Finland’s Simple But Radical Solution to Homelesssness

While most of the developed world struggles with growing or stubbornly unchanged rates of homelessness, one nation is bucking the trend: Finland has seen the number of homeless people decline from its peak of 18,000 just thirty years ago, to 7,000 today (of whom 5,000 are at least in temporary housing with loved ones). It has accomplishd this in a deceptively simple way: by giving homeless people homes.

According to the Christian Science Monitorit all began with the Finnish government making homelessness a national priority:

The elimination of homelessness first appeared in the Helsinki government’s program in 1987. Since then virtually every government has devoted significant resources toward this end.

Around 10 years ago, however, observers noticed that although homelessness in general was declining, long-term homelessness was not. A new approach to the problem was called for, along with a new philosophy.

The optimal solution, a group of four experts appointed by the Ministry of the Environment found, was Housing First. “Solving social and health problems is not a prerequisite for arranging housing,” they observed. “Instead, housing is a prerequisite that will also enable solving a homeless person’s other problems.”

The concept behind the new approach was not original; it was already in selective use in the US as part of the Pathways Model pioneered by Dr. Sam Tsemberis in the 1990s to help former psychiatric patients. What was different, and historic, about the Finnish Housing First model was a willingness to enact the model on a nationwide basis.

So while the Finns aren’t the first to tackle homelessness, they are the first to do so on a national level, thus bringing many more resources and ideas to bear.

“We understood, firstly, that if we wanted to eradicate homelessness we had to work in a completely different way,” says Mr. Kaakinen, who acted as secretary for the Finnish experts. “At the same time right from the beginning there was a national consensus that the problem had reached a crisis point. … We decided as a nation to do something about this.”

[…]

As a result, in 2008 the Finnish National Program to reduce long-term homelessness was drafted and put into place. Helsinki and nine other Finnish cities committed to the program, with the Ministry of the Environment coordinating its implementation, and local governments and nongovernmental organizations, including the Y-Foundation, joining the team.

One of those goals was to cut the number of long-term homeless in half by producing 1,250 new homes, including supported housing units for tenants with their own leases, and around-the-clock presence of trained caring staff for residents who needed help.

 At the same time, the extant network of homeless shelters was phased out. This also involved phasing out the “old way” of thinking about homelessness. “There was some work to be done on attitudes,” concedes Kaakinen. “Some of the people in the NGOs found the idea of unconditional housing hard to accept.” Also some staff had difficulty with not forcing tenants with alcohol or drug problems to go cold turkey before they were given housing.

The model’s success speaks for itself: across the nation, chronic homelessness fell by 35 percent between 2008 and 2015; in some communities, it was halved.

Of course, building new housing and employing specially trained, round-the-clock caregivers is not cheap, costing the government nearly $382 million in that same span of time. Yet supporters of the program point out that this all pays for itself: according to one 2011 study, the country saved $18,500 annually for every homeless person given housing and professional support. That’s because they no longer needed to rely on emergency medical or police services to help them.

But as Juha Kaakinen, CEO of the Y-Foundation, which helps provide 16,500 low-cost apartments for the homeless, points out:

“Of course the fact that the program pays for itself is important, but beyond that, from a moral point of view, as a society which cares for all of its citizens, we didn’t think we see an alternative. This, we felt, was the way to go forward. And we did.”

The Cheapest and Most Sensible Solution to Homelessness

You guessed it (I think): giving homeless people housing. It sounds so deceptively obvious, even a bit humorous, yet it remains a relatively novel concept in the long fight against chronic homelessness. As I discussed in a previous post, a few cities have been experimenting with giving chronically homeless populations permanent housing; these initiatives have been met with great success, both ethical and economic (not only do people get the shelter they need, but cities and states save money on homelessness-related policing, incarceration, and emergency hospitalization).

Back in May, the Central Florida Commission on Homelessness, which looked at three counties in the state, found the annual cost of giving homeless people a residence and a dedicated caseworker was $10,000 per person — about one-third less than the $31,000 currently spent every year per homeless person (again, on policing, jailing, etc.). Similar recent studies found large financial savings in Charlotte and Southeastern Colorado by just providing housing. Continue reading

U.S. Government Rules Against Bans of Homeless People Sleeping Outside

Boise, Idaho is one of a multitude of cities across the United States that prohibits homeless people from sleeping or camping in public spaces. Following a lawsuit against the city brought by the National Law Center on Homelessness & Poverty (NLCHP), the U.S. Department of Justice weighed in with a statement of interest that could greatly impact local policy towards homeless people well beyond Boise.

