DEEP DIVE: Why the Housing First Model Works Nationwide (documentary insights)

Thanks to Minnesota Housing for underwriting funds that enable us to spend time developing stories about housing needs and solutions. 

The documentary “Beyond the Bridge: A Solution to Homelessness” screened at Parkway Theater in Minneapolis in early June — part of a national tour of at least 40 cities that includes San Diego, Atlanta, Houston, and others. The two independent filmmakers, Don Sawyer and Tim Hashko, interviewed people who have experienced homelessness, city officials, advocates, and other stakeholders about needs and solutions.

The film is deep, moving, and ultimately uplifting. We captured a few quotes in the film, but rarely the attributions. What follows are a few of the major talking points and concepts, some quotes, and a few stills the filmmakers shared with us. Behind-the-scenes blog posts and interviews can be found at asolutiontohomelessness.com.

Nicole Thomas (Courtesy of A Bigger Vision Films)

 

The Milwaukee Story

The film begins with conversations in Milwaukee, where the goal was set in 2015 by city leaders to end homelessness. In five years, the overall homelessness population has gone down 46.3 percent, and the unsheltered street homelessness reduced by 91.8 percent, with the collaborative Housing First model. As the city’s website puts it: “The Housing First philosophy provides housing to those most in need without pre-condition. This is because, we have found, the most vulnerable in our community can only solve one life-changing problem at a time.”

A business leader said his first concern was that he would lose customers because of the homeless population nearby. “My reaction five years ago would have been to call the police,” he says. Now he’s part of the city solution to help get people out of tents and into housing.

A Housing First city initiative hire included an Outreach Services Manager to develop a community-wide collaborative, to bring together police, medical personnel, volunteer outreach teams, housing navigators to help find homes, and others. The outreach  team engages with people generally during late nights and early mornings, “when people are most likely to be in their spots,” to share information about what their options are. Said one, “We can hand out food, and provide clothing and tents, but is that something that’s going to solve the problem?” 

A police officer said a starting point was to stop arresting people for small infractions — having an arrest record makes it even harder to find housing. Warrants were cleared. People were given resources.

A landlord engagement coordinator was hired to find new landlords willing to join the network of places that will take people moving in from the streets. 

Private developers, such as Cardinal Capital, were engaged to build affordable housing. The effort enabled Milwaukee’s collaborative effort to house thousands of people, which has brought in additional private money and philanthropic donations from United Way and health care organizations. The city now has the lowest homeless population per capita in the U.S. 

Said one city leader, “The healthier community for every single one of our citizens, the healthier our economy.”

Milwaukee success in eradicating homelessness

Origins of Housing First

In 1963, the film indicates, President John Kennedy signed a bill to close mental health facilities and to provide housing and stronger outpatient care in place of what had become a degraded system. Three weeks later, Kennedy was killed. The hospitals closed, but housing and mental health care never scaled up to serve the population.

President Carter, years later, signed a bill to integrate community housing and mental health services. The bill was largely killed a year later by President Reagan, who “slashed the mental health budget by 30 percent.” With the federal budget for affordable housing and social safety nets also cut, “the number of homeless people exploded.”

The film points out that by 1989, an estimated 300,000 mental health patients were homeless. Since then, no other U.S. President has done what was needed to solve the growing problem.

The Housing First model was created by community psychologist Dr. Sam Tsemberis, founder of Pathways to Housing. “People who are younger think that homelessness is part of the landscape. I was not of that generation. I actually watched it develop in slow motion, one person at a time, added to the streets of New York City. I was working at Bellevue Hospital. Some of the people I was seeing on the street were people treated at Bellevue psychiatric hospital.”

Recognizing how many people on the streets are there because of mental health issues, he began to work with colleagues and ask questions of people who needed to feel more agency in their own lives. They gave them choices about what they needed: Shoes? Blankets? Coffee? Sandwiches? “What people said to us, immediately and repeatedly, was, ‘Isn’t it obvious? We need a place to live.’”

