In summary

A more effective approach to homelessness is to provide housing that is accompanied by active, ongoing support and treatment.

By Sam Tsemberis, Los Angeles

Sam Tsemberis is founder and CEO of Pathways Housing First Institute.

Re “One man’s lonely journey through California’s plan to end homelessness”; California Divide, Jan. 17, 2022

The excellent report by Jackie Botts describes a long and painful 2-year journey of a veteran who goes from living in a tent under a highway, to a room in a hotel provided by Project Roomkey and, eventually, to a small apartment of his own in a building filled with other formerly homeless individuals.  

There is a homeless encampment outside of Fernando Maya’s building, and drugs and drug dealing are rampant inside and outside his building. To make matters worse, the program has little coordination among agencies responsible for managing the building and support services. There is no one consistent person there he trusts to turn to for his basic needs, whether practical, medical or emotional. Fernando is housed, yes, but he is also suffering and miserable. This article reveals the reasons people criticize such programs, but it is not truly a Housing First program. Housing “only” is not Housing First. 

What true Housing First programs do is to provide homes for individuals without requiring sobriety or treatment, and – the crucial element – provide robust support and treatment services that meet the needs of the person. Study after study has confirmed that such Housing First programs work far better than programs that require homeless people to be clean, sober and program compliant. Housing First programs deliver results by providing individuals with support by interdisciplinary teams like those of California’s Full-Service Partnership that have the clinical expertise to work with the client and provide services, whether medical, psychological or vocational.  

Repeatedly subjecting unhoused people to living conditions like Fernando’s will, more often than not, fail. And the failures of programs are now pushing policymakers to advocate for returning to a surefire recipe for failure, i.e., requiring treatment and sobriety before housing is “awarded” to an individual. This step backward will take us to a place where very few of these individuals will ever be housed or achieve independent, productive lives. 

A simpler and more effective approach is to provide housing that is accompanied by high levels of active, ongoing support and treatment that enable individuals to recover from their often frayed and wounded lives and, as in true Housing First programs, retain the stable housing and community integration we wish for them and they desire for themselves. 

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