Housing First is a cornerstone of DESC philosophy because our experience, backed by research, shows it is most helpful and most cost-effective for people experiencing homelessness along with substance use disorder, mental illness, and other disabling conditions. Housing First doesn’t mean “housing only.” It means, “come inside, feel comfort, privacy, and support so you have the foundation you need to pursue your goals and reconnect to the life of the community.”
Many critics believe that housing must be earned through prior completion of treatment for substance use disorder, mental illness, or other conditions. But requiring treatment participation before housing simply prolongs suffering, allows medical and psychiatric conditions to worsen and produces more chaos on the street.
Our Housing First programs all ensure the provision of substance use disorder (SUD) treatment and psychiatric or other behavioral health care. Many of our clients are well-acquainted with SUD treatment and have attempted it many times. This treatment is more successful when people are permanently housed, safe, warm and fed. Studies show that regardless of a person’s clinical presentation, housing is essential to a life where one can recover from many difficulties.
People repeatedly try to get help, but need a home and active support
A DESC study documented an average of 16 prior treatment episodes for a group of people thought to have rejected help—people some would call “homeless by choice.” They wanted help; they sought treatment to get better; but despite repeated attempts, they couldn’t successfully complete treatment without the stability of a home and active supports from DESC staff.
For people to be successful at staying in housing, they must be paired with robust services—services that tenants choose to participate in on their own terms. We know that people deserve direct, personal care and can thrive when they get it.
Despite this, when DESC tenants experience crises, we increasingly hear critics blaming Housing First and claiming that this practice unduly stresses emergency services and wastes taxpayer dollars.
Treatment for substance use or mental health can take a long time to become truly effective. For people with substance addiction, across all sociodemographic groups, a single round of treatment rarely results in sustained abstinence from substances. And medications, talk therapy, and case management services are not always highly effective against the most debilitating psychiatric illnesses, such as schizophrenia. Add in the trauma experienced while living homeless, and treatment effectiveness can be even more elusive.
Crises can still happen, but they are greatly reduced
Given that these are complicated and relapsing conditions, we recognize that crises can still happen. But viewed in isolation, even high numbers of emergency responses to a program do not show the full picture of how the provided services benefit individuals and the whole community.
Far from being a wasteful strain on emergency services and budgets, a DESC Housing First study found that the program cut costs to crisis services in half, jail time nearly in half, and emergency medical services by 54%. Another study on a DESC housing project showed a 44% reduction in psychiatric hospitalizations. Those are amazing results and great improvements that we are proud of, even while we acknowledge that more can be done to address recurring and persistent problems.
DESC is committed to caring for the people who live at the periphery of society. When the most marginalized people are able to sign a lease and move in without the precondition of completing treatment, they have an opportunity for a better life, for themselves and for the community.