Story at a glance

  • The Housing First model turned traditional homelessness policy on its end, with startling results.
  • After Finland adopted the plan, homelessness dropped by 40 percent.
  • Tsemberis is now setting his sights even bigger, on the millions of homeless people in the developing world.
In the early 1990s, in a small pocket of New York City, Sam Tsemberis, a clinical psychologist, began his war on homelessness with a simple idea: Give homes to homeless people first, and then treat them for illnesses later.
The Housing First model, as Tsemberis calls it, was initially described by critics as too simple to be the solution to a global economic crisis, but after early results showed an 85 percent retention rate for the homeless in New York City, the Housing First model was a proven success. Years later, in 2009, when the model became a national policy, New York saw its homeless veteran population decline nearly 80 percent, going from 5,879 people on the street to 1,248 in 2016.
“In general, wherever Housing First is implemented the population to which it is targeted goes down by virtue of the rapid access that homeless people have to the one thing that they most want, which, of course, is a place to live,” says Philip Mangano, former director of the U.S. Interagency Council on the Homeless.
Nearly every city and state in America has implemented the Housing First model as a way to reduce homelessness. New Orleans, which had seen a staggering rise in homelessness after Hurricane Katrina, was able to reduce their homeless population by 90 percent with the model. And recently Utah saw roughly the same decline from 11,619 homeless people in 2007 to 1,188 as of last year.
“The genius of Housing First is that it is ultimately consumer oriented. And in some ways, consumer driven,” says Mangano. “When you ask homeless people what they want, they never say, a pill, a program or a protocol. They say they want a place to live."
Now 30 years later, Tsemberis resides in New York City, where he is the president of the Pathways Housing First Institute, which provides training and consultation on Housing First policy and practice nationally and internationally.
In countries like Finland, where Housing First has been turned into a national policy, homelessness has declined by 40 percent over the course of a decade. The country's capital, Helsinki, used to have 600 homeless beds and now has only 52. And in Canada, where Housing First was introduced in 2009 through a study named Chez soi, or At Home, more than 1,000 homeless people were able to be housed over a four-year period in five major cities.
Shifting policy
The Housing First model has changed the way that experts view homelessness policy, “from treatment or sobriety first to housing first,” says Tsemberis. “And when it's been taken on, and funded on a national scale, we've seen really the end of chronic homelessness.”
The latest country to introduce the model has been New Zealand. In 2016, 189 people were living on the streets in the center of its capital city Auckland, a vast majority of whom were suffering from either mental health or addiction issues.
It wasn’t until Tsemberis was invited to visit Auckland in 2017 to work with Lifewise, a charity organization, in early 2017 to introduce a two-year Housing First pilot program that they began to see significant progress. Only a year after the pilot’s initial launch, 37 people had moved into permanent housing in Auckland, according to the charity. Excited by the program’s success New Zealand then spent $63 million to expand the program to several other major cities in the country, leading to 720 people and families being homed by March of this year.
Homelessness in the global south
However, despite the fact that Western countries are continuing to reduce homelessness through the Housing First model, the southern hemisphere has still yet to catch-up. Chronic homelessness in the developing world is expected to increase in the next two decades, according to a United Nations report. Part of this can be attributed to governments in the developing world having a different housing standard.
“Housing in different parts of the world, especially in the global south where the housing standard is very different, where a portion of the population is living in what we may think of as makeshift or substandard housing is very large,” says Dennis Culhane, professor of social policy at the University of Pennsylvania. “So, differentiating the population of people who could get into conventional housing is just a different concept.”
And with different standards of housing, tackling homelessness might be less of a concern to those countries. But in cities such as Buenos Aires in Argentina, where an estimated 8,000 people are currently living on the streets, and 200,000 people are living in poverty, the government is under pressure to address homelessness as soon as possible.
“Many people who are homeless in these countries, [the] vast majority of [them] just need a place to live, so we’re talking about a global right to housing movement,” says Tsemberis. “Even though the U.N. talks about housing as a basic human right, we’re sadly seeing that not being implemented everywhere.”
That’s why Tsemberis was invited to share his Housing First model at a conference in Argentina last year. And now, with financial backing from the United Nations Development Fund and Argentina, the Housing First program will be introduced in Argentina in November at the earliest, according to Tsemberis.
Ultimately, the solution to getting people off the street will rely on whether or not governments are willing to keep funding programs like Housing First, he says.
“Some countries are much more focused on the building of affordable housing as recognition that not everyone can make enough money for housing,” says Tsemberis. “At the end of the day, we have to decide as a society, ‘Are we going to make that available for everyone?’ Do we want to have a society where people are outside living on the streets or do we want to have a society where everyone is housed?
Published on Nov 04, 2019