The Case for Housing First

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Housing First actually helps people exit the cycle of homelessness. The only solution to homelessness, is to get people housed.

Housing First programs reduce homelessness, increase housing stability, and improve quality of life for people who are experiencing homelessness. Evidence from a systematic review shows Housing First programs more effectively reduce homelessness and improve housing stability for unhoused individuals. Housing First programs also lead to reduced hospitalization and use of emergency health departments by people experiencing homelessness. A 2021 study found that Housing First programs decreased homelessness by 88% and improved housing stability by 41%, compared to Treatment First programs. A recent study found that Housing First programs not only substantially reduced veteran homelessness, but also prevented a large increase in veteran homelessness. Both older and younger adults experiencing homelessness benefit from Housing First.

By recognizing an individual's inherent right to housing, the Housing First model is the ethical choice.

The Housing First model is rooted in humanitarian philosophies of dignity, empathy, and personal choice. It also respects an individual’s right to run their own lives without bureaucratic intervention. With Housing First, each person is offered a tailored approach – including access to stable, affordable housing, linked with voluntary services as needed. While this approach will be different for everyone, the goal is the same: to quickly end homelessness and provide individuals with the support they want and need to achieve housing stability.

Housing First increases health equity and improves health outcomes. 

While it may sound counterintuitive, studies have shown that by not mandating treatment and respecting the right to personal choice, the Housing First model is actually more effective at engaging clients in treatment. These studies have shown that Housing First participants are more likely than others to report reduced usage of alcohol, stimulants, and opiates.  One study published earlier this year, found that within the two-year study period, people who received Housing First services had significantly more outpatient psychiatric visits, fewer ED visits, greater medication adherence, and greater use of other health care than people who were not engaged in housing first services. This corroborated an earlier 2015 study that found that Housing First programs are more effective at increasing outpatient service utilization, as well as outreach to and engagement of clients who are not appropriately served by the public mental health system. Critics’ fears about increased substance use and psychiatric symptoms have not been supported by research findings.

For Taxpayers, Housing First policies are cheaper than "treatment first" models and much cheaper than "letting it be".

Housing First can reduce healthcare and other costs. A systematic review found that the economic benefits exceed the intervention cost for Housing First programs in the U.S., with societal cost savings of $1.44 for every dollar invested. The economic benefit due to the intervention is the combined savings from healthcare, emergency housing, judicial services, welfare and disability costs, and benefits from increased employment. Studies also show that Housing First reduces hospital visits, admissions, and duration of hospital stays among homeless individuals, and overall public system spending is reduced by nearly as much as is spent on housing. The average cost savings to the public ranges from $900 to $29,400 per person per year after entry into a Housing First program.

Housing First works at AHCH.

At AHCH, we built our housing program around the Housing First model. We believe that housing is a human right and that it is an essential health care service. Without housing, individuals are exposed to unsafe and traumatizing conditions that seriously impact their health and impede any progress towards their personal goals. Therefore, we provide no-barrier housing navigation services to all who seek it. We also provide case management to support individuals in housing programs. 
This year, we supported 170 people in finding and maintaining their apartments. 84% of clients who participate in our Housing First programs have kept their housing for over 12 months and continue to work with our housing program. We also advocated for dedicated Medical Respite Housing vouchers, so that individuals who will stay in medical respite to rest and recover from illness will be able to exit into housing. But it’s not enough. We continue to strive to expand and advocate for equitable housing opportunities to prevent and reduce homelessness.

Resources and References:

Homelessness is unacceptable and solvable.
However, even with nearly 40 years of expertise serving this community, we know we can’t do it alone.

Thank you for walking beside us and supporting our mission. If you would like to support change, please consider making a gift towards health, hope, and housing today.

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