Housing First

There was an Op-Ed in today’s USA Today advocating the housing first approach with “chronic public inebriates” (CPIs).

I have no objection to housing first is they continue to try to facilitate recovery. I’m uncomfortable with programs that place NO contingencies on the housing. I think there ought to be some expectation of at least minimal particiation in treatment or recovery support services. If a program opts not to place those contingencies on housing, they ought to at least continuously encourage use of those services/resources–looking for windows of opportunity. Housing is not enough.

The reason many programs seem to wince at this suggestion seems to be philosophical. They believe that addiction doesn’t cause homelessness. Gentrification, racism, sexism, domestic violence, and other societal problems cause homelessness. That homelessness is not caused by individual factors, but community conditions. Therefore, to focus on their addiction is to blame the victim.

I also worry two other things. Financial considerations are important, but we shouldn’t reduce these decisions to accounting exercises. We also need to be careful that these programs don’t send messages to clients and the community that CPIs are hopeless and fan the flames of stigma.

Other posts on housing first here.