Dr. Sam Tsemberis wants you to know that ending homelessness isn’t very complicated. Simply put, it just requires providing people with housing. The clinical psychologist and founder of New York City-based Pathways Housing First visited Grand Rapids in mid November to meet with organizations that provide services for the city’s homeless population, as well as to give a talk at Fountain Street Church. He also sat down with MiBiz to discuss his housing-first model and how Grand Rapids could end homelessness in a year if the city were to commit to it.
How would you summarize the housing-first model?
When you ask a (homeless) person with (mental health or addiction) problems for their treatment plan, they immediately provide the sequence as housing first. So housing first is a consumer’s solution to their multiple problems in a sequence that makes sense for them. We got to it because someone showed us the way. That someone was the client.
How do you evaluate a city like Grand Rapids and how it might utilize the housing-first model?
I do have a set of things I like to learn about in every city. My focus is quite narrow. It’s the feasibility of housing first and the feasibility of it going to scale. First thing I want to know is how many chronically homeless are here? The answer for Grand Rapids is about 200.
Then I ask about the housing market. Here, it’s struggling. It’s improving but not all the way there, which makes for good news for people who are homeless because there are affordable housing units and homes that are accessible. So the resources and the numbers of people in terms of quantity, it’s a very good fit. I think we could end homelessness in a year.
That seems pretty ambitious. What would it take?
We need rent stipends for 200 people and the support systems they need once they’re housed. But it’s not like we need to build more affordable housing because it’s not that big of a group. It won’t solve all homelessness but if we prioritize, … the conditions are highly favorable.
Cities like Grand Rapids are building all types of housing to keep up with demand. How do we go about prioritizing when we need more of everything?
It doesn’t matter how you prioritize, but it matters that you prioritize. The only reason we got to zero on (homelessness for) veterans is because we prioritized veterans. … If we had the same mindset and cared about the rest of the homeless the way we cared about veterans, we have the cure. It’s not like other people need a different cure than veterans. … If the city wants to prioritize homeless families — moms with kids, let’s say — then let’s do that. It doesn’t matter. But you can’t get an effective outcome unless you prioritize. And the values of the community will determine the priorities.
If the simple idea of your housing-first strategy is to provide housing for those experiencing chronic homelessness, why does that so frequently get missed?
Well, I’ve got a very complicated answer to a very simple question: Think about the housing first (model) as a program entity that’s in the shape of an iceberg. The totality of housing first is an iceberg. What people see as housing first is the tip of the iceberg.
What do you mean by that?
Here’s someone with a lot of complex problems. You give them housing. But why did it take us so long to figure it out? It seems ridiculously easy. And it is. I can’t answer why it took us so long, but I can answer what was getting in the way.
What line of thinking has been a barrier to finding a solution?
Before we were able to reach that solution, what was getting in the way was misinformation. If someone has a mental illness, they need supervised housing with around-the-clock support. … If someone has addiction problems, then how can they manage? We need to get them clean and sober, otherwise they’ll fall asleep smoking and burn the house down. We need sobriety before housing.
Do you disagree with that?
We created a caring system, but it’s misguided in its assumptions about people’s priorities. We kept trying to cure mental illness and addiction before we would provide housing. We still don’t know how to cure mental illness and addiction, but we do know how to provide housing for people. What it took for people to see the light, frankly, was to step away from traditional, clinical beliefs.
What do you see as your successes over the years of doing this work?
I think the success was immediate — like at the end of the first year, our housing retention rate was 84 percent. This was just the first 50 people. We all understood that we were on to something. Our initial thought was to do more of it. For years, it was a lot of learning. It wasn’t intuitive, it wasn’t following a cookbook — we were writing the book. There were constant new situations, but we were developing and doing the practice at the same time.
Do you see cities making a dent in their homelessness problems?
Probably for the first time, as long as I’ve been doing this, there are cities like Phoenix, New York … figuring out how to end homelessness for veterans. That’s the first time in my experience where people are reporting the end of this.
So what are the cities ending veteran’s homelessness doing right?
If you focus on a group of people and put the resources in place, (you can) actually drive the number down to zero. That’s extraordinary. That’s never happened before. We’ve known there’s a solution to ending homelessness, but until some of these new initiatives, we’ve never resourced well enough to actually deliver.