turquoise house and boarded house
turquoise house and boarded house

“Housing First” Policy Is Not Helping the Homeless

Crossposted at Fix Homelessness

The United States has been combating homelessness for many years. Billions have been invested to help the unhoused find reliable shelter, but the catastrophe has only gotten worse. Indeed, in the last few years, miles of squatter camps of unhoused individuals huddling in tents, crashing in subway stations, or living in sometimes illegally parked vehicles have proliferated in once world-class cities like San Francisco, Portland, Los Angeles, and Seattle. Americans have now witnessed once unthinkable scenarios of city streets befouled with human waste, discarded drug needles littering parks where children play, increased crime, open drug sales, people on the streets delirious from substance abuse, and businesses abandoning once-bustling downtowns because customers no longer believe shopping districts are safe.

Clearly, remedial efforts have proved inadequate. But abandoning the unhoused to their own misfortunes is unthinkable. These are fellow human beings to whom we owe a duty of fidelity and care. But what’s often not discussed is what those who need help getting off the streets owe us and themselves: we need the homeless to be dedicated to helping remedy the underlying causes of their own distress.

 “Housing First” Has Failed

Current policies on housing have proved to be both ineffective and expensive. In 2013, the Obama administration promulgated new regulations governing the federally funded campaign against homelessness, known as “Housing First.” This remains the current federal policy, and it treats homelessness primarily as an issue of shelter. The government pours money into taxpayer-subsidized housing vouchers based on the idea that when people find shelter, they will return to meaningful and productive lives.

But that approach often puts the cart before the horse. Many among the unhoused—certainly not all, but a large percentage—became homeless because of their own dysfunctional personal behaviors. Housing First does nothing to address this aspect of the problem. To the contrary: Housing First forbids requiring beneficiaries, as a condition of receiving assistance, to attend drug rehabilitation programs, look for work, or even take their mental health medicines as directed by a doctor. They can accept services that might be—and often are—offered, but they are under no enforceable obligation to do so. If they take drugs, refuse work, or even are charged with crimes, housing is still available to them.

That’s like putting a bandage on an inflamed wound without also applying medicine to heal the underlying infection. As a result, many of the unhoused receiving Housing First benefits make no effort to turn their lives around, leaving them mired in dysfunction and dependence.

This isn’t how it was supposed to be. Supporters promised that the Housing First approach would solve the homelessness crisis by 2023—in other words, by now. That clearly hasn’t happened. Indeed, a new study on the crisis published by the Discovery Institute’s Center on Wealth and Poverty estimated that, in the aggregate, there are now close to 1.2 million adults experiencing profound housing insecurity. This figure represents an increase in aggregate homelessness among adults from about 900,000 in 2013—with a particularly dramatic increase in unsheltered individuals increasing by 20.5 percent between 2014 and 2020. This uptick in homeless might, in fact, be worse than the figures I cite here: the Biden administration failed to report the national unhoused statistics for 2021, perhaps to mask the dramatic increase of homelessness under the Housing First regime.

In addition to the above dire statistics, the homelessness crisis among children also continues to worsen. The Department of Education considers children homeless if they are living unsheltered, in motels/hotels, in shelters or transitional housing, staying with others, or if their location is “not reported.” The total number of such children increased from 679,724 in the 2006-2007 school year to 1,508,265 in the 2017-18 school year, a pre-COVID increase of 122 percent. Inexcusably, the number of children in an unsheltered situation—i.e., on the streets or in vehicles—increased by 104 percent between the 2016-2017 and 2017-2018 school years. This is a crucial failure that can carry down the years since many adult unhoused people first experience homelessness during childhood.

The sum of adult and child homelessness evidences the abject failure of current remediation efforts. According to Dr. Robert G. Marbut, former executive director of the US Interagency Council on Homelessness and a co-author of the Center on Wealth and Poverty report“When you add the HUD counts with the ED numbers, we are sadly approaching 3 million people, and many advocates think we are undercounting ‘street-level’ adults and children under the age of 5.” That’s about as many people as live in the city of Chicago.

Adding to the scandalous nature of the catastrophe, the federal resources devoted to helping the unhoused increased dramatically. Indeed, in 2023, Congress appropriated more than $9.7 billion billion for targeted homelessness assistance, and President Biden has asked for $10.3 billion for FY 2024. This represents more than a threefold increase from the $2.8 billion spent in 2008, and doesn’t include the billions spent by states, local governments, and the nonprofit sector. Clearly, it isn’t the amount spent on the crisis that caused the failure of policy, but the design of the policies themselves.

The Unhoused Need to Participate in Their Own Rehabilitation

The time has come for a different approach. If we truly care about those without permanent homes, we will pursue policies that not only help unhoused people find proper shelter—certainly, an important goal—but also require them to participate in their own return to independence. This isn’t retribution for falling into deep poverty, but an act of love aimed at restoring people to dignified self-sufficiency and respect.

That last goal is the key. It takes excruciating self-loathing for a person to defecate on public sidewalks, shoot up with poisonous drugs, and engage in rampant criminality. The mental illness and dissipation are sometimes so profound that many of these poor people die on the streets. Providing housing vouchers alone simply doesn’t cut it.

If we are to begin to truly ameliorate this catastrophe, homelessness assistance should require capable recipients to participate in customized programs to improve their own lives—such as accepting targeted treatment for substance abuse, attending job training classes, and participating in efforts to alleviate mental health issues. Generally stated, the ultimate goal would not be to increase the number of taxpayer-subsidized housing vouchers but to see people become self-reliant. This leads to self-respect, which, in turn, would empower those receiving care to take the constructive actions necessary to become the forever formerly homeless.

So, what specific proposals should Congress and state legislators explore? First and foremost, Congress should pass legislation eliminating Housing First as the exclusive approach for service providers that provide assistance to unhoused people. This change alone would unleash innovation in helping people get off the streets and allow healthy competition based on results. In this regard, Congress should pass the Housing PLUS Act (H.R 6018). Congress should also eliminate the current discriminatory policy that forbids providing homelessness program grants to faith-based organizations, which would allow service programs with a proven track record of success in helping the homeless turn their lives around—such as the Salvation Army—to qualify for federal funding. The government could also move to a block grant system rather than a top-down approach. This would permit states and localities to design programs best suited to their particular communities. Finally, the government must eliminate the exclusion that prevents Medicaid from paying for inpatient mental health treatment, which too often leads to premature cessation of such care.

Overcoming the homelessness catastrophe will not be easy, or something that will be accomplished quickly. But allowing ideological inertia to prevent us from engaging in needed reform is unacceptable. The homelessness crisis can be overcome if we care enough about our homeless brothers and sisters (and their children) not only to put roofs over their heads, but also to help them regain the dignity and self-respect of becoming responsible and productive citizens. A truly loving community should do no less.

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.