The Housing First model gives someone a place to live and then — “critical to the model” — also offers support services, such as mental health treatment. If someone is struggling mentally, and then is on the street, they are not getting back into steady employment and housing unless the services that they cannot otherwise access comes with it.

As the film points out, this costs less to a community than the alternatives: public-funded health care, incarceration for mental illness (while waiting for treatment center space to open), and public safety violations.

“If you don’t want affordable housing in your backyard, you’re going to end up with homeless people in your front yard.”

Andrea Johnson (Courtesy of A Bigger Vision Films)


Voices of People Who Have Experienced Homelessness
  • One man recalls being sent to the nurse’s station by his second-grade teacher because he couldn’t sit in his chair. When his shirt was lifted up, many welts on his back were visible from what he was experiencing at home. Verbal, mental, physical, and sexual abuse often go untreated, and leads to pent-up frustration, anger, and lack of a sense of personal power that can derail a child’s development into stable adulthood.
  • Another man said he was a victim in his father’s pedophile ring.
  • “I was hit by a drunk driver, My first surgery cost me $47,000. That bankrupted me.”
  • “I’m a carpenter by trade. My life was not worthless.”
  • A woman indicated she had been living on the streets because of health problems and lack of family support. She used to drive to a rest stop outside the city to sleep in her car. At age 38, the Housing First program enabled her to move into an apartment for the first time.
  • A mother indicated she and her kids lived in a Ford Explorer vehicle. The baby slept in a playpen in the back. “If I paid all of my bills [including rent], I would have $30 left to last for the next two weeks. … I remember what it was like to be cold in the car and to wonder if my kids are going to die in the middle of the night if I close my eyes too long.”
  • “I cannot survive with $8.75 minimum wage while taking care of a three-year-old.”
  • “I went to five elementary schools, six middle schools. I fell behind because we moved around so much.”
  • “Would you hire me if I didn’t have a place to take a bath?”

 


“Housing should not be a reward for good behavior.”

The filmmakers went to Houston, among others, to see how the Housing First model worked in a large city. Because of its housing issues, the city was given technical assistance to bring in experts to advise the mayor’s office, the housing department, and local agencies. Said one spokesperson, “Everybody sat in a room together to figure out what we were doing wrong and what we needed to do to fix it.”

In most nationwide communities, homeless intervention is done through a step-by-step model, the film points out. Heavy discipline is used to reform behavior. There is zero tolerance toward mistakes, including substance use. 

Explained one woman: “After you’re in shelter, you graduate into transitional housing, and then you might graduate into permanent supportive housing. [That process] didn’t work for many of the people that I was working with.” She said there were fail points given if someone did not have five job applications filled in every week, were unable to maintain complete sobriety, or even if a bed wasn’t made the right way. The hoops jumped through are to “prove worthiness — behave this way in order to advance to the next level, step by step. If you make a mistake, we take your house. The system was set up in a way that expected perfection.”

Said one former resident, “At some point, I’m done trying. You are going to feel worse about yourself than you already do. Here’s another example of how you’re a failure. That system of treatment and sobriety first works 30 to 40 percent of the time. For most people, it doesn’t work.”

The film describes a kind of “Housing First Light” program, that does not offer enough of the supportive services “which are fundamental to the success.”  This less effective model might have 20 people with urgent needs in a space with one case manager who is in an office 9 to 5. “A disaster happens and police are called —this is not really the Housing First model.”

When people feel like the only recourse to address homelessness in their neighborhood is to call police, that is a problem, people in the film indicated. 

  • “No one has been able to reduce homelessness just through enforcement.”
  • “We’ve got to turn off the faucet that is pouring people into the system. Mass homelessness is not caused by the individuals; it is a structural issue, which requires structural responses.”
  • We all know the song: homeless folks are homeless by choice, because they are lazy, they are drug addicts, they won’t take responsibility and go get a job. [They are told] to pull yourself up by your bootstraps, even though they have no straps.”

