Anyway, housing first is a proven method for resolving the cycle of homelessness[0]. Rather than placing restrictions on people (get sober, get a job, etc) to access shelter, putting people in a stable home environment right off the bat has greater success at keeping people housed long-term.
I learned about a study on housing first and one of the primary champions of the initiative in a fantastic podcast series called According to Need, by the 99% Invisible crew. It's an eye-opening look at the beuracracy that keeps people unhoused when they seek help[1]. Bonus points that it's reported on in the Bay Area, where the problem is completely out of control. Episode three deals with housing first, but I'd really recommend listening to the entire series if you have the time.
"However, for the chronically homeless population, which represents about 10 percent of the homeless population, research has shown, and our experience has been, that when these individuals have a place of their own where they can be safe, the drinking and drug use decreases. Also, with effective case management support, we have found a positive supportive community is created in the single site locations."[2]
[0] https://nlihc.org/sites/default/files/Housing-First-Research... [1] https://99percentinvisible.org/need/ [2] https://www.kitsapsun.com/story/opinion/editorials/2016/07/1...
It’s still probably the best idea we have going, but it’s not without significant downsides. Where I live, many small time landlords who have agreed to participate in programs like this with the city have had to evict the tenants placed with them because they made the entire property unlivable for other people through actions like smoking meth in their apartments, letting their dealers move in with them, or in one case, piling all their belongings into the bathtub and lighting them on fire in a state of meth induced psychosis.
In Portland, there is a large housing complex called Bud Clark Commons that provides low barrier housing to the homeless. Since it was constructed, the area around it has become far more dangerous than it was before. There are hundreds of tents surrounding it, meth dealers operating openly from RVs, and trash strewn all around the area. But what’s really interesting about Bud Clark Commons is that the staff actually struggles to keep people there. People cycle in and out, often leaving to return to the streets voluntarily.
It’s really depressing to consider, but it seems clear that some of the people living on our streets have been fundamentally changed in such a way that will make it extremely difficult for them to find their way back into society again. Especially for addicts, the call of euphoric oblivion right outside the door seems very hard to resist in the long term.
Housing first doesn't work, shelter first probably does.
I'd expect something like: You get 1 year of "housing-first"-style free housing with no requirements, then you get 1 year of "tough love" free housing with sobriety and job-search requirements, then you get kicked out.
People with complex issues have variable amount of time to resolve it. Can't put a time on it. But you can figure what cost you more and how much you value human dignity within that cost framework.
So an arbitrary time limit in this case does not make sense as a government public welfare policy.
Until you actually implement it and discover that the problem isn't housing, it's drug use and mental health. After all, homeless individuals have "stable" housing in their encampments (which is why they form in the first place).
And then you realize that the problem isn't solved until you can force the individual into rehab or into treatment, which you can't do because the homeless advocates will fight you in court to prevent treatment and cite stories like the above, but these homeless advocates are the reason why the bureaucracy doesn't work.
Mental health care or substance use treatment just cannot be very effective if a person doesn't have a safe, climate-controlled place to be and keep their stuff. If policy insists that the mental health or substance use must be addressed prior to housing support, then money is being wasted. More importantly, people who could have gotten better under a housing first system are being denied the chance to do so.
Homeless advocates are not the reason for the failures of housing policy. There's barely any of them and they have basically no power. It seems strange to blame them when all they do is ensure that people's rights are upheld, and clearly there are much larger forces at play.
As someone who works in human services, forced treament almost always leaves the person being subjected to it worse off; it's used to satisfy the needs/biases of providers. Once someone is isolated from their supports, that's when they are most vulnerable. Providers treat people as objects to fulfill their own incentives; abuse runs rampant.
The idea that we could fix homelessness if we just canceled the human and legal rights of people who are homeless is a terrifying take. If this ethical stance is unconvincing, please know that it would cost more and be even less effective in helping people.
You know what the most effective way of treating homeless drug addicts is? Forcing them into rehab, while incarcerated.
You know what the most effective way of treating mental illness is? Forcing them into mental hospitals where they are forcibly medicated.
You know what the least effective way of treating mental illness and addiction is (of the ways where some sort of action is taken)? Housing first. Because it focuses on the wrong problem: it focuses on the symptom (homelessness) and not the cause of the homelessness (drug addiction or mental illness).
If housing first worked, then permanent shelter assignments would be the quick and easy fix to the homeless problem.
The idea that we could fix homelessness if we just canceled the human and legal rights of people who are homeless is a terrifying take. If this ethical stance is unconvincing, please know that it would cost more and be even less effective in helping people.
This is the kind of silly belief that keeps the mentally ill and the addicted on the streets, shitting themselves and being eaten by rats and preyed on by rapists and drug dealers. Human rights are an theoretical concern for the homeless, not a tangible one.
A lot of rampant predatory quackery involved when forcing therapy and medication on those with no means of recourse, too.
Since you are appealing to your authority: I have worked with the homeless. I have also been homeless. I know firsthand what works and what doesn't. You are wrong.
> You know what the most effective way of treating homeless drug addicts is? Forcing them into rehab, while incarcerated.
> You know what the most effective way of treating mental illness is? Forcing them into mental hospitals where they are forcibly medicated.
Both of these are absolutely false, both in my experience and according to every study I've ever come across. Involuntary treatment, whether physically forced or coerced by denying certain benefits, almost never has successful outcomes. Why would it? Recovery is an active process that cannot be forced onto someone.
