'Housing First' - The Imaginary Panacea to the Problem of Homeless Veterans

Homelessness is not simply a person without a place to sleep at night.

Homelessness is the end result of a whole series of events that result in diminished capacity, loss of self-determination, most often loss of employment, loss of family, isolation, poverty, and lack of self-esteem, all leading to inability to pay for housing.

Walking out of a home for the last time without knowing where to lay your head that night is the final straw in a long line of trials that are brought on by life's cruel circumstances, some prompted by bad habits and self-deception, others the result of substance abuse or mental illness, lack of opportunity or lack of education. There is no one single factor that if solved, will end homelessness as we know it.

Since the mid-eighties our society has been cognizant of a growing disparity in this country that has created a dispossessed minority that has been pushed off the edge of society's table and into homelessness.

To the surprise of some, veterans have been part of this unfortunate minority; surprise because these men and women are part of an American military alternately described as "warriors" and "heroes."

How could these men and women, whose sacrifices we recognize this Veterans Day along with those of their less desperate comrades, have fallen so far?

Becoming a soldier, sailor, airmen or Marine does not exempt anyone from the vicissitudes of life, or the weakness of the human spirit, or the inequity in our market driven system. Certainly what men and women gain from their military experience can equip them with the skills and experience to become leaders in their communities, but it is not a free pass that allows them to sidestep the realities of living a life.

In the late eighties the homeless veteran service provider community that I am part of began educating the public, and the government, about the increasing numbers of homeless veterans among the ranks of the homeless in an effort to bring more attention and government funding to the cause. By that time, the number of homeless veterans had reached upwards of a quarter of a million -- virtual regiments of veterans living on the streets and in the homeless shelters of the richest nation on earth.

As a result of persistent and passionate advocacy, the Veterans Administration began taking steps to address this issue, working with hundreds of community non-profits to create a system of 15,000 transitional housing beds that offer a comprehensive array of services that include employment assistance, mental health counseling, substance abuse treatment, case management and permanent housing referrals. Over the past 20 years, this system has been hugely successful, reducing homelessness among veterans by three quarters.

Like any large system -- especially one in which a huge bureaucracy like the VA is a partner -- there are different opinions on how to attack this problem. Because it provided a significant proportion of the funding for these programs, the VA felt it had the responsibility, or the right, to determine how these funds should be spent. The community based non-profits, much more nimble, collaborative, and responsive to evolving issues, wanted to use these funds more flexibly, leveraging them with other funding sources that wanted "innovative" ideas on how to reduce the homeless veteran's population. There has always been a tension (healthy or unhealthy, depending on who you talk to) between the big government bureaucracy and the feisty community based providers.

Counting the number of homeless has always been part science, part guesswork, and part politics, but it appears that the number of homeless veterans in this country has been reduced to about 60,000. But 20 years is a long time to work on solving one problem and many within congress are asking why it is taking so long. They want an answer to this persistent problem.

VA Secretary Eric Shinseki focused new attention on the problem in 2009 when he announced that the Obama administration wanted to end homeless among veterans by 2015. This resulted in increased funding, especially funding to help veterans find permanent housing, which is the final step out of homelessness.

The concept of "housing first" gained favor in the capitol and among many providers. "Housing First" is a very specific model, designed to help the many chronically homeless who are persistently mentally ill and are resistant to strict transitional housing programs. These homeless are housed first, and then offered an array of optional services in the attempt to improve their quality of life. Proponents say that it is more humane to offer them housing, even if they continue the destructive habits that led to their homelessness. Detractors say that this is simply warehousing veterans, that rehabilitation is critical to their well-being and more emphasis should be put on the support services that can lead to an improvement to their quality of life.

The problem is that the "Housing First" movement gained so much favor, that many have begun to tout it as the only solution to homelessness of all stripes, mentally ill or not, employed or not. This predominant message has brought many to the conclusion that housing is the solution to homelessness; the panacea congress has been seeking.

But if housing were the solution, given the money, we could simply build our way out of the problem. That would be ignoring two crucial aspects of the problem. First, it ignores that long line of events which led to their homelessness. Addressing those issues is how we heal the wounds that caused their homelessness, and is how we empower people with the skills to lift themselves out of homelessness. To hand everyone who is homeless a house not only disempowers them, it will break the national budget.

And secondly, how about all the people who are falling into homelessness every year, which is approximately two and a half times the number of people who are homeless on any one night? That stream of people has been subjected to a life story that a roof over their heads will not completely solve.

As is often the case, the answer to a problem of this complexity is multifaceted and there is no easy fix. A solution will force us to not only look at the homeless and the many needs they have, but at ourselves and our society and the way we live. There is less "community" in our large metropolitan areas, and more callousness; more isolation, and more selfishness. The haves and have-nots are farther and farther apart.

The solution will demand that we deploy a robust range of prevention and early intervention services that will slow the flow of people sliding off the edge. This will not be cheap, but it is considerably less expensive, and more humane, then waiting for people's lives to unravel and end up on the street.