Menus Subscribe Search

Follow us


Homelessness: More Evidence on the Wisdom of Housing First

• March 31, 2009 • 10:55 PM

 

Abstinence always seems like the easiest way to end behavior we don’t like, but studies with homeless alcoholics finds that a little leeway leads to lots of savings.

In the current edition of Miller-McCune magazine Frank Kosa’s “The Homemakers,” looks at three gentlemen whose efforts to tackle persistent homelessness in the United States “has greatly reduced — and just might end — homelessness.” A study just published in the Journal of the American Medical Association has provided further evidence that this ambitious contention might not be all that wide of the mark.

The study’s findings aren’t too surprising if you read the magazine piece, but they’re revolutionary if you haven’t. In short, giving alcoholics living on the street a place to stay and some health and other social services — and not requiring them to give an almost-certain-to-be-broken pledge to lay off the sauce — can save the public purse thousands of dollars per subject. Plus, once the homeless are in a decent place, on average they start drinking less anyway.

There are a lot of moving parts to the paragraph above, so let’s hear a quote from the lead author of the JAMA paper, psychiatry professor Mary E. Latimer of the University of Washington. “Our study suggests that homeless alcoholics who qualify to take part in Housing First can stay out of jails and emergency rooms, and cost the taxpayer a lot less money as a result. We also found that these benefits increase over time and that they are possible without requiring that participants stop drinking. And yet, the longer the participants stay in the housing program, the less they drink.”

The subjects of our article — policy analyst Dennis Culhane, New York psychologist Sam Tsembris, and bureaucrat Philip Mangano — could have told you this, and did in our article, but this study “represents the first U.S. controlled assessment of the effectiveness of Housing First specifically targeting chronically homeless alcoholics,” according to a news release from the Robert Wood Johnson Foundation’s Substance Abuse Policy Research Program, which paid for the study.

With April 15 annoyingly close, what kind of savings numbers are we talking about?

The study looked at 95 residents of a Housing First program in downtown Seattle and compared them with 39 other homeless alcoholics (on a waiting list for the program) for six-month periods beginning in November 2005 (the study ended in March 2007). The subjects were drawn from a list of Seattle’s “most expensive users” of hospitals, jails and sobering centers.

In the first year, government costs per subject in the program ranged from $2,067 to $8,264 a month, with a median cost of $4,066. If you’re currently laid off or making less than say $50,000 a year, that might stick in your craw. But after six and then 12 months in housing, median costs fell to $1,492 and $958 a month respectively.

Those of us with cold little hearts might balk at spending even that on homeless alcoholics, but the study found that it was on average $2,449 a month less than what was already being spent anyway.

Parsing the numbers another way, Larimer is quoted in the release, “Each (enrollee) had cost state and local governments an average of $86,062 per year before being housed, compared to an average of $13,440 it costs per person per year to administer the housing program.”

And so at the end of a longer period, the subjects never drink and go on to win fame and fortune? Maybe, maybe not. To draw again from the release, “Because health care and criminal justice system costs for the participants continued to decrease over time, as did their alcohol use, Larimer says, she and her co-authors concluded that permanent housing may be necessary in order to take full advantage of the cost-savings identified in the study.”

Nonetheless, Seattle saved $4 million in the program’s first year, and that was for just 95 people.

So returning to the big picture, “In most U.S. cities, people with behavioral health disabilities die on the streets far more frequently than any other subset of the homeless population,” said William G. Hobson, executive director of Seattle’s Downtown Emergency Service Center and a paper co-author. “Before they die, they use large amounts of taxpayer-funded services in our health care and criminal justice systems. The housing program, known in Seattle as the 1811 Eastlake project, was created to stabilize people and stop them from endlessly cycling through emergency rooms, prisons and other crisis institutions, reducing the amount of taxpayer money spent on them.”

So there’s something to like here even if you do have a cold little heart.

Michael Todd
Most of Michael Todd's career has been spent in newspaper journalism, ranging from papers in the Marshall Islands to tiny California farming communities. Before joining the publishing arm of the Miller-McCune Center, he was managing editor of the national magazine Hispanic Business.

More From Michael Todd

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

October 1 • 9:14 AM

Mysterious Resting State Networks Might Be What Allow Different Brain Therapies to Work

Deep brain stimulation and similar treatments target the hubs of larger resting-state networks in the brain, researchers find.


