On any given day, at least 800,000 people are homeless in the United States, including about 200,000 children in homeless families. Over the course of an average year in the late 1990s, at least 2.3 million and perhaps as many as 3.5 million people experienced homelessness. This approximates 1 percent of the total U.S. population, and 5 and 10 percent of poor people.
There are many systemic factors that increase homelessness, including low rental vacancy rates, high rents, and great differences between the incomes of better-off and poor people, and these factors worsened in the 1990s. Personal difficulties such as mental illness or job loss may increase vulnerability to homelessness, but they cannot explain the magnitude of the problem. Therefore, a national strategy to prevent homelessness must include new housing resources, related services, and strategies that address societal factors contributing to homelessness.
The results of a decade and a half of research to determine what works to end homelessness are fairly conclusive about the most effective approaches. Providing housing helps currently homeless people leave homelessness; in fact, without housing, virtually nothing else works. Housing often needs to be accompanied by supportive services, at least for a time, but such services without the housing do not end homelessness.
Demonstration projects, and the experiences of providers in many communities around the country, have shown over the years that even the most chronic, most severely mentally ill people can be brought off the streets and can live stable lives, if they are supplied with housing. The same is true for families headed by a person struggling with mental illness. With the appropriate help, even people with extensive histories of substance abuse have been helped to leave the streets and find stable housing. Evidence shows, too, that the cost of providing housing plus supportive services is almost identical to cost savings that derive from reduced use of emergency room, jail, prison, mental hospital, substance abuse, and other public services.
Services for currently homeless people also need to be comprehensive and high quality. Too often certain key resources in areas such as health, mental health, substance abuse, child welfare, housing, vocational rehabilitation, and employment and training are missing from a service network, or don’t function well.
For a housing-plus-services approach to succeed, case management for homeless people is essential. Homeless people often have difficulty finding the right program or negotiating a variety of systems. In addition, many of these agencies – whether providing drug rehabilitation or psychological counseling – may be unable or unwilling to address the specific problems of being homeless. Under these circumstances, some homeless service agencies expand their mission, providing their own psychiatric care, substance abuse treatment, health care. This approach may be necessary, but it is wasteful, and deprives homeless individuals and families of resources that would be available if mainstream agencies were competent and willing to do the job.
Finally, many people who have been homeless, especially those with multiple barriers to remaining stably housed, may need ongoing support; the programs that help them transition to permanent housing need to be funded at levels that enable them to provide these services.
When a community assures that housing exists within reasonable price ranges, offers its members living-wage jobs, provides schooling good enough to develop the capacity to hold these jobs, and offers other supports for families and individuals, people can keep themselves in housing. But far too few communities have these resources or are positioned to provide them.
Without these basic building blocks of a civil society, we are creating an underclass of persistently poor people vulnerable to homelessness. The costs of this neglect are too high in both individual lives and public dollars for health, mental health, and correctional institutions. It is more effective, more humane, and ultimately more fiscally prudent to invest in prevention and support that leads to self-sufficiency and independence for all residents.