Some late night reflections on housing first, and systems...
A light bulb went off so brightly that it woke me out of a sound sleep tonight. This is why "housing first" is going to be a waste of time in most applications: because it's given lip-service without support. I think (at best) it's proving a waste of time, and (at worst) a set up for failure. Here's why:
Housing first has been shown to be effective in cases where chronically homeless people are housed in situations that accompany them with intensive case management and support. Wonderful. But that's not what is happening in many programs that are claiming to use the approach. A program can call itself a "housing first" approach, but if it does not offer the tools or resources to provide the level of case management that has been shown to be effective in housing first, well, it's NOT. If the program doesn't offer the longer-term support that is key to the effectiveness of the housing first approach, it won't work. Many have shared their hands-on experience in programs for the homeless.....it is often after six months or longer that these programs see their highest levels of effectiveness.
So....there are programs out there today that are being touted as solutions that will "solve" the homeless problem in less than a year from now (give or take). That's a set up for failure. It will fail. These programs are not designed to provide long term and intensive case management support.
Our streets are strewn with people who have made choices that have gotten them there, and many of them continue to choose the streets despite help that is offered because they place (for whatever reason) greater value on things other than being housed. That's not a value judgement, it's an observation.
Will putting them in housing produce a newfound appreciation for being housed? Will it motivate them to do ANYTHING it takes to STAY in that housing? Not without someone holding their hand through that entire process. That's housing first. It's not, however, what we're offering them.
In terms of systems...we can all fly around at 30,000 feet and look around the city. We can land in the airport and then take off again. None of that really tells us what's going on on the ground. Are we forgetting (did we ever know?) that we're part of a system? We aren't just landing on another planet ready to solve that planet's homelessness problem. We live here, we're part of the system that has created and continues to "empower" the problem. Our service agencies are also systemsthemselves. They are made up of people who are part of innumerable and overlapping systems...and each person is a complicated system unto herself...that includes and cannot be separated from the environment and her own psycho-social matrix.
So if we KNOW that the elephant is in the middle of the room (to borrow a model from a fairly well-known system) why do we continue to feed it, groom it, tend to it, shovel its shit...but not acknowledge it? Wouldn't acknowledgement then lead to better design? Wouldn't acknowledgement lead to an improved diet for the elephant so that it will grow and thrive into the kind of elephant that we aspire to, as decided in community?