Structural issues are at the core of the experience of homelessness for Massachusetts families. As a group, homeless families experience deep poverty and work in low-wage jobs in a market that lacks affordable housing. Other factors that either contribute to, or are a consequence of, homelessness include intimate partner violence (IPV),7 unaddressed issues of traumatic stress and depression,8, 9, 10, 11 and challenges to parenting.12 For children, half of whom are under age five,13 frequent moves, family separations, and exposure to IPV can result in child welfare involvement,14 developmental delays, mental health issues, and school problems.15
In most communities, emergency shelters, transitional housing, and permanent supportive housing are the typical housing options available to literally homeless families.16 In some states, such as Massachusetts, motels have been used to manage the overflow of families needing shelter. However, evidence demonstrating program effectiveness is severely lacking.17
For 30 years, the dominant paradigm used to meet the needs of homeless families has been one that is adult-focused, rather than family focused, and resource-based rather than needs-based. Within this paradigm, the integration of housing with essential support services has been minimized (except for those in the highest need category) to focus resources on housing needs.18, 19 A recent (2016) large scale study conducted by the Department of Housing and Urban Development (HUD) confirmed the consensus that housing vouchers are effective in helping families move from homelessness to more stable housing in the community, however, it did little to examine the alignment of families’ complex needs with services.20 Although the study highlighted the structural components of homelessness – the need for affordable housing and federal resources for vouchers to move families out of homelessness – it failed to comprehensively address the complexity of families’ experiences and service needs.