October 1 • 6:00 AM

Would You Like a Subscription with Your Coffee?

A new app hopes to unite local coffee shops while helping you find a cheap cup of good coffee.


October 1 • 4:00 AM

How to Plant a Library

Somewhere outside of Oslo, there are 1,000 newly-planted spruce trees. One hundred years from now, if everything goes to plan, they’ll be published together as 100 pieces of art.



September 30 • 10:09 AM

Trust Is Waning, and Inequality May Be to Blame

Trust in others and confidence in institutions is declining, while economic inequality creeps up, a new study shows.


September 30 • 8:00 AM

The Psychology of Penmanship

Graphology: It’s all (probably) bunk.



September 30 • 6:00 AM

The Medium Is the Message, 50 Years Later

Five decades on, what can Marshall McLuhan’s Understanding Media tell us about today?


September 30 • 4:00 AM

Grad School’s Mental Health Problem

Navigating the emotional stress of doctoral programs in a down market.


September 29 • 1:21 PM

Conference Call: Free Will Conference


September 29 • 12:00 PM

How Copyright Law Protects Art From Criticism

A case for allowing the copyright on Gone With the Wind to expire.


September 29 • 10:00 AM

Should We Be Told Who Funds Political Attack Ads?

On the value of campaign finance disclosure.


September 29 • 8:00 AM

Searching for a Man Named Penis

A quest to track down a real Penis proves difficult.


September 29 • 6:00 AM

Why Do So Many People Watch HGTV?

The same reason so many people watch NCIS or Law and Order: It’s all a procedural.


September 29 • 4:00 AM

The Link Between Depression and Terrorism

A new study from the United Kingdom finds a connection between depression and radicalization.


September 26 • 4:00 PM

Fast Track to a Spill?

Oil pipeline projects across America are speeding forward without environmental review.


September 26 • 2:00 PM

Why Liberals Love the Disease Theory of Addiction, by a Liberal Who Hates It

The disease model is convenient to liberals because it spares them having to say negative things about poor communities. But this conception of addiction harms the very people we wish to help.


September 26 • 1:21 PM

Race, Trust, and Split-Second Judgments


September 26 • 9:47 AM

Dopamine Might Be Behind Impulsive Behavior

A monkey study suggests the brain chemical makes what’s new and different more attractive.


September 26 • 8:00 AM

A Letter Becomes a Book Becomes a Play

Sarah Ruhl’s Dear Elizabeth: A Play in Letters From Elizabeth Bishop to Robert Lowell and Back Again takes 900 pages of correspondence between the two poets and turns them into an on-stage performance.


September 26 • 7:00 AM

Sonic Hedgehog, DICER, and the Problem With Naming Genes

Wait, why is there a Pokemon gene?


September 26 • 6:00 AM

Sounds Like the Blues

At a music-licensing firm, any situation can become nostalgic, romantic, or adventurous, given the right background sounds.


September 26 • 5:00 AM

The Dark Side of Empathy

New research finds the much-lauded feeling of identification with another person’s emotions can lead to unwarranted aggressive behavior.



September 25 • 4:00 PM

Forging a New Path: Working to Build the Perfect Wildlife Corridor

When it comes to designing wildlife corridors, our most brilliant analytical minds are still no match for Mother Nature. But we’re getting there.


Follow us


Mysterious Resting State Networks Might Be What Allow Different Brain Therapies to Work

Deep brain stimulation and similar treatments target the hubs of larger resting-state networks in the brain, researchers find.

Trust Is Waning, and Inequality May Be to Blame

Trust in others and confidence in institutions is declining, while economic inequality creeps up, a new study shows.

Dopamine Might Be Behind Impulsive Behavior

A monkey study suggests the brain chemical makes what's new and different more attractive.

School Counselors Do More Than You’d Think

Adding just one counselor to a school has an enormous impact on discipline and test scores, according to a new study.

How a Second Language Trains Your Brain for Math

Second languages strengthen the brain's executive control circuits, with benefits beyond words.

The Big One

One company, Amazon, controls 67 percent of the e-book market in the United States—down from 90 percent five years ago. September/October 2014 new-big-one-5

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.