> You know what the least effective way of treating mental illness and addiction is (of the ways where some sort of action is taken)? Housing first. Because it focuses on the wrong problem: it focuses on the symptom (homelessness) and not the cause of the homelessness (drug addiction or mental illness).
You're now arguing with a strawman. Housing first claims to be neither mental health care, nor substance use treatment. It just makes those things dramatically easier. As I said in my first comment, housing first programs always offer mental health and subsrance use support in addition to the housing.
It should be self-evident that navigating treatment is easier when you have a safe, consistent place to live. It's easier to get mail fron Medicaid and other supports (and you should know that you can lose your benefits if you don't respond to certain pieces of mail!). It's easier to have providers arrange transportation to and from appointments. You have a physical boundary you can set with people who are triggers for unhealthy behavior. And it just takes off a massive cognitive load so you can focus mental energy on recovery.
> If housing first worked, then permanent shelter assignments would be the quick and easy fix to the homeless problem.
Be consistent. Don't compare it to "quick and easy". Give an honest, apples-to-apples comparison to your suggested alternative.
If we take all the permanent housing assignments after forced treatment, are those "quick and easy solutions"? No, long-term success rates are abysmal.
Housing first isn't a magical spell, it just works better, at a lower cost, with less authoritarianism than the alternatives.
> This is the kind of silly belief that keeps the mentally ill and the addicted on the streets, shitting themselves and being eaten by rats and preyed on by rapists and drug dealers. Human rights are an theoretical concern for the homeless, not a tangible one.
No, it's the hardass mindset which you're advocating that prevents sufficient funding toward evidence based approaches. Having safe, stable housing one controls reduces the chances that someone will be "eaten by rats" or "raped". We've tried what you're proposing and it was a human rights disaster.
During my time in the system, I avoided seeking help at times because I knew I might get psychiatrically locked up and lose my job. That's my human rights being a tangible concern.
It's very cavalier of you to suggest other people's human rights are "theoretical concerns". Thank goodness our (including anyone who is homeless, me, and you) human rights are legal, and not subject to what you deem "theoretical". They matter to me, and to the people who I support in my work.
Involuntary treatment, whether physically forced or coerced by denying certain benefits, almost never has successful outcomes. Why would it? Recovery is an active process that cannot be forced onto someone.
Absolutely false. It has worked 100% of the time I have seen it forced upon my clients (in every case because as their legal guardian I made that decision for them).
Every single one of my clients was happy that they were forced into treatment. EVERY SINGLE ONE. Because they didn't want to be mentally ill, but when their illness surfaced they couldn't make the decision to take their medications or go in for treatment. And the addicts abjectly refused to voluntarily get treatment because they were absolutely terrified of the effects of withdrawal, which in almost every case required hospital settings to manage.
But once they were sane/sober again, they were glad that I made the decision for them, because they absolutely preferred sanity and sobriety over the alternatives but couldn't get their on their own.
Housing first isn't a magical spell, it just works better, at a lower cost, with less authoritarianism than the alternatives.
This is false. LA County spends many multiples on its housing first strategy than it does when it simply commits someone to a mental hospital. Not surprisingly, mental hospitals are cheaper and more effective than housing first.
And critically, you ignore a very crucial thing about your housing first mantra: it only works for those individuals whose addictions or mental illnesses are mild enough that they can handle their own rehabilitation or medication, or in other words, a very small minority of the mentally ill and homeless in LA County.
It's very cavalier of you to suggest other people's human rights are "theoretical concerns".
When someone is so far gone that they're shitting themselves in the middle of a busy downtown street, their "human rights" are purely theoretical given the likelihood that they will die very shortly.
Thank goodness for people like me who ignore the theoretical human rights concerns so that these homeless/addicts can get the treatment they need and actually survive long enough, and be sober/sane enough, for their human rights to actually matter to them.
Sounds cheaper as well compared to the policing and emergency hospital bills needed to deal with them as well.
I honestly think the drug problem is more powerful and detrimental than homelessness itself. The drug trade definitely feeds on homelessness, but it would likely still find a vulnerable population if homeless people were eliminated.
In LA 3 times more homeless people died than in NYC.
https://michaelshellenberger.substack.com/p/three-times-more...
You can call or email Lourdes Morales in the non-partisan CA LAO if you're truly interested.
Note that nearly 1/4 of the entire United States homeless population currently resides in California. The state deals with homelessness at a scale/complexity that makes advice like "we should have better government" and "people should be accountable" not very helpful.
There's also the factor that it is a nation-wide problem. Once city can't solve it, if they did everyone would just go there.
How does an inner city lefty being against such a law (which just seems to be criminalizing extreme poverty), put them in league with the people who don't want a social safety net and so are placing people in that very situation?
Isn't it cheaper to give them food than to lock them in prison ... and then give them food?
More specifically, supporting the mentally ill to refuse treatment. Later (as you allude), they will vocally support not enforcing various quality of life laws that have been broken. Logically, these two things are in conflict. Either the mentally ill are competent to make decisions, or they aren't... pick one.
This, combined with lack of funding are the primary hurdles to helping these folks get into places to care for them. I would also support other subsets of the homeless population to be helped. But, a lot of people prefer them just where they are apparently. The results of their actions speak louder than words.