Permanent Supportive Housing fails on most measures, research finds
Local nonprofit spokespeople recently took to the op-ed pages of local media to buttress SJ's widely criticized Housing First and Permanent Supportive Housing strategies. Their rickety defense neglects crucial details on how barrier-free permanent housing is ineffective, costly, and wrongly targeted. Various expert sources below analyze PSH’s inadequacies to assist local communities. To receive daily updates of new Opp Now stories, click here.
Contrary to spokespeople's dubious claims, PSH fails to reduce local communities’ homelessness populations. Christopher Rufo of the Heritage Foundation relays how PSH can’t deliver on its most cogent promise:
Unfortunately, the promise of Housing First—solving homelessness and reducing public expenditure simultaneously—turned out to be little more than wishful thinking. More than a decade after hundreds of American cities submitted their Housing First-inspired “10-year plans to end homelessness,” none of these plans has survived contact with reality. In many West Coast cities, homelessness is more acute than ever before, and, as of January 2020, is the top concern among voters in California, Oregon, and Washington State…
… despite nearly doubling the nation’s stock of Housing First units since 2007, there is no compelling evidence that overall homelessness has been reduced.
Additionally, according to the National Academies of Sciences, there is “no substantial published evidence as yet to demonstrate that [Housing First] improves health outcomes or reduces health care costs.”
The new director of USICH, Robert Marbut, has signaled strong opposition to Housing First, releasing a chart that shows a dramatic rise in unsheltered homelessness after the widespread adoption of Housing First policies.
What went wrong? Despite Housing First advocates’ insistence that their approach would be “research-and-data-driven, performance-based, and results-oriented,” the policy failed to produce results even on its own terms.
Read the whole thing here.
Zooming in specifically on California, The Hill’s Rep. Roger Williams and Michele Steeb note that the state's homelessness rates continue to rise even as PSH expenditures go up:
Under the Housing First rule, homelessness rose by 16 percent as opposed to the promised demise of homelessness, and the unsheltered population of the homeless (those living on the streets) rose 21 percent. These failed results happened during a period of robust economic growth and prior to the COVID-19 pandemic… and under a jaw-dropping 200 percent increase in spending to the program.
California—the only state that went completely all-in on Housing First—experienced a 47.1 percent increase in street-level homelessness since its 2016 adoption at the state level, and a 33.8 percent increase in homelessness overall.
Read the whole thing here.
While its defenders rarely invoke any metrics-based cost/benefit analysis, serious data reveals that the Housing First Model and PSH are tremendously expensive for taxpayers—in addition to being ineffective. Christopher Rufo explains:
[On California’s pervasive Housing First project,] The Los Angeles city controller issued a scathing report, “The High Cost of Homeless Housing,” which shows that some studio and one-bedroom apartments were costing taxpayers more than $700,000 each, with 40% of total costs devoted to consultants, lawyers, fees, and permitting. The project is a boon for real estate developers and a constellation of nonprofits and service providers, but a boondoggle for taxpayers. The physical apartment units are bare-bones — small square footage, cheap flooring, vinyl surfaces — but have construction costs similar to luxury condos in the fashionable parts of Los Angeles. Meanwhile, unsheltered homelessness has increased 41%, vastly outpacing the construction of new supportive housing units.
Read the whole thing here.
PSH defenders rarely acknowledge that their approach doesn’t help residents manage the underlying issues intertwined with homelessness. Serious mental illness—affecting over 50% of homeless individuals—is not meaningfully improved by PSH. Stephen Eide of the Manhattan Institute breaks it down:
HUD estimates that 16% of the homeless population exhibits “Chronic Substance Abuse” and that “Severe Mental Illness” afflicts 20%. Drug addiction and mental illness drive much of the “chronic homelessness” challenge. Permanent housing is seen as a condition of recovery for this cohort… But the research is ambiguous as to how much permanent housing, on its own, stimulates recovery…
… a 2017 survey of the literature by researchers Stefan G. Kertesz and Guy Johnson judged Housing First to have demonstrated, at best, modestly beneficial clinical impacts. The Trump administration’s CEA acknowledged the research on Housing First residential stability but argued: “For outcomes such as impacts on substance abuse and mental illness, Housing First in general performs no better than other approaches.” The 2018 study published by the National Academies of Sciences, Engineering, and Medicine found no strong evidence of Housing First and improvement of mental disorders, as have other surveys.
Read the whole thing here.
Similarly, substance abuse frequently stagnates or worsens when a person is provided Housing First but not required to maintain sobriety. Judge Glock of the Cicero Institute gives the details:
Another reason Housing First doesn’t work is that it ignores that the major problems for the chronically homeless aren’t just lack of a home. A recent UCLA study found that more than 75% of this population have a serious mental illness, and 75% have a substance abuse problem, and the majority have both. These individuals are reluctant to accept assistance without mandates and requirements, and a house without such mandates will not encourage use of these services…
… studies have now shown that simply providing people subsidized housing does not reduce drug use, and often encourages it, which makes sense because there is no mandated treatment in PSH and the free unit provides people with more money to pursue their habits. In one randomized-control trial in Ottawa, the homeless put in PSH had higher rates of substance use, mental illness, and death than people simply left on the streets. We’ve seen similar results for mental illness. A chilling documentary on PBS showed that for many people with mental illnesses a permanent apartment increased social isolation. More concerning, a survey of all PSH studies from the National Academies of Science found “that there is no substantial published evidence as yet to demonstrate that PSH improves health outcomes.”
Read the whole thing here.
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