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Chronically homeless individuals are those who spend long periods of time living on the street or other places not meant for human habitation, and who have one or more disabilities, frequently including mental illnesses and substance use disorders. In the 2014 Department of Housing and Urban Development (HUD) point-in-time count of people experiencing homelessness, over 84,000 individuals met the definition of chronically homeless, down from more than 120,000 in 2008. In part the decline is due to the federal governments plan, announced in 2002, to end chronic homelessness within 10 years. The target date has since been extended to 2017. Among the federal programs focused on ending chronic homelessness are the HUD Homelessness Assistance Grants, the HUD and Veterans Affairs Supported Housing Program (HUD-VASH), and several HUD demonstration programs. One of the reasons that federal programs have devoted resources to ending chronic homelessness is studies finding that individuals who experience it, particularly those with serious mental illness, use many expensive services often paid through public sources, including emergency room visits, inpatient hospitalisations, and law enforcement and jail time. Even emergency shelter resources can be costly. In addition to potential ethical reasons for ending chronic homelessness, doing so could reduce costs in providing assistance to this population. This book summarises the research surrounding permanent supportive housing (PSH) for chronically homeless individuals. In doing so, it attempts to examine the nuance in the research to determine where PSH could be considered successful and where gaps may remain. The book discusses what it means to be chronically homeless, the way in which assistance for chronically homeless individuals has evolved, and how federal programs target assistance to individuals experiencing chronic homelessness. In addition, it summarises the research regarding chronically homeless individuals who move into PSH.
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
This book provides a unique portrayal of Housing First as a 'paradigm shift' in homeless services. Since 1992, this approach has spread nationally and internationally, changing systems and reversing the usual continuum of care. The success of Housing First has few parallels in social and human services.
As an evidence-based practice, Housing First has not only been proven to be successful in ending homelessness, but is also embraced as the most cost-effective solution. Today, the Housing First model is being implemented in hundreds of communities across the United States, Canada and Europe. As the model evolves one thing remains constant: Housing First ends homelessness. Housing First is simple: provide housing first, and then combine that housing with supportive treatment services in mental and physical health, substance abuse, education, and employment.Housing First details:solid, actionable information about the program's philosophy, operations, and administrationthe composition, staffing structures, and day-to-day operations of the clinical and support servicespractices in client assessment and engagementproperty management operationsthe best protocols for assisting clients with the search for housing, relationships with landlords, and the overall "settling in" processthe research evidence for the effectiveness of the Pathways modelThe Pathways model has been remarkably successful in ending chronic homelessness. Since its founding, housing retention rates have remained at 85 – 90 percent even among individuals who have not succeeded in other programs. Not only is Housing First effective at keeping people housed and working toward recovery, it has also proven to be incredibly cost-effective.
Wall Street Journal Bestseller New York Times bestselling author Dan Heath explores how to prevent problems before they happen, drawing on insights from hundreds of interviews with unconventional problem solvers. So often in life, we get stuck in a cycle of response. We put out fires. We deal with emergencies. We stay downstream, handling one problem after another, but we never make our way upstream to fix the systems that caused the problems. Cops chase robbers, doctors treat patients with chronic illnesses, and call-center reps address customer complaints. But many crimes, chronic illnesses, and customer complaints are preventable. So why do our efforts skew so heavily toward reaction rather than prevention? Upstream probes the psychological forces that push us downstream—including “problem blindness,” which can leave us oblivious to serious problems in our midst. And Heath introduces us to the thinkers who have overcome these obstacles and scored massive victories by switching to an upstream mindset. One online travel website prevented twenty million customer service calls every year by making some simple tweaks to its booking system. A major urban school district cut its dropout rate in half after it figured out that it could predict which students would drop out—as early as the ninth grade. A European nation almost eliminated teenage alcohol and drug abuse by deliberately changing the nation’s culture. And one EMS system accelerated the emergency-response time of its ambulances by using data to predict where 911 calls would emerge—and forward-deploying its ambulances to stand by in those areas. Upstream delivers practical solutions for preventing problems rather than reacting to them. How many problems in our lives and in society are we tolerating simply because we’ve forgotten that we can fix them?
