More and more I am seeing different orders of government – municipalities, states, provinces, federal – slip the words “housing first” or “Housing First” into their documents, policy briefs and contracts. I suspect (because I used to be one in a former life) there is a policy wonk that did some research, found the evidence of this approach to homelessness compelling, and advised political masters it was the bees knees.
But does government know what it is asking/endorsing/requesting? Is what the policy advisor is recommended understood and translated well in the political arena? Do program designers that may have never delivered direct service at any point in their lifetime in this field really know what they are asking for?
My experience suggests this is probably not the case. All of the evidence that pointed to this approach being a good one requires fidelity to practice of a true Housing First model, either through Intensive Case Management or Assertive Community Treatment. You can read my thoughts on this or listen to the podcast here or watch a video about it here.
Truth is government should be demanding fidelity to practice in exchange for investment of resources. And government should be investing in the training to help service providers gain the knowledge necessary to fulfill the requirements of the practice. Not doing so is a gross injustice to homeless people, and will not yield the results (housing stability, cost savings, etc.) that were expected when the community went down the road of this approach to service delivery.
Things that should not be happening that I see far too often in my travels:
- Government touting that they have invested in a Housing First approach when they may have invested in a housing program, but not Housing First
- Various government entities requiring communities to have a Housing First approach in their local housing/homelessness plans, but not providing any direction or definition of what it is they mean (or worse, asking people to provide an explanation of what “Housing First” will mean/look like in their community…um, that’s like asking a triage nurse in one emergency department to explain a litany of medical tests and screening they do to determine if someone has had a heart attack and the next hospital over interpreting the testing and screening for a heart attack as being able to read Winnie the Pooh, provide the patient a cuddle, and tickle their toes – and considering both to be valid/appropriate!!!)
- Service providers bragging that they do Housing First, but conveniently ignoring some of the core concepts or parts of the necessary service orientation (for example, there is no such thing as a Sober-Living Housing First Program, nor is there such a thing as a Compliance Based Transitional Housing First Program…two examples from just the last month of travels)
- Slapping the “Housing First” label on previously existing practices and just calling it something else
- Reporting that anyone housed in a community was part of a “Housing First” approach, when Housing First is for a very specific type of individual/family
- Lack of evaluation of whether what is being done is actually Housing First when it is called that
- Service providers and CoCs convincing government reps that somehow they are unique and a true Housing First program will not work in their community, but that they will adapt the Housing First model in a way that works locally (see triage nurse example above)
- Government rolling up data across communities to speak of investments in Housing First services, when there is tremendous variation of service delivery, many communities that are not actually doing Housing First, and somehow treating all as being the same
I’ll stop there. I don’t want this to turn into one of my rants.
I don’t want governments to stop promoting, endorsing or requiring Housing First. But, I want it to be done intelligently, with merit, and with expectations of being able to measure fidelity so that they can achieve the results of the investment that they were planning on achieving. Not doing so is simply a waste of our tax dollars. We can and should do and demand better.