This post first appeared on StreetSense.org.
Homelessness has been with us since Biblical times when, we were told, "the poor you shall always have with you." For too long, we have accepted that as a prediction that we would never solve this intractable social problem, especially for people whose homelessness is chronic -- that is, long-term and accompanied by a mental health or substance abuse disorder (or both).
For much of the last four decades, America decided to "manage" chronic homelessness through the use of shelters, transitional housing and punitive measures to require homeless folks to comply with programmatic requirements. Unless they presented themselves clean and sober, took psychotropic medications and complied with strict behavioral contracts, many homeless programs turned people away. As the evidence has shown us--and as anyone who walks down the street of a major city can tell you--this approach has not been very successful.
But the arrival of Pathways to Housing DC in 2004 signaled a dramatic turnaround. By developing personal relationships with people living on the streets, and working on the root causes of their homelessness, Pathways DC, slowly but surely, ended chronic homelessness for more than 650 people. Its not-so-secret formula is -- with support from the District's housing voucher and Medicaid programs -- to offer permanent supportive housing, together with voluntary wraparound services that have been individually designed for each person.
There are no prerequisites or treatment requirements; quite literally, Pathways DC offers the housing first, knowing that a stable home will allow a person to begin to address mental health, addiction, and other challenges. Each program participant is assigned a team of professionals and formerly homeless support workers who are available 24 hours a day, seven days a week, to provide whatever support is needed to allow clients to succeed. Peer-reviewed studies -- and Pathways DC's own lived experience -- show that this approach prevents a return to homelessness for nine out of ten clients. A success rate twice as good as the old-fashioned approach.
The success of Pathways DC's "housing first" approach is evident in at least two ways. Over the past decade, it has moved individuals that some social service agencies label as "the hardest-to-serve" homeless people in the District into their own apartments, under individual leases, in all eight wards of the City. Pathways DC also provides street outreach services that have been successful in engaging and housing people who have been on the streets for decades, seemingly unreachable by other providers. Perhaps more importantly, Pathways DC was the catalyst for a revolutionary change in District policy and funding decisions, which are unequivocally focused on the housing first approach. Most homeless services providers in DC now proudly identify themselves as supporters of the philosophy, and have the positive outcomes to show for it.
Because it works, the housing first approach boasts supporters across the political spectrum, and draws strong support from the District's business community. A concerted effort to keep an individual housed and supported in the community makes sense because it costs significantly less than neglecting those needs and having that person end up in an emergency room, jail cell, psychiatric hospital or homeless shelter (the costs of which are borne by taxpayers). Recent support from the Bowser administration has helped Pathways DC double its street outreach capacity and to act as a lead agency in a new coordinated entry system designed to serve homeless people more quickly and more effectively.
I've been a District resident and civil rights lawyer for 30 years, with much of my career devoted to poverty, disability and discrimination issues. And I serve as Chair of the Pathways to Housing DC Board of Directors. No single effort in which I have been involved -- in litigation or policy advocacy -- has been as successful as the quiet revolution wrought by Pathways DC and the District government over the past decade.
Not so long ago, skeptics and insiders labeled the idea of providing housing and services to chronically homeless people a utopian idea, destined to failure. Now, we stand poised at the brink of ending chronic homelessness in the District of Columbia. We have gotten here by upending conventional notions about homeless people, deploying programs that work, and because of stalwart support from the District's elected officials. Just think of the other problems we could solve with this same commitment.