Introduction To Housing First/Permanent Supportive Housing
What is Housing First?
Whether you’ve studied business, medicine, psychology, or some other discipline, you’ve likely learned about Maslow’s Hierarchy of Needs. Maslow’s Hierarchy, as demonstrated in this graphic, shows that people must satisfy basic physiological needs—like breathing, eating, drinking, excreting, sleeping, and having stable housing —before they can successfully attend to successively higher needs.
Since this theory’s publication in 1943, it illuminated our understanding of human motivation, performance, and capability, immeasurably impacting psychology, psychiatry, health care, business, education, social work, and numerous other fields.
Unfortunately, traditional approaches to homelessness often fly in the face of what we know, expecting or requiring people who are experiencing the trauma of homelessness to accept offers of service or treatment without also offering a stable place to live. Not surprisingly, our traditional approaches are often unsuccessful. Housing First is an exception.
Housing First is a homelessness intervention that prioritizes providing permanent housing to people experiencing homelessness, ending their homelessness and serving as a platform from which they can improve their quality of life. This pragmatic approach reflects the reality that people need basic necessities like food, sleep, and a stable place to live before attending to any secondary issues, such as getting a job, budgeting properly, or attending to substance use issues. Housing First also reflects evidence that allowing residents to exercise choice in housing selection and supportive service participation is key to making them more successful in remaining housed and improving their life.
How is Housing First different from other approaches?
Housing First does not require people experiencing homelessness to address the all of their problems including behavioral health problems or to graduate through a series of services programs before they can access housing. Housing First does not mandate participation in services either before obtaining housing or in order to retain housing. The Housing First approach views housing as the foundation for life improvement and enables access to permanent housing without prerequisites or conditions beyond those of a typical renter. Supportive services are offered to help people with housing stability and individual well-being, but participation is not required: services are proven to be more effective when the recipient chooses to engage. Other approaches make such requirements for a person to obtain and retain housing; these approaches are far less effective.
What is permanent supportive housing?
Supportive housing is an evidence-based housing intervention that combines non-time-limited affordable housing assistance with wrap-around supportive services for people experiencing homelessness, as well as other people with disabilities.
Research has proven that supportive housing is a cost-effective solution to homelessness, particularly for people experiencing chronic homelessness.
Studies consistently show that supportive housing not only resolves homelessness and increases housing stability, but also improves health and lowers public costs by reducing the use of publicly-funded crisis services, including shelters, hospitals, psychiatric centers, jails, and prisons. For more information on these studies, please see the “Housing First Evidence” document.
The following is a non-exhaustive sampling of introductory sources that provide basic orientation to Housing First and Permanent Supportive Housing programs, including videos, news articles, and links to other resources.
Videos
A fast breakdown of the challenges of homelessness and a sensible approach for finding our way out of it. Last Week Tonight with John Oliver.
Probably the most popular (and most humorous) explanation of Housing First ever filmed: "The Homeless Homed" on The Daily Show with Jon Stewat, by Hasan Minhaj.
Robin's story about how she lost her son and was drinking herself to death, until DESC's 1811 Eastlake — a Housing First building — saved her life. As told to the The Moth, the popular collector of true stories told live.
How Housing First saved Lanny, a veteran living on the street in Seattle. From the incredible collection of stories gathered by Invisible People/Mark Horvath. Includes a talk with Housing First pioneer Dr. Sam Tsemberis.
"It's not wet housing — it's just housing." Another story from Invisible People's Mark Horvath, who talks to Third Door member Daniel Malone about DESC's pioneering work.
Recent News Articles
Urban.org (August 2021)
https://www.urban.org/features/housing-first-breaks-homelessness-jail-cycle
● Results from Denver’s 5-Year supportive housing program.
● Residents of permanent supportive housing used less emergency services, stayed housed, consumed less medication, spent less time in jail, and experienced fewer contacts with law enforcement. Half the cost of the program was offset by savings in other areas.
New York Times (June 2018)
https://www.nytimes.com/2018/06/05/opinion/homelessness-built-for-zero.html
● Overviews Housing First/Permanent Supportive Housing efforts of one national coalition through Community Solutions.
● “Over the past three years, nine communities in the United States have reached a rigorous standard known as “functional zero” for either veteran or chronic homelessness — a standard that indicates that homelessness is rare and much briefer than in the past for their populations — and 37 others have accomplished measurable reductions toward that goal.”
Wired (June 2018)
https://www.wired.com/story/big-tech-isnt-the-problem-with-homelessness-its-all-of-us/
● Looks at homelessness on the West Coast and in particular the Bay Area.
● Touches on Permanent Supportive Housing and Housing First; concludes that more housing in cities and neighborhoods is needed.
● Briefly touches on some partnerships between large corporations and nonprofit providers, including Cisco and Kaiser Permanente.
Guardian (July 2017)
● Feature of one UK man’s journey through homelessness and the value of Housing First and Supportive Housing models.
Famous, Paradigmatic Article About the Costs of Chronic Homelessness
New Yorker (Feb. 13, 2006) Million Dollar Murray by Malcolm Gladwell
http://dpbh.nv.gov/uploadedFiles/A%20MillionDollarMurray.pdf
Posts from the Benioff Homeless and Housing Initiative