Opponents who criticize a more fully resourced Housing First program claim it is housing with no rules, which is “not true.” People have to meet the terms and conditions of a standard lease, such as paying 30 percent of income toward rent, and meeting with the treatment team. 

A fully effective Housing First model is much less conditional because “People make mistakes.” If someone immediately loses their entire support system, and their housing, they start at the bottom again. That is not a fair or realistic process. “My housing isn’t taken away when I make a mistake, as long as I’m paying my rent or my mortgage, as long as I’m being a good neighbor.”

Kelly Miller, sitting with filmmaker Don Sawyer (Courtesy of A Bigger Vision Films)


Collaborations Are Essential

Another point made in the film: “If we really are serious about reducing homelessness in America, we have to put money into treatment, and it has to be trauma informed. It has to be customized to your needs. And stop blaming each other. That’s what I’ve seen around the country, because everybody wants to blame each other for what’s going on, instead of working together. There are cities where every council member is going in a different direction, the city is going in a different direction than the county. The Chamber of Commerce is in a different direction from the police from their homeless service agencies. If they are going to continue to operate that way, they’re not going to get anywhere.”

When effective policy is paired with government resources and the hard work of agencies, “the sky’s the limit. Too often, the general public see the people that are still experiencing homelessness. They don’t see the people we’ve housed. It’s important that the gospel gets spread. Once that happens, citizens will notice — they will agree to be part of this long-term systemic change. Not just moving individuals into a different neighborhood and calling it a day.”

“In Houston, before they even set up their homeless response systems, they came to terms with the humanity of the people as worthy of a clean slate and second chance. And that’s reflected in the systems that they set up. That’s why they’re so successful.”

The film shared voices of unhoused people describing neighbors being openly hostile to them — which is part of the issue in not solving it — and headlines of stories around the country of homeless people simply shot dead.

Said one person, “You’re treated like an animal by society, because they don’t understand that when you’re outside, you have to fend for yourself.”

Said one man, “I was sitting at a train station and a dad had his kids throwing rocks at me.”

Mathematic Reasons for Homelessness

Spiking mortgage rates — in some cities 50 percent higher than they were before the pandemic — is pushing more people to the streets. 

Gregg Colburn, author of “Homelessness Is a Housing Problem,” is quoted in the film, saying that fast–growing cities “have dynamic economies where people want to live and work. And generally speaking, they have not built enough housing to accommodate the people who want to live there. Communities keep thinking that if we build luxury units, we’re only going to get high-income people moving to our city, improving our tax base. But what they’re really doing is taking the people who live there and squeezing them until they break. And when they break, that’s homelessness.”

Rents are rising, the film indicates, because demand is high, and supply is low. Disinvestment in public housing began in the 1990s. Most estimates suggest that the housing shortage is between 3 and 5 million units. There are 23.5 million people paying more than 50 percent of their income in rent, “which means that those people are essentially one paycheck away from becoming homeless.”

The filmmakers indicated that they found developers who want to build affordable housing, but many municipalities make it difficult with hefty development fees and regulatory requirements — such as sidewalks and upgraded lighting and roofing pitch lines — that add too much cost to the projects.

Colburn said an analogy shared in the book is that if you were playing musical chairs with 10 people and nine chairs, “and Mike’s on crutches, the music stops, everyone scrambles for a chair, and Mike loses. …  Fundamentally, the reason he didn’t have a chair is because we didn’t have enough chairs.”

The Shelter Industry

The film also depicts the profits that can come from the shelter industry. One study indicates it is a $10.5 billion industry, which is an average of $27,000 per bed per year “for a cot in a room that might be in a room with 20 or 100 other cots. … When you’re paying $3,000 a month for a shelter bed in New York City, something’s wrong. You can get a decent apartment for that.”