The crux of the DOJ argument is that these bans violate the Eighth Amendment’s protections against cruel and unusual punishment. The reasoning is as follows:

When adequate shelter space exists, individuals have a choice about whether or not to sleep in public. However, when adequate shelter space does not exist, there is no meaningful distinction between the status of being homeless and the conduct of sleeping in public. Sleeping is a life-sustaining activity—i.e., it must occur at some time in some place. If a person literally has nowhere else to go, then enforcement of the anti-camping ordinance against that person criminalizes her for being homeless.

According to the New York Timesthis is the first time in twenty years that the Justice Department has gotten involved in this “still-unsettled” area of law. In doing so, the federal government is basically warning cities across the nation to treat homelessness more humanely. Either lift the bans, or ensure that there is adequate shelter space and housing so that homeless people do not have to sleep outside in the first place. Continue reading

Lessons From Charlotte and Salt Lake City On Ending Homelessness

Hundreds of thousands of Americans are homeless across the country, and it seems no city, big and small, is without a sizeable number residents deprived of permanent shelter.

Though Charlotte, North Carolina may be an exception.

According to a recent article in HuffPo, the city of over 775,200 has made groundbreaking strides in addressing chronic homelessness — and it has done so in the simplest way possible.

Moore Place, a nonprofit that provides permanent housing and other services to homeless people, has saved Charlotte $2.4 million in medical costs alone since 2012, according to a new report from UNC Charlotte. The study also found that the program’s clients are more likely to take advantage of preventative health care services, and get off the streets for good, than people who aren’t offered stable housing.

After two years of partaking in the program, 81 percent of clients remained in permanent housing.

“Stable housing provides a foundation for recovery and well-being,” Lori Thomas, a UNC professor of social work who led the study, said in a statement.

The 85-unit apartment complex follows the “housing first” model, an approach that once raised eyebrows, but has repeatedly proven to be cost-effective and efficient.

The concept promotes giving homeless people housing, and then addressing their mental health, unemployment or addiction issues after they’re settled.

Run by Urban Ministry Center, Moore Place opened in 2012 and gives clients access to a team of social workers, therapists, a nurse and psychologist, in addition to a place to call “home.” It costs about $14,000 to house an individual and residents contribute 30 percent of their incomes to rent. The rest is subsidized by private donations and public funding.

The program gives participating clients a fresh start and has led to major savings in the city’s medical system.

Tenants visited emergency rooms 648 fewer times and were in the hospital 292 fewer days after two years in the program.

Moore Place, a nonprofit that provides permanent housing and other services to homeless people, has saved Charlotte $2.4 million in medical costs alone since 2012, according to a new report from UNC Charlotte. The study also found that the program’s clients are more likely to take advantage of preventative health care services, and get off the streets for good, than people who aren’t offered stable housing.

After two years of partaking in the program, 81 percent of clients remained in permanent housing.

“Stable housing provides a foundation for recovery and well-being”, Lori Thomas, a UNC professor of social work who led the study, said in a statement.

The 85-unit apartment complex follows the “housing first” model, an approach that once raised eyebrows, but has repeatedly proven to be cost-effective and efficient.

The concept promotes giving homeless people housing, and then addressing their mental health, unemployment or addiction issues after they’re settled.

Run by Urban Ministry Center, Moore Place opened in 2012 and gives clients access to a team of social workers, therapists, a nurse and psychologist, in addition to a place to call “home”. It costs about $14,000 to house an individual and residents contribute 30 percent of their incomes to rent. The rest is subsidized by private donations and public funding.

The program gives participating clients a fresh start and has led to major savings in the city’s medical system.

Tenants visited emergency rooms 648 fewer times and were in the hospital 292 fewer days after two years in the program.

