How do you stop the cycle of homelessness?

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How do you stop the cycle of homelessness?

Sian Griffiths reports on the Housing First movement. It is changing the solutions to long-term homelessness.


Someone sleeps on the street in the entrance of a church next door to Trump Tower. Housing First started in New York City in 1992. It has now all across North America and in other countries. © dpa picture alliance/Alamy Stock Photo

Twenty-five years ago Sam Tsemberis was running an emergency homeless project for a New York psychiatric hospital.

‘Our job was to interview people who were homeless and mentally ill and decide if they might hurt themselves. We had to call the police and take them in when they didn’t want this. It was very difficult.

‘We also saw a lot of people who didn’t need to be in hospital. They were not healthy and had been homeless for a long time.’

Tsemberis kept seeing the same people sleeping on the street.

‘We knew we needed to do something different.’

He began to ask homeless people what they wanted.

‘They said they needed a place to live. I wasn’t sure.’

Housing programmes then were only for people who did not take drugs or drink. ‘We thought that people on drugs and drink couldn’t manage their own housing.’

But these people couldn’t stop drinking, hated taking medication and didn’t want to try.

‘That’s when I started in the housing business,’ says Tsemberis.

He got a grant of half a million dollars, so he started Pathways to Housing. The main idea: housing first. Give the homeless a place to live and make sure they have support. Dr Tsemberis and his team brought together psychiatrists, social workers and nurses. When people have their own home, it’s easier to help them.

In one place

After five years, 80 per cent of the people helped through Pathways to Housing were still in their homes. This success rate is much higher than the traditional model, where people have to first show they are stable enough to have a home.

A study of this ‘Housing First’ approach in 11 US cities had similar success. Also, healthcare cost less and people managed addictions better.

Many people in America became interested. Lloyd Pendleton, a businessman and former head of humanitarian services for the Mormon Church in Utah, did not think it would work. He thought homeless people were lazy and needed to get a job.

But Pendleton changed his mind after he heard Sam Tsemberis talk at a conference about homelessness in 2003. He learned that homelessness cost a lot of money through the police, the courts, prisons and hospitals. It is cheaper to give these people stable housing with support.

Pendleton started a small project in Salt Lake City with 17 people who had been homeless for a long time. Two years later they were still in their homes.

Pendleton was then the leader of a big Housing First (HF) plan across the state. In 2015 the state had no more long-term homelessness.

The Housing First model is now in 20 US cities.

It also started in Canada. In 2008, the Canadian Mental Health Association (CMHA) began an $80, 5-year study of the HF model. The conclusion was that 75 per cent of Canadian Housing First participants stayed in their homes. They felt happier and safer.

And it didn’t cost any extra money – every dollar that went to Housing First cut healthcare, social service and legal costs by a dollar. The CMHA said it cost $10,500-$16,500 per person per year.

Medicine Hat in Alberta (population 60,000) started Housing First in 2009. The Mayor, Ted Clugston, didn’t agree with HF at first. But he soon changed. It was cheaper and it was a good way to treat people. Six years later Medicine Hat had also ended long-term homelessness. In 2013, Canada’s government (then Conservative) thought the results of Housing First were so good that it gave $450 million to start HF across the country.

The year after, Hamilton, Ontario, gave 65 per cent of its federal homelessness money to HF. ‘Transitions to Home’ (TtH), developed by Wesley Urban Ministries, has been a great success.


Kevin (right) got a home with Housing First with his social worker, Rolly (left). Sian Griffiths

‘I love it here’

Shaun and Kevin, used to be long-term homeless. They are very happy with their new homes.

‘I love it here,’ says Shaun, 53. ‘When you are cold, it’s very difficult to sleep.’ When he was young, he was in gangs and was in prison for robbery. He became homeless after he left prison in the early 2000s.

He used to be a heroin addict. Now he takes methadone in his home and he doesn’t have to worry that other people will steal it. The Salvation Army helped him find a home – near his parents – and they supported him.

Four years ago, Kevin had a stroke and can no longer use his left shoulder. His doctor told him this was because of decades of heavy drinking. He stopped drinking but he became homeless and had memory problems.

Last November, he met Rolly de Montigny who worked with the CMHA. A month later he was in a one-bedroom home with his son Gage who has a brain injury.

Kevin said that it was important for him (an indigenous person) to be near the river – but also to be able to walk to the city centre. ‘I love Rolly! He’s in my family now,’ he says.

Rolly is now trying to help Kevin get disability income. He also helps him go to appointments and takes him to the local food bank. Many more people need cheaper housing in Ottawa. Rent for a small apartment is about $600 a month.

Both Shaun and Kevin are below the poverty line. But Housing First can’t stop poverty.

Sam Tsemberis says the solution is to make the gap smaller between rich and poor.

‘If only a few people have money and rent is high and wages are low, more people will have nothing.’

Homelessness will continue if we don’t change what we think. ‘Society walks past homeless people – we have lost part of our humanity. It is natural to get upset. But there is a solution.’

Sian Griffiths lives in Ottawa. She writes and volunteers with the Salvation Army homeless programme in her city.

NOW READ THE ORIGINAL: (This article has been simplified so the words, text structure and quotes may have changed).