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 23 • 2:00 PM

American Companies Are Getting Way Too Cozy With the National Security Agency

Newly released documents describe “contractual relationships” between the NSA and U.S. companies, as well as undercover operatives.


October 23 • 12:00 PM

The Man Who’s Quantifying New York City

Noah Davis talks to the proprietor of I Quant NY. His methodology: a little something called “addition.”


October 23 • 11:02 AM

Earliest High-Altitude Settlements Found in Peru

Discovery suggests humans adapted to high altitude faster than previously thought.


October 23 • 10:00 AM

The Psychology of Bribery and Corruption

An FBI agent offered up confidential information about a political operative’s enemy in exchange for cash—and they both got caught. What were they thinking?


October 23 • 8:00 AM

Ebola News Gives Me a Guilty Thrill. Am I Crazy?

What it means to feel a little excited about the prospect of a horrific event.


October 23 • 7:04 AM

Why Don’t Men Read Romance Novels?

A lot of men just don’t read fiction, and if they do, structural misogyny drives them away from the genre.


October 23 • 6:00 AM

Why Do Americans Pray?

It depends on how you ask.


October 23 • 4:00 AM

Musicians Are Better Multitaskers

New research from Canada finds trained musicians more efficiently switch from one mental task to another.


October 22 • 4:00 PM

The Last Thing the Women’s Movement Needs Is a Heroic Male Takeover

Is the United Nations’ #HeForShe campaign helping feminism?


October 22 • 2:00 PM

Turning Public Education Into Private Profits

Baker Mitchell is a politically connected North Carolina businessman who celebrates the power of the free market. Every year, millions of public education dollars flow through Mitchell’s chain of four non-profit charter schools to for-profit companies he controls.


October 22 • 12:00 PM

Will the End of a Tax Loophole Kill Off Irish Business and Force Google and Apple to Pay Up?

U.S. technology giants have constructed international offices in Dublin in order to take advantage of favorable tax policies that are now changing. But Ireland might have enough other draws to keep them there even when costs climb.


October 22 • 10:00 AM

Veterans in the Ivory Tower

Why there aren’t enough veterans at America’s top schools—and what some people are trying to do to change that.


October 22 • 8:00 AM

Our Language Prejudices Don’t Make No Sense

We should embrace the fact that there’s no single recipe for English. Making fun of people for replacing “ask” with “aks,” or for frequently using double negatives just makes you look like the unsophisticated one.


October 22 • 7:04 AM

My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.


October 22 • 6:00 AM

How We Form Our Routines

Whether it’s a morning cup of coffee or a glass of warm milk before bed, we all have our habitual processions. The way they become engrained, though, varies from person to person.


October 22 • 4:00 AM

For Preschoolers, Spite and Smarts Go Together

New research from Germany finds greater cognitive skills are associated with more spiteful behavior in children.


October 21 • 4:00 PM

Why the Number of Reported Sexual Offenses Is Skyrocketing at Occidental College

When you make it easier to report assault, people will come forward.


October 21 • 2:00 PM

Private Donors Are Supplying Spy Gear to Cops Across the Country Without Any Oversight

There’s little public scrutiny when private donors pay to give police controversial technology and weapons. Sometimes, companies are donors to the same foundations that purchase their products for police.


October 21 • 12:00 PM

How Clever Do You Think Your Dog Is?

Maybe as smart as a four-year-old child?


October 21 • 10:00 AM

Converting the Climate Change Non-Believers

When hard science isn’t enough, what can be done?



October 21 • 8:00 AM

Education Policy Is Stuck in the Manufacturing Age

Refining our policies and teaching social and emotional skills will help us to generate sustained prosperity.


October 21 • 7:13 AM

That Cigarette Would Make a Great Water Filter

Clean out the ashtray, add some aluminum oxide, and you’ve (almost) got yourself a low-cost way to remove arsenic from drinking water.


October 21 • 6:00 AM

Fruits and Vegetables Are About to Enter a Flavor Renaissance

Chefs are teaming up with plant breeders to revitalize bland produce with robust flavors and exotic beauty—qualities long neglected by industrial agriculture.


October 21 • 4:00 AM

She’s Cheating on Him, You Can Tell Just by Watching Them

New research suggests telltale signs of infidelity emerge even in a three- to five-minute video.


Follow us


Earliest High-Altitude Settlements Found in Peru

Discovery suggests humans adapted to high altitude faster than previously thought.

My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.

That Cigarette Would Make a Great Water Filter

Clean out the ashtray, add some aluminum oxide, and you've (almost) got yourself a low-cost way to remove arsenic from drinking water.

Love and Hate in Israel and Palestine

Psychologists find that parties to a conflict think they're motivated by love while their enemies are motivated by hate.

How to Water a Farm in Sandy Ground

Physicists investigate how to grow food more efficiently in fine-grained soil.

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.