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Continuum of Care: What is Housing First and why is it important?

By Heather Hogue - | Oct 1, 2022

Sammy Jo Hester, Daily Herald file photo

Stephanie Willmore passes out posters showing those in need where to find help on Wednesday, Feb. 17, 2016. Willmore helps manage the Housing First Fund that Provo City raised in 2015 to help people with expenses moving from homelessness to housing.

In Utah, we have a commitment to ending chronic homelessness utilizing something called the Housing First model. There are a lot of misconceptions about what the Housing First model is and how it works.

The Housing First model utilizes evidence-based research patterned from Maslow’s hierarchy of needs. Abraham Maslow, a psychologist, created a model by which behavioral changes are possible. His model is widely used in psychology and human development today. In this model, he posits that in order for a human being to be motivated to change behavior, he must first have basic physiological and safety needs met. These needs include food, water, warmth, rest, security, clothes, and shelter.

Housing First is not free housing for every individual experiencing homelessness

An important detail to note is that Housing First is the best-practice model for ending chronic homelessness. It is not a panacea to end all types of homelessness. Chronic homelessness is unique in that individuals experiencing this type of homelessness typically die before the age of 50. People who are chronically homeless have been homeless for more than 12 months and have a diagnosed disabling condition. These are individuals who, due to disability, cannot pull themselves up by their bootstraps. These are individuals who will need support for a lengthy amount of time. They are more likely to be victims of crime on the street, more likely to not be able to manage medications, and more likely to die due to exposure or illness.

Housing is not a reward for good behavior

In a Housing First model, housing is not a reward. It is a compassionate, preventative measure designed to keep the most vulnerable from suffering or dying on our streets. In social work, we work with people who are in crisis. We work with people every day who do not have these basic physiological and safety needs met.

We also work with people who have significant barriers in their lives that often go unaddressed while they remain in crisis mode, unsure where their next meal, water, shower, rest, or shelter is going to come from. These barriers are sometimes things that a person did not choose — such as severe mental illness or a history of abuse.

Sometimes these barriers are the results of choices — such as substance use. In some housing models, an individual experiencing homelessness must overcome these barriers before being allowed into housing projects. Can you imagine taking daily medication for mental illness when you don’t know where your next meal is coming from?

Can you imagine going through a detox process from drugs or alcohol while sleeping under a bridge? In this outdated model of addressing barriers before addressing basic needs, individuals are set up to fail. It also misses community compassion for those who are suffering.

Housing first does not prevent individuals from taking accountability

One of the biggest misconceptions about the Housing First model is that it prevents individuals experiencing homelessness from taking accountability in their lives. Housing First is not a handout — it is the belief that housing is a human right and each human being has intrinsic worth. It requires a tremendous amount of support and work from the individual being housed, the case managers who provide services to address the barriers that led to homelessness, and the community.

Any time that a community is dealing with homelessness, there is a significant investment regardless of the sheltering and housing solutions that they choose. Housing First channels that investment into data-proven models that provide compassionate, humane, and practical solutions for ending chronic homelessness, rather than pushing the problem down the road for later consideration.

Chronically homeless individuals who enter Housing First programs in Utah County have an 87% success rate of maintaining their housing at a 12 month mark by utilizing the supports that are in place. These supports include case managers, nurses, doctors, medical providers, therapists, vocational therapists, faith-based groups and many others.

We have seen in Utah through direct data, that chronically homeless individuals placed in Housing First projects work to address their barriers once they are in a place of safety and security.

Housing First is a compassionate and fiscally responsible focus

Another misconception about Housing First is that it’s an expensive use of tax dollars. A recent nationwide study shows that the average savings on emergency services is $31,545 per person housed in a Housing First program over the course of two years. Another study showed that a Housing First program could cost up to $23,000 less per individual annually than a shelter program. The Housing First model for Utah is a win-win. Not only are we able to provide humanity, dignity and compassion to the “least of these” but we’re also saving money by doing the right thing for our most vulnerable.

What does the evidence say?

From 2009 through 2019, veteran homelessness nationwide was decreased by 50% by utilizing a Housing First model. From 2007 through 2019, chronic homelessness was decreased by 20% nationwide by utilizing a Housing First model. In Utah County, we have reduced chronic homelessness by 50% in the last three years utilizing a Housing First model. We have the data to prove it.

Housing First is the national standard for a reason — it provides a combination of humane compassion to those in our community who are suffering, data-driven proof that these individuals remain housed and address their barriers, and fiscally responsible uses of tax and community dollars.

Heather Hogue is the Mountainland Continuum of Care Project Coordinator.

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