It seems like common sense: solve homelessness by giving the homeless homes. In some cases, it may not even be necessary to build any new stock, since most cities have ample vacant developments (especially following the burst of the real estate bubble). Providing permanent shelter helps line everything else into place, from finding steady employment (for which a permanent address is contingent) to, as Charlotte found, getting adequate healthcare.

Salt Lake City, Utah has seen similar resounding success with its decade-long “Housing First” initiative, which has lead to an incredible 91 percent reduction in chronic homelessness (defined as those who are homelessness longer than one year or who endure four episodes of homelessness in three years, and they have a disabling condition).

More from Deseret News:

Utah’s program places chronically homeless people in housing and supports them with services that help address the root causes of their homelessness such as physical and mental illness, substance abuse and addiction, low educational attainment, criminal records, or poor work histories.

Before “Housing First” started in 2005, about 14 percent of Utah’s homeless population met the definition of chronic homelessness and consumed about 58 percent of resources.

“Before the ‘Housing First’ model, people had to change their lives, and then we would offer them housing. Now what we do is we offer them housing and allow them to change their lives if they choose to do so,” Walker said.

Utah is the only state that has achieved such a sharp reduction in chronic homelessness on a statewide basis, he said.

“No other state is even close. We’ve had no additional resources than anyone else has had to do this, but by focusing, having a plan and having great collaboration with our partners, we’ve been able to see successes,” Walker said.

Around 10 percent of the nation’s homeless population is chronically homeless, and they account for more than 50 percent of available resources going to Americans experiencing homelessness. Housing these individuals in particular would not only improve their lives substantially, but will free up a considerable amount of capital and resources to other efforts (such as medical care, job training, and the like).

The Economic Sensibility of Housing the Homeless

It goes without saying that addressing the problem of homeless on all levels is a moral imperative. The ethical merit of keeping people off the streets, and helping uplift those already there, requires no argument (at least I should hope).

But unfortunately, in our world, morality is apparently not a good enough incentive. Even with all the capital that is available — whether it is wasted on the military industrial complex, sitting in offshore banks, or poured into pork-barrel projects — policies and solutions need to be cost-effective to gain any sort of political currency and public support.

Thankfully, there is a solution to alleviating homelessness that can bring together both moralists and cynics, providing the cost-efficiency that is so imperative to policymakers while legitimately helping those in need. 

Vox.com reported on a study by the Central Florida Commission that compared several approaches to addressing homeless in that region of the state (Florida has one of the highest rates of homeleness, not to mention poverty, in the country). 

[The study indicated] that the region spends $31,000 a year per homeless person on “the salaries of law-enforcement officers to arrest and transport homeless individuals — largely for nonviolent offenses such as trespassing, public intoxication or sleeping in parks — as well as the cost of jail stays, emergency-room visits and hospitalization for medical and psychiatric issues.”

Unsurprisingly, just dealing with the problem ad hoc or in a superficial sense is both costly and ineffective. But by contrast…

[Getting] each homeless person a house and a caseworker to supervise their needs would cost about $10,000 per person.

This particular study looked at the situations in Orange, Seminole, and Osceola Counties in Florida and of course conditions vary from place to place. But as Scott Keyes points out, there are similar studies showing large financial savings in Charlotte and Southeastern Colorado from focusing on simply housing the homeless.

The general line of thinking behind these programs is one of the happier legacies of the George W Bush administration. His homelessness czar Philip Mangano was a major proponent of a “housing first” approach to homelessness. And by and large it’s worked. Between 2005 and 2012, the rate of homelessness in America declined 17 percent. Figures released this month from the National Alliance to End Homeless showed another 3.7 percent decline. That’s a remarkable amount of progress to make during a period when the overall economic situation has been generally dire.

Here is a visual picture of the state of homelessness in the U.S.

Screen_shot_2014-05-30_at_9.26.15_am

Source: National Alliance to End Homelessness / Vox.com.

Keep in mind that this statistical success has taken place during some of the toughest economic times in our country’s history (and Florida’s economy was especially hard hit). As the article notes, there is a good reason why housing the homeless is more tenable than many would think:

When it comes to the chronically homeless, you don’t need to fix everything to improve their lives. You don’t even really need new public money. What you need to do is target those resources at the core of the problem — a lack of housing — and deliver the housing, rather than spending twice as much on sporadic legal and medical interventions. And the striking thing is that despite the success of housing first initiatives, there are still lots of jurisdictions that haven’t yet switched to this approach. If Central Florida and other lagging regions get on board, we could take a big bite out of the remaining homelessness problem and free up lots of resources for other public services.

