Housing First

Housing First is a philosophy and an intervention. As a philosophy (lower case “h”, lower case “f”) it is the belief that all people should be housed prior to working on anything else. This philosophy can permeate every individual program and the collective system to focus on moving people into housing as quickly as possible, then providing the appropriate level of support to ensure long term housing stability. This philosophy also lowers barriers to program access, prioritizes people that have the highest barriers (highest “acuity level”) to stable housing first, and believes that everyone is housing ready.

As an intervention (capital “H”, capital “F”) it is the delivery of direct supports through an Assertive Community Treatment Team (the highest level of Mental Health Service available short of hospitalization) or Intensive Case Management (specifically trained case managers following a step by step curriculum focused on long term housing stability), intentionally working with those people that have most acute needs first. Additionally, Housing First is based on the simple idea that a person experiencing homelessness will be most successful when able to make his or her own informed decisions about housing and health. It is client centered, practices harm reduction, works with the individual or family in their natural settings (not in the office), and every interaction revolves around how it will help maintain housing.

The Housing First model addresses chronic homelessness by providing housing and specialized case management focused on housing stability. This model is proven to be more effective than traditional “housing readiness” approaches requiring individuals to meet certain goals, such as achieving sobriety, entering treatment, or completing training, prior to accessing housing.

Housing First is efficient. This model rehouses as many people as possible with the available funding. The key to achieving efficiency is providing “just enough” support to each homeless person in order to become and stay housed. For some, “just enough” may be very little; after short-term help to get into housing, they are able to resolve the rest of their issues by themselves. But for others it may be quite a lot. But is has successfully demonstrated all across the country to be less expensive than the costs of not providing the service.

Research shows that Housing First yields higher housing retention rates, lower returns to homelessness, and significantly reduces the use of crisis services and institutions. Jurisdictions that implement Housing First–such as New Orleans, Phoenix, Houston, and communities in Utah–have all seen large reductions in chronically homeless populations (US Interagency Council on Homelessness).

Guilford County has developed a Housing First team that drastically reduced the number of Chronically Homeless individuals in the community from 107 in 2014 to 36 in 2016 (2016 Point In Time Count). This partnership between the Salvation Army Greensboro, Psychotherapeutic Services, Inc. and the Servant Center’s SOAR program (Disability Assistance) have changed the landscape of long term homelessness in this community.