Pathways Housing First: How To Stop Managing Chronic Homelessness and Start Ending It

A new model for ending – yes ending – chronic homelessness for people with complex needs due to the challenges of psychiatric diagnosis and substance misuse has crossed the Atlantic. Housing First is taking root in cities as disparate as Lisbon, Marseilles, Glasgow, and Helsinki. This revolutionary new approach starts from the simplest, and perhaps most obvious of observations: what homeless people need is a home.

The idea that adults who are chronically homeless need a home more than anything else might seem obvious to you and me, but it is a radical, even dangerous, idea to many people, including those who shape social policy and who provide homeless services. Before Housing First, many policy makers and service providers believed that chronically homeless adults are homeless because they aren’t ‘housing ready’: they don’t have the skills needed to live independently. They may have psychiatric challenges for which they need to take medication, and maybe they don’t like to take their medication. So they “need” to learn to be “treatment compliant”. Or maybe they have histories of alcohol or drug misuse, or perhaps are still even actively using or misusing psychoactive substances. Housing is used a bit like a carrot and a stick: you can have a home if you comply with our rules (carrot), but if you don’t, you’ll go back into supervised accommodation, or even back on the streets (stick).

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