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One issue facing chronically homeless individuals is the lack of low-threshold, harm reduction focused direct housing. Individuals experiencing chronic homelessness often have difficulty tolerating behavioral restrictions in permanent supportive housing. It is unreasonable to believe that the root cause of an individual's homelessness will resolve itself when that individual moves into housing.
Low threshold, harm reduction focused direct housing focuses on keeping individuals housed while addressing the root causes of their homelessness instead of creating a more pronounced crisis by evicting the individual from housing and exacerbating the crisis that precipitated their homelessness.
Jennifer Kowalski
shared this idea
3 comments
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Laura Hansen
commented
This is critical if we are to get the chronically homeless off the street.
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Fred Berman
commented
As per a comment I made in another section, chronically homeless individuals typically have histories of involvement with one or another government-funded system of care. In the same way that "every journey begins with a single step," just about every instance of chronic homelessness has its roots in a failed transition from a system of care back to the community... whether or not the path from discharge to homelessness was direct or indirect, by way of a series of stays on couches, or a stay in a short-term "re-entry" program, etc.
Given what we know about the predictors of recidivism and homelessness, the best thing that we can do to end chronic homelessness is to ensure that when individuals with disabling conditions and questionable means for self-support enter one of our residential treatment systems, the treatment regimen includes re-entry housing and the support system to ensure that the client can retain that housing. Likewise, when such an individual enters the corrections system, the rehabilitation/discharge plan should include a clear path to re-entry housing which lasts as long as needed to ensure successful community reintegration.
The federal government, which pays for treatment via block grant programs and Medicaid, is in a great position to leverage a re-thinking of these systems of care whereby the housing outcomes are seen as carrying the same weight as clinical outcomes of treatment. Likewise, through its DOJ grant-making process, the federal government is in a strong position to leverage re-thinking of corrections policy, such that re-integration is understood -- and funded -- as a process that extends well beyond the first 30 or 60 days after the client/offender exits the corrections system and re-enters the mainstream.
This more holistic approach to re-integration -- from clinical care, foster care, or incarceration -- will, of course, depend upon the existence of housing options where the client/patient/ex-offender can receive multi-faceted support for successful assimilation into the mainstream, at whatever level his/her disabling conditions allow.
In the absence of such next-step supported housing options, shelters and the street will continue to be the default "housing program" for ex-offenders who can't support themselves after release from prison, or who can't find housing because of their prison record; for addicts and alcoholics who complete halfway house treatment, but can't afford to support themselves in mainstream housing (and can't get a lease because of their track record of eviction), for treatment drop-outs, and for the people who complete detox but can't find a residential treatment program; for mental health patients who can't access community housing because there simply aren't enough slots; for young adults who simply aren't ready to support themselves when they age out of foster care ... whether the threshold for aging out is 18 or 21 or higher.Or, in more graphic terms, in the absence of such next-step supported housing options, shelters and the street will continue to be the incubators of chronic homelessness.
HUD has long known about the importance of "closing the front door" to shelters, and has appropriately required state and local jurisdictions to certify that they will not discharge inmates/patients/clients into homelessness. While the administrators of these systems of care presumably follow the letter of their commitment, they are under-resourced to provide the step-down housing their exiting clients need. So when patients/inmates talk about moving in with a friend or drop out of treatment or "wrap" their sentence and escape the oversight of the corrections system, there are no community-based housing alternatives to offer them.
To the extent that policy is based on cost/benefit analysis, the question is, "is the cost of recidivism and relapse and all the public health/public safety concomitants great enough to warrant an investment in an integrated model of treatment that culminates in community housing, instead of a treatment model where responsibility ends when the inmate/patient/client walks out the door?" One way or the other, though, if we are serious about ending chronic homelessness, we have to find a way of meaningfully closing that front door.
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Ellen commented
Low threshold, harm reduction housing is facing a reality in the system that has been otherwise denied. If people who are difficult for any reason are prohibited from housing then who will be living on our streets?
