The homeless crisis in America
is worsening again. The COVID pandemic caused a surge in
housing costs and a rise in unemployment, leaving nearly
600,000 Americans unhoused in 2020. You have to shut down a
piece of our own humanity,to be able to walk past another human
being that is in such difficult situation. Being homeless, your
days are anywhere spent from where I'm going to lay my head
at tonight, where I'm going to get my next bite of food from.
And what people don't typically realize when they walk past a
person who is homeless is that this person is costing taxpayers
a lot of money. Cities across America are spending more than
ever to combat the crisis. In 2019, New York spent a record
breaking $3 billion to support its homeless population.
California is also expected to break its record, allocating
$4.8 billion of its budget to the same issue over the next two
years. And areas like that just don't seem to be getting any
better, despite the fact that every politician claims that
this is a top priority of theirs and the budgets keep going up.
Overall, homelessness in America has only improved 10% compared
to 2007. It's even worse for certain subgroups such as
individual homelessness, which dropped only a percent in the
same period. On the contrary, 2020 saw a 30% increase in the
unsheltered homeless, erasing over half a decade of work since
its dramatic rise in 2015. Right now, we are trending in the
wrong direction. So the state of homelessness right now is pretty
tenuous. And there are some small increases that are taking
place across the board. So how is the US addressing the
homeless crisis and can it ever be solved? Homelessness is known
to prey on some of the most vulnerable populations in
America. In 2020, more than 120,000 of those who were
unhoused had severe mental disorders, while more than
98,000 suffered from chronic substance abuse. In response,
the US has long relied on a housing ready approach to
homelessness, where those who are unhoused had to meet
specific requirements such as sobriety or completion of
treatment in order to qualify for a home. That was until this
man, Dr. Sam Tsemberis pioneered the Housing First Initiative. At
some point, myself and the people we're working with
realized that really insisting that people change, get sober,
take medication, get your life together in order to earn or be
awarded housing was not working. You know, people couldn't.
People were on the street. They couldn't stay sober. They
couldn't. They were not interested in medication. They
were interested in being somewhere safe and secure. The
Housing First Initiative follows two tenets. First, the most
effective solution to homelessness is permanent
housing. And second, all housing for the homeless should be
provided immediately, without any preconditions. Putting
people in Housing First, which is what they were desperate to
do, calms that survival thing and people are safe, secure, and
then they're saying to us, "I need more help here." So then
rather than having it us pushing or coercing people to get the
treatment, people get housing and then they want the
treatment. Under the George W. Bush administration, the Housing
First Initiative gained the spotlight as the key to ending
homelessness. Related programs soon received billions of
dollars in support from government agencies, such as the
United States Interagency Council on Homelessness and the
Department of Housing and Urban Development. Housing First's
rise really begins in the 90s, especially in the late 90s. And
I think it really gained traction as the philosophy that
should dominate these dedicated homeless services, agencies and
programs. And so we are in a situation now where you meet
people who work at HUD on homelessness or in major
agencies in California and New York, it's relatively rare to
not find them be committed to Housing First. If you really
look at it, this year, the federal government will give
about 2.7 billion to housing and service providers and housing in
cities across the country. For decades, the Housing First
policy has successfully housed individuals that need it the
most. Shannon McGhee is one of them. A nonprofit organization
Pathways to Housing helped Shannon move into his supportive
housing in 2020 after staying unhoused for four years. It
started in 2008. Losing my mom to lung cancer then not having a
strong support system to support me throughout the process, I
ended up losing the family house. They sold the family
house and I didn't have anywhere to go. And that started the
stint of being homeless. From being housed to now being
unhoused, the shelter for me was very hard to... it was a
cultural shock. It was very hard to adjust to the environment,
the living standards. I finally got connected to the Veteran
Affairs and a social worker with them connected me to pathways.
And since being connected to Pathways, everything got turned
around 360 degrees. I'm housed. I'm looking for gainful
employment. I'm in school now. So without having Pathways there
to kind of be that support and that coach to guide me into
housing, I wouldn't be where I'm at now. A study in 2004
discovered that when individuals were provided with stable,
affordable housing with services under their control, 79%
remained stably housed at the end of six months. Another study
in 2000 found it to be more effective than traditional
programs. 88% of the participants in housing first
programs remain housed compared to just 47% in the city's
residential treatment program. And it's not just in the United
States, a similar study conducted in Canada revealed
similar results, showing participants of housing first
programs obtaining and retaining housing at a much higher rate.
The evidence has shown that by getting people housed
immediately and eliminating the chaos of homelessness, created a
space where people would be more successful. I don't have to be
in that environment anymore, where I'm subjected to using
drugs or to doing things for money that I didn't want to do.
