevention will be most effective. See the full study at Annual Review of Public Health: Solving Homelessness From A Complex Systems Perspective: Insights For Prevention Responses

Footnotes

  1. Provisionally housed refers to people who are couch surfing or staying temporarily with friends or family. It also refers to people with no fixed address who are hospital patients or in the correctional system on the day of the count.