The shelter system was originally envisioned as a temporary location for people, not a permanent solution to homeless issues. The film indicates there are about 60,000 people on an average day living in New York City shelters, and that slightly more than half of homeless single adults don’t even sleep in the facilities — largely because of violence, including rape — so it is an inefficient and ineffective solution. “Most of these organizations are run on threadbare budgets, by very well-meaning, well-intentioned people who are trying to help.”

Tania Cole (Courtesy of A Bigger Vision Films)

Redlining Impact

The film also points out that 88 percent of people experiencing homelessness in the District of Columbia identify as Black or African American, even though the general population is 44 percent identifying as Black or African American. Small percentage of people in Los Angeles are Black, but one-third of the people on the streets are Black. More than half the homeless people in Denver are people of color.  Details: Racial Inequity and Homelessness: Findings from the SPARC Study,”

For those who don’t know the history, this might seem to be a failing of the individuals, rather than the impact of redlining — which prohibited people of color from buying homes at least into the 1960s. As the film explains, this discriminatory practice of banks and neighborhoods “prevented people from using the easiest mechanism for wealth in this country.” The 30-year mortgage rate, created as a response to the Great Depression, primarily benefitted white people, as did the GI Bill.

The same people who could not get strong housing appraisals for bank backing “are also the people who get saddled with environmental disasters in their backyard,” and highways that cut through neighborhoods [as happened in Saint Paul and Minneapolis]. “There’s a systemic approach to how we do community development, that was an advantage to certain communities and disadvantage to others, and it falls along racial lines.”

Addressing Veteran Homelessness: First Step

Because of concerted efforts federally and in states, homelessness among veterans has declined by 55 percent, generally with Housing First models that provide wraparound services to provide the stability needed to keep them on their feet.

People in the film indicate the next step is to extend that same dignity to people with other chronic issues that contribute to homelessness — which is a public health crisis.

The overarching message in the film is that if you treat people with dignity, and give them the support they need to thrive, success rates are 80 to 90 percent.

Vikki Vickers was diagnosed with schizophrenia at age 22. “That homeless person you’re afraid of, that is dirty and maybe screaming at things you can’t see or hear — there’s a person in there.”

Vikki Vickers (Courtesy of A Bigger Vision Films)


Lt. Gov. Peggy Flanagan offered post-film comments, as did a panelist of Minnesota housing advocates. This will be part of a future housing story in our series.

 

asolutiontohomelessness.com

 

 

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1 reply
  1. bill betzler
    bill betzler says:

    What a great article! First one I’ve read that connects the origins of our unhousedness back to the Supreme Court Olmsted Decision emptying mentl health facilities like Fergus Falls.
    Supportive services are the key to a successful walk from the streets to stable housing. In MSP, the non-profit managers of Housing First; have not fully funded the services required. Their idea of supportive servicesis to give the client a “TO DO” list & not to do an intensive look @ where they are right now & then w/ the client identiy a series of baby steps to walk w/ them from where they are to where they want to be. In my experiece; it all starts w/ building & maintaining a relationship of mutual trust & respect. W/ it, anything is possible. W/O it nothing works. And LOVE for a brother or sister is the key ingredient to the relationship b/w a case manager & the client. LOVE is also the worst 4-letter word in all human services. Let’s be professional! I believe that none of the Housing First Nonprofit managing agencies are really into transitioning people up & out of poverty permanently. That’s too much work. They’d prefer have stable caseloads that don’t change much year-to-year. Finally, I don’t believe Housing First was ever thought of as a permanent solution for our unhoused sisters & brothers. I believe Housing First w/ it’s resource tool box & relationhip rich community was originally supposed to be yet another temporary baby step towards as full a future as the client needs & wants. i believe theonly goal worth having for Housing First is maximum empowerment of the client & a liberated life! Radical! Subversive!! But that’s just me. bb

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