I can change my focus. Now I can say, "Hey, you are housed. How
can we get you to your next level of finding gainful
employment? What steps can we work on now?" Housing first not
only supports those in need with housing, but the assistance they
need to get back on their feet again. It's Housing First, not
Housing Only. Because there are very rich services, like there's
a team of people really, whether they're social workers, or
social workers and nurses and psychiatrists, people with lived
experience, it's like a support services team. And then the team
says to you, "How can I help you?" They provide wraparound
support for me. So if I need assistance in getting things
such as my ID or birth certificate, they help with
that, they support me through that process. If I need to make
appointments at the VA hospital, they support me through that
process. What any and everything that I pretty much need done, I
have support through pathways to housing. Supporters of Housing
First also argue that it's cost efficient. A comprehensive study
in 2015 concluded that shelter and emergency department costs
decreased with housing first policies. What people don't
typically realize when they walk past a person who is homeless is
that this person is costing taxpayers a lot of money. People
get very sick when they're homeless, they have to be taken
to the hospital. Sometimes they steal food, they have no money,
they get arrested, court costs, police time, jail time. When you
tally up the annual costs of people who are homeless and very
vulnerable, it turns out, we're actually spending sometimes
$50,000 a year or $100,000 a year in some cases, and the
person is still homeless. But perhaps the biggest advantage to
Housing First is the improvement in the quality of life it
provides. Being homeless and being a parent, I kind of didn't
want my child to see me in that situation. So it kind of put a
wedge in our relationship for a little bit. But once I got house
now, I could provide a space where we can interact together,
and she wouldn't have to be subjected to that lifestyle.
Being able to have my housing first, I know that I'm in
control of my environment now. What happens here, it's all
about what I create. But housing first also comes with its own
set of criticisms. Experts like Stephen Eide from the Manhattan
Institute believe that housing first hasn't shown any real
result. When the public is told that this particular policy is
going to end homelessness, what they're expecting is that
they're going to see fewer homeless people around. That
homelessness numbers will significantly drop as a result
of the implementation of this policy. And I don't think that
we've seen that in the case of housing first. Critics also
point out that Housing First might not be as cost effective
as it looks. Research in 2015 discovered that while permanent
housing intervention was more successful in achieving housing
stability. It was also more expensive than temporary
housing. A 2018 survey by the National Academy of Sciences,
Engineering and medicine also concluded that there is no
published evidence to prove that permanent supportive housing
improves health outcomes or reduces healthcare costs. No
government that I'm aware of has saved money by investing in
homeless services through a housing first approach. You can
talk about potential cost offsets. That is, if you invest
a million dollars in Housing First, that will trim some of
the budgets and some other service systems, you're not
going to actually save money, reduce the cost of government to
the point where you could be talking about, let's say, a tax
reduction as a result of investing in Housing First. So I
think that there has been some misleading of the public with
respect to that concern. There's also the question of whether the
need for housing actually triumphs over the need for
treatment. If we want more from people, we
have to be talking about far more than just housing. But in
the housing first era, there's a way in which housing just
continues to suck all the air out of the room and all we keep
coming back to is, are we doing enough to expand the stock of
subsidized housing to help the homeless. Meanwhile, Dr.
Tsemberis argues that the criticisms towards Housing First
are designed to blame those who are unhoused rather than to
assist them. They want to go back to treatment and sobriety
first, you know, and then housing maybe. Because that
changes the entire narrative back to homelessness is the
fault of the individual. You know, anybody who fails in a
capitalist society like ours, you know, with no taxation and
no government is only because it's their fault. Housing First
hit its first bump under the Trump administration that sought
to replace it with programs focused more on treatment and
sobriety. They were talking about housing fourth as a
policy. Housing fourth, okay? And that was very deliberate
because it's Housing First and they were like, "No, housing
fourth." You know, treatment, sobriety, employment and housing
maybe. It was a very, very targeted attack. The Biden
administration, however, showed a return to Housing First. The
American Rescue Plan Act of 2021 included 70,000 emergency
housing vouchers and a staggering $350 billion in state
and local fiscal recovery funds in an effort to aid homelessness
and housing instability. The Biden administration absolutely
support the Housing First approach. They feel that in a
society as ours that housing should be a right and not a
privilege, that every American deserves a safe and stable place
to call home. So they are, you know, providing the resources
and the support. Critics of Housing First believe that
lawmakers need to be giving more alternative policies a chance
and approach the homeless crisis in a more structured manner. We
need to have them invest in a broad range of programs,
residential programs that can benefit the homeless population
in all its variety, because the homeless population is very
diverse. Within that framework, Housing First like programs
would have a place, low barrier programs would have a place, but
they would not rule the roost in the way that they currently do.
Those in support of Housing First believe that more
resources and support from the government are needed to truly
end the crisis once and for all. Well, if you don't have the
resources in the program to deliver a place to live, then
your listening and your promise to them is hollow. You need to
have the listening, let's call that the policy, which is you
know, housing first and person first. But then you need the
resources behind the policy: apartments, subsidy, support
services, in order to actually make the package viable. We're
nowhere near where we need to be in investment, either of
building public housing or affordable housing, having the
capacity to address the homeless problem, we're nowhere near.
What's important is that homelessness is a crisis that
can be solved as long as there is enough attention, care and
resources to support the cause. It's just very disgraceful that
in a country that's so blessed, so wealthy, that has done some
things right in the past if not everything, that we can't do
something to fix this problem or at least make it smaller,
ameliorate it. So there's a lot of good work going on. So that's
what gives me hope that we can actually turn the nighttime
stars into a daytime where we just turn up the lights enough
to really end it for all because the other thing that gives me
hope is we know how to do it. We have the cure. We have good
examples of how it's done. We need to take it to scale.
