Fifteen years ago, programs to house the chronically homeless increasingly began turning to permanent supportive housing, or PSH, which combines subsidized housing with services to treat mental illness, substance abuse and other afflictions.
The novelty was that homeless clients could receive housing whether or not they took advantage of the other services. Before that, participation in treatment programs often was a prerequisite for receiving a place to live.
Today PSH is the dominant policy at the federal, state and local level. Since 2007, the number of PSH units has grown by 50 percent, from 189,000 to 284,000. Has it worked? A new study in the June 2014 Social Service Review suggests that it has—up to a point.
In “The Relationship Between Community Investment in Permanent Supportive Housing and Chronic Homelessness,” researchers affiliated with several universities and the Veterans Administration examine data on chronic homelessness gathered from 327 communities between 2007 and 2012. They conclude that an increase of one PSH unit per 10,000 population correlated with a one percent decrease in the number of chronically homeless.
The federal government defines the chronically homeless as those who suffer from a disability and have been homeless at least a year, or who have suffered four episodes of homelessness in the previous three years. On any given night the chronically homeless make up about 23 percent of the overall homeless population.
The researchers were surprised that PSH programs did not have a larger effect. One reason, they suggest, is that only 27 percent of PSH units around the country are set aside for the chronically homeless. Agencies overseeing the programs may be favoring clients with less severe problems.
Indeed, the Department of Housing and Urban Development, a major source of PSH funding, sent out new guidelines last June in an effort to increase the numbers of chronically homeless in PSH programs.
“From a policy perspective the direction is pretty clear,” says Thomas Byrne, an assistant professor of social work at Boston University and one of the authors of the study. “Policy makers decided that this is something that should be expanded on a larger scale. There are those who think the model itself is not the best, that the treatment-first approach is better. But the momentum is very much in favor of this.”
Byrne, Thomas, et al. “The Relationship Between Community Investment in Permanent Supportive Housing and Chronic Homelessness.” Social Service Review 88 (2): 234-263.