The Open Door provides a comprehensive, carefully documented "state of the science" on homelessness and mental illness. The book reviews the effectiveness of service and housing interventions targeted at this constituency, and discusses efforts to bring evidence-based programs to scale.
It is all too easy to assume that social service programs respond to homelessness, seeking to prevent and understand it. The Value of Homelessness, however, argues that homelessness today is an effect of social services and sciences, which shape not only what counts as such but what will?or ultimately won’t?be done about it. Through a history of U.S. housing insecurity from the 1930s to the present, Craig Willse traces the emergence and consolidation of a homeless services industry. How to most efficiently allocate resources to control ongoing insecurity has become the goal, he shows, rather than how to eradicate the social, economic, and political bases of housing needs. Drawing on his own years of work in homeless advocacy and activist settings, as well as interviews conducted with program managers, counselors, and staff at homeless services organizations in New York, Los Angeles, San Francisco, and Seattle, Willse provides the first analysis of how housing insecurity becomes organized as a governable social problem. An unprecedented and powerful historical account of the development of contemporary ideas about homelessness and how to manage homelessness, The Value of Homelessness offers new ways for students and scholars of social work, urban inequality, racial capitalism, and political theory to comprehend the central role of homelessness in governance and economy today.
Foreword by Nan Roman, President and CEO of the National Alliance to End Homelessness This book explains how to end the U.S. homelessness crisis by bringing together the best scholarship on the subject and sharing solutions that both local communities and national policy-makers can apply now. In the Midst of Plenty shifts understanding of homelessness away from individual disability to larger contexts of poverty, income inequality, housing affordability, and social exclusion. Homelessness experts Shinn and Khadduri provide guidance on how to end homelessness for people who experience it and how to prevent so many people from reaching the point where they have no alternative to sleeping on the street or in emergency shelters. The authors show that we know how to end homelessness—if we devote the necessary resources to doing so. In the Midst of Plenty: Homelessness and What to Do About It is an excellent resource for policy-makers, professionals in the homeless services system, and anyone else who wants to end homelessness. It also can serve as a text in undergraduate or masters courses in public policy, sociology, psychology, social work, urban studies, or housing policy. "The knowledgeable and thoughtful authors of this book—two brilliant women who know as much as anyone in the country about the nature of homelessness and its solutions—have done a great service by taking us on a journey through the history of homelessness, how our responses have changed, and how we can end it." —Nan Roman, President and CEO National Alliance to End Homelessness. "Shinn and Khadduri's new book is a thorough yet concise examination of what we know about the nature and causes of homelessness, and the crucial lessons learned. This critically important work provides a roadmap to restoring basic housing and income security as viable policy options, in the face of our daunting inequality divide that otherwise threatens millions with destitution and homelessness." —Dennis Culhane, Dana and Andrew Stone Professor of Social Policy, University of Pennsylvania "Marybeth Shinn and Jill Khadduri have combined their significant expertise to create an essential guide about the history of modern homelessness and to offer a clear path forward to end this American tragedy. Their policy recommendations on ending homelessness are culled from the best about what we know works." —Barbara Poppe, Executive Director US Interagency Council on Homeless, 2009-2014
Creative solutions for global cities addressing their urgent homeless crises. This book takes on perhaps the most formidable issue facing metropolitan areas today: the large numbers of people experiencing homelessness within cities. Four dedicated experts with first-hand experience profile ten cities—Bogota, Mexico City, Los Angeles, Houston, Nashville, New York City, Baltimore, Edmonton, Paris, and Athens—to explore ideas, strategies, successes, and failures. Together they bring an array of government, nonprofit, and academic perspectives to offer a truly global perspective. The authors answer essential questions about the nature and causes of homelessness and analyze how cities have used innovation and local political coordination to address this pervasive problem. Ten Global Cities will be an invaluable resource not only for students of policy and social work but for municipal, regional, and national policymakers; nonprofit service providers; community advocates and activists; and all citizens who want to collaborate for real change. These authors argue that homelessness is not an insurmountable social condition, and their examples show that cities and individuals working in coordination can lead the charge for better outcomes.