Two of the latest researchers on the homelessness scene claim that addiction and mental illness are not the cause of homelessness, rather, they claim the people sleeping on the streets and in the parks merely lack affordable housing.
Having spent 13 years running on the front lines running one of California’s largest programs for homeless women and children, and in five years of research since, I have found that the “housing solves homelessness” myth has unequivocally devastated lives and communities and has squandered billions in annual taxpayer funding.
The Department of Housing and Urban Development (HUD) rolled out Housing First—more aptly titled “housing only”—in 2013, promising it would eliminate homelessness within a decade.
However, HUD’s Annual Homeless Assessment Report (AHAR) data paints a very different picture.
Under Housing First, the nation’s unsheltered homeless population rose by 20.5%, despite a 200% increase in federal homelessness assistance spending in the decade leading up to 2019 and despite a 42.7% increase in the number of permanent housing units dedicated to the homeless during the 2014–2019 period.
In California, the only state to have fully adopted Housing First in 2016, unsheltered homelessness—largely those living on the street—grew by 47.1%, despite a 101% increase in spending and a 33% increase in the number of housing units dedicated to the homeless.
And all of this happened in a period of historically high economic growth accompanied by rapidly rising real wages.
If housing alone were the key to solving homelessness, the unsheltered homeless population would have declined at the nationally and in California.
The theory behind Housing First is that the homeless cannot be helped unless they first have their own home. Once permanently housed, only then will the homeless accept services, such as substance abuse programs, counseling, work training and so on. But this approach has proven false.
More than three-quarters of the street homeless struggle with substance use disorder and/or mental illness, and the vast majority of the addicted/mentally ill struggle with anosognosia—a deficit of self-awareness. To the surprise of few who understand these diseases, and who understand human nature, very few of the housed end up requesting services once they are comfortably housed and able to continue to engage in negative behaviors.
What’s more, HUD defunded mental health, addiction counseling, and employment training services when they rolled out Housing First in 2013.
Human wreckage and community wreckage has resulted.
Indeed, a 14-year-long Boston study completed last year revealed that the focus on housing rather than treatment and recovery saw impressive early results. However, by year five, only 36% of the housing recipients remained sheltered and nearly half of the cohort died due to a “trimorbidity” combination of medical, psychiatric, and substance use disorder.
The Housing First approach discourages behavior change and no longer funds the treatment the homeless need to address their underlying struggles. What’s more, it ensures that nearly everyone who enters the homelessness system stays in it, as they are provided subsidized housing for life, without any expectation of healing and work, ever.
It’s obvious Housing First doesn’t work. We need a new approach—a human-first approach—that addresses the root causes of homelessness which include trauma, untreated mental illness and substance abuse.