Housing First: For Those Who Slip Through the Cracks

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Image courtesy of Invisiblepeople.tv
 

In my previous article I tackled the topic of Universal Basic Income as a form of aid for the homeless population and found numerous benefits associated with implementing this strategy. While it would provide much needed relief for those experiencing homelessness, treating it as the sole solution would leave the burden of acquiring housing solely on homeless individuals. This would be especially difficult for those experiencing chronic homelessness due to the fact that this demographic contains some of the most stigmatized and vulnerable individuals (Council For the Homeless, 2019). 

Typically, those experiencing chronic homelessness struggle with mental health issues and/or substance use disorders — characteristics that commonly disqualify individuals from participating in UBI studies. The exclusion of substance users stems from concern over the participants not using their income for basic necessities or for the potential to negatively skew results. While it's possible that UBI may make a difference in these individuals' lives if given the chance, it could fail to address issues such as being barred from renting due to one's background, ongoing mental health issues, or substance use disorder. Where does that leave them for finding help?

This is where housing first comes in, a solution proposed to offer homeless individuals secure and permanent housing. Housing first can be defined through its key principles, which according to Council For the Homeless, are:

  • Homelessness is first and foremost a housing problem and should be treated as such
  • Housing is a basic human right, NOT a reward for success
  • Issues associated with what caused homelessness are best solved with housing

With these principles in mind, I imagine it would be far easier to meaningfully address substance use disorders and/or mental health issues within a stable environment rather than the high stress environment associated with homelessness. Maladaptive substance use is linked with stress and mental health disorders whereas stress can even cause the onset of mental health disorders. Expecting those on the streets to somehow address these issues before being granted housing is, in my opinion, quite backwards (and cruel).

Housing first as a strategy also highlights what homeless people believe would best help them. According to Housing Matters, there exists the misconception that homeless people prefer living on the streets when, in reality, the opposite is true. Seattle surveyed 892 people experiencing homelessness in the city and found that 92.9% would move into indoor living spaces if they were available. When asked which services would help them off the streets, the majority answered that rent assistance (68.1%) and/or affordable housing (64.1%) would be desirable (Ferrante, 2024).

Now, how well does a housing first approach work? Several studies have found that it actually works quite well. According to Housing Matters, permanent housing has reduced reliance on emergency services and increased access to community-based care (Ferrante, 2024). Furthermore, permanent housing programs have made their participants more likely to access housing and remained housed compared to usual assistance programs. The Denver Supportive Housing Social Impact Bond Initiative (Denver SIB) found that for the first year, people in the treatment group for their program remained housed for 172 days on average while the control group was housed for 19 days on average. Furthermore, 80% of people in the treatment group remained housed after 3 years compared to the control group's 18% (Ferrante, 2024). A housing first program taking place in Boston Massachusetts found that 90% of their participants remained housed — with the added bonus of saving $10,000/year in health and safety costs per participant (Council For The Homeless, 2019).

Since both UBI and Housing First have positive results, which strategy should we settle on? That's a bit of a trick question. In the case of UBI, I already highlighted the potential shortcomings in the fact that it doesn't inherently remove the structural barriers associated with acquiring housing. For Housing First, some potential issues may arise from lack of resources. Coachella Valley Association of Governments' Homeless Committee (CVAG) were short of reaching their goal to permanently house 65 individuals, with only 50 of the 175 individuals they had targeted for the program being given secured housing. Rising costs of rent were one of the cited challenges that got in the way of this goal, along with limited permanent housing vouchers and limited housing units (White, 2025).

With all this in mind, implementing multiple strategies may be key to meaningfully addressing homelessness as a whole. It's possible that Housing First could act as the foundational strategy with UBI working in tandem as a fail-safe and/or preventative measure. Since we can't expect one single strategy to be the solution for a problem with many sources, adopting a multifaceted approach that addresses a variety of scenarios may be our best bet to end homelessness once and for all.

Further Reading

Housing first toolkit - strategies organizations can adopt: https://endhomelessness.org/resource/organizational-change-adopting-a-housing-first-approach/

References

Ferrante, Dana. “Housing First Is Still the Best Approach to Ending Homelessness.” Housing Matters, Urban Institute, 14 Feb. 2024, https://housingmatters.urban.org/feature/housing-first-still-best-approach-ending-homelessness.

“Chronic Homelessness and Housing First: Council for the Homeless.” Council For The Homeless, 31 Jan. 2019, www.councilforthehomeless.org/chronic-homelessness/.

Sherrel, Zia. “Stress Disorders: ASD, PTSD, and More.” Medical News Today, MediLexicon International, 29 Aug. 2024, www.medicalnewstoday.com/articles/stress-disorders.

Sinha, Rajita. “Chronic Stress, Drug Use, and Vulnerability to Addiction.” Annals of the New York Academy of Sciences, vol. 1141, Oct. 2008, pp. 105–30. PubMed Central, https://doi.org/10.1196/annals.1441.030.

White, Cynthia. “CVAG Staff Reports on ‘CV Housing First’ Homeless Assistance Program.” KESQ, 20 Feb. 2025, https://kesq.com/news/2025/02/19/cvag-staff-reports-on-cv-housing-first-homeless-assistance-program/.

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