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Understanding Homelessness: From Memoir to Pathways Home (May 2014): Pathways Out of Homelessness

By Irene Glasser and Eric Hirsch

Pathways Out of Homelessness

The causes of homelessness are two-fold: the inability of the private housing market to provide housing to low-income people and the failure of local, state, and federal governments to compensate for this failure by providing publicly subsidized housing alternatives.  Those seeking solutions to homelessness must therefore start with understanding housing policy.  One of the best recent analyses in this area is A Right to Housing: Foundation for a New Social Agenda, edited by Rachel Bratt, Michael Stone, and Chester Hartman.  This collection covers a broad range of housing-policy issues, including affordability, segregation and discrimination, finance, federal housing subsidies, housing organizing, and community development.  It also provides a history of policies designed to end homelessness.  The book argues that all Americans have a right to decent, safe, affordable housing.

The Housing First project, which was pioneered in New York City, is a recent model for housing homeless individuals who also suffer from mental illness and substance abuse.  The concept is an implied contrast to “treatment first,” in which the homeless individual moves through a continuum from shelter, to transitional program, to supportive housing that may or may not be permanent.  In the treatment-first model, the individual needs to demonstrate his/her “housing readiness” by accepting mental health treatment and/or substance abuse treatment based on abstinence.  Housing First challenged this order and suggested that people could be provided with housing directly from the streets and shelters, with services offered but not mandated in order for them to keep the housing.  The individual would have to follow the requirements of the lease as any other renter does.

An excellent primer on the Housing First model is Sam Tsemberis’s Housing First: The Pathways Model to End Homelessness for People with Mental Illness and Addiction, which describes the model that Tsemberis helped develop.  The book also discusses assertive community treatment (ACT), which is a team approach to supporting people with severe mental illness in the community.

Another book on homeless policy solutions is How to House the Homeless, edited by Ingrid Gould Ellen and Brendan O’Flaherty.  This book covers exit from homelessness, homeless prevention, mental health policy, housing-first approaches, and broader housing policy approaches that could end homelessness.  The book includes an excellent chapter by Sam Tsemberis, “Housing First: Ending Homelessness, Promoting Recovery, and Reducing Costs,” which presents the research evidence of the efficacy of the housing first model regarding improved mental health, improved housing stability, and reduced costs when housing first is compared to shelter living.

Works Cited