The "housing first" response to homelessness
For some years now there has been a dialogue within the supportive housing, mental health care and addiction/treatment communities about the best way to serve chronically homeless men and women who are experiencing mental health, behavioral health and/or addiction challenges.
Like the chicken-and-egg conundrum, one perspective is that individuals need to be stabilized with regard to their respective challenges before they can succeed in an independent supportive housing community. The other viewpoint is that housing is foundational to achieving stability and should therefore precede treatment.
The latter perspective advocates for the “housing first” model, which many communities across the country have adopted as the primary means of responding to the homelessness crisis.
A catalyst for health, change and hope
I personally advocate for and support the “housing first” concept and believe that home and community form an essential platform for the treatment and resolution of many mental health, behavioral health and addiction challenges. My own research has revealed that regardless of a person’s impediments – whether chronic homelessness, addiction, mental illness, incarceration, etc. – emplacement in a permanent affordable home within a supportive community serves as a bridge to a better life, stability and enrichment.
What supportive housing can do
In the spirit of qualitative research, I decided to test my beliefs and previous findings about the power of community by reaching out to one of our own Providence Supportive Housing residents who has been very candid about her personal struggles.
Rosemary St. Amand has lived at Providence Vincent House in downtown Seattle for 23 years. At age 78, she talks openly about her years of alcoholism and periodic homelessness and equally as openly about the stability and family she has found at Vincent House. I asked Rosemary if she thinks housing or treatment should come first for prospective new residents.
This is what Rosemary has to say:
I think it has to be home first. How are you going to remember your appointments or manage your medications if you don’t have a home? [I]n the beginning of treatment, you’ve got to have someone there to hold their hand and walk them through the steps.
An incentive for treatment
Reflecting on her own experience and the experience of others she has observed over many years at Vincent House, Rosemary is describing the rationale for housing first and the power of home to promote health and wellness, particularly for those who have experienced mental health, behavioral health and addiction challenges. Rosemary also regards housing as a sort of incentive for new residents to seek treatment and greater stability. She explains:
When you finally get into treatment, or when you become sober or you start taking your medication for your mental illness, you start coming out of that cloud and things start to become clear. You begin wanting to take responsibility for your actions and your own life and you begin wanting to become part of your new community.
The power of home and community
Safe, permanent and affordable housing may not be the first and best solution for everyone and every diagnosis or health challenge, but together home and community remain an underestimated and powerful force for health and change. Just ask Rosemary.
This blog post is the fourth in a series about housing and health authored by Timothy Zaricznyj. The fifth and final post will explore how the rising cost of housing is pricing seniors out of their communities and contributing to a growing but often unrecognized problem of seniors facing homelessness.
Tim Zaricznyj and Rosemary St. Amand reflect on the intersection of housing and better mental and behavioral health.
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This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
About the AuthorMore Content by Timothy Zaricznyj, Ed.D.