There you go: a win-win for everyone, especially (and most importantly) he hundreds of thousands of homeless people across the country whose plight needn’t be ignored for either ethical or practical reasons. 

Your thoughts?

Portraits of the Homeless

As I’ve often lamented in previous posts, it’s not often many of us truly look at the human side of a lot of things. We hear so much about deaths here, or destroyed homes there, and other tragic occurrences that befall humans at every turn, and each time we react with a sort of perfunctory sense of sympathy.  Of course we feel bad, but we don’t truly know or understand the raw depths of these misfortunes. It’s not that we’re bad or selfish creatures, as most human beings are at least nominally moral or ethical (even if they have different standards of those things). There are many reasons for this disconnection from one another, including our limited cognitive and sensory abilities that literally keep us from being able to focus attention on too many sympathetic subjects, especially if they’re distant.

Of course, none of this justifies the level of callousness and even disgust that is often displayed towards the unfortunate. Homeless people are a case in point. It’s often assumed that they’re either crazy or lazy, if not both. Granted, there is a certain kernel of truth to these stereotypes, as with any: certainly, most homeless people, as far as we can tell, suffer from some sort of mental illness or another. And there are always going to be people who suffer misfortune due to their own neglect and irresponsibility. But to look down on all destitute people as vagrants, drug addicts, and wackos is not only a display of lazy, ignorant thinking; it dehumanizes an entire class of people who are every bit the same as us as we “better off” folks are to each other.

Regardless of which narrative you prescribe to, homeless people and other itinerants are pretty much ignored in most societies  (indeed, even in countries where people are predominately poor, you find vast amounts of segregation based on class and income, creating a virtual state within a state in some extreme cases). We go about our everyday lives not consciously aware of them, and even upon a chance encounter with one, we do our best to look away or not really acknowledge their existence. I know there are reasons for this beyond mere callousness, but it still fascinates me nonetheless.

Thankfully, I’m not the only one who is curious about all this. A photographer  form the UK named Lee Jefferies has pretty much made a career out of depicting the rawness and depth of the homeless, giving them an intense level of humanity through detailed black-and-white portraits. Most of those pictured are from his native Britain, as well as continental Europe and the US. They all display striking character in their expression and features. Interestingly, many of them appear elderly or close to it.

A link to these images, twenty-five in total, can be found here, with many more available here. The collection is quite large, but the sheer diversity of subjects is captivating. If anyone is interested in looking at more of his excellent work besides that of the homeless, Jefferies  has over a hundred more photos of various other subjects in his Flickr account.

Since I was a child, I’ve always been fascinated by homeless people. I grew up in a relatively well-off, middle-class family. I lived comfortably and satisfied, and the very idea of eking out an existence on the streets or in condemned housing seemed both unimaginably awful and remarkably inspiring. I thought about the lack of a warm bed, good food, personal amenities, and dignity. I thought of what it must be like to live in such a lonely, cold, dirty, and unhealthy environment, with everyone looking down on your or pitying you. You have to take your pick between being a subject of pity, often patronizing as it were, or outright contempt and hostility; you were either a poor, unfortunate wretch, or the scum of society. Either way, you existed in a different world that was shuttered away from most of the more fortunate.

As usual, I’m sure I’m romanticizing all this far more than I should. Reality is usually far more stark and straightforward. But I don’t care. It’s these victims of misfortune and cruel chance that remind me how luck I am to be sitting in the comfort of my room, surrounded by my nice things, writing about them. It’s their plight that has committed me to doing everything I can to make sure as many of them – if even just one of them – can be brought out of such misery and given a chance as possible. Few people deserve such a fate, and fewer still should be forgotten just because it’s befallen them. Anyone of us has as much chance as being in these photos as we do looking at them through our personal computers.

Many thanks to my good friend Mike for introducing me to these pics and, as always, spurring some deep reflections.