“The Invisible Crisis: Unpacking the Hidden Factors Behind Homelessness in America”
As we walk through the streets of our cities, it’s easy to overlook the faces of those struggling to find a place to call home. Homelessness is a complex issue that affects millions of Americans, leaving them without a roof, a bed, or a sense of security. But what drives this crisis? Is it solely a matter of economic instability or lack of affordable housing? The answer lies in a tangled web of factors, one of which is gaining increasing attention: limited access to healthcare.
The Importance of Housing in Reentry and Reintegration
Housing is arguably the most important element of reentry. Housing is foundational for stability in which to reintegrate and for avoiding further law enforcement contact associated with homelessness. Housing is critical to employment, substance use recovery, and successfully completing parole or probation—all critical for reentry.
As part of the Urban Institute’s “Returning Home” study, researchers found that people returning from prison view housing as a vital, if not the most vital, element of successful reintegration after incarceration (La Vigne, Visher and Castro, 2004). Given housing’s centrality to successful reentry and the myriad barriers to housing experienced by formerly incarcerated people, policies aimed at preventing and ending homelessness for criminal justice-involved populations are of great importance.
In the United States, there are only 37 units of rental housing affordable and accessible for every 100 extremely low-income (ELI) households, defined as households making less than 30 percent of the area median income (National Low Income Housing Coalition, 2021b). Areas with the highest housing costs tend to have the lowest availability of ELI housing and the highest prevalence of homelessness.
Housing First Approach
What is Housing First?
Housing First is a homeless assistance approach that prioritizes providing permanent housing to people experiencing homelessness, thus ending their homelessness and serving as a platform from which they can pursue personal goals and improve their quality of life.
This approach is guided by the belief that people need basic necessities like food and a place to live before attending to anything less critical, such as getting a job, budgeting properly, or attending to substance use issues. Additionally, Housing First is based on the understanding that client choice is valuable in housing selection and supportive service participation, and that exercising that choice is likely to make a client more successful in remaining housed and improving their life.
How is Housing First different from other approaches?
Housing First does not require people experiencing homelessness to address all of their problems, including behavioral health problems, or to graduate through a series of services programs before they can access housing. Housing First does not mandate participation in services either before obtaining housing or in order to retain housing.
The Housing First approach views housing as the foundation for life improvement and enables access to permanent housing without prerequisites or conditions beyond those of a typical renter. Supportive services are offered to support people with housing stability and individual well-being, but participation is not required as services have been found to be more effective when a person chooses to engage.
Who can be helped by Housing First?
A Housing First approach can benefit both homeless families and individuals with any degree of service needs. The flexible and responsive nature of a Housing First approach allows it to be tailored to help anyone.
As such, a Housing First approach can be applied to help end homelessness for a household who became homeless due to a temporary personal or financial crisis and has limited service needs, only needing help accessing and securing permanent housing. At the same time, Housing First has been found to be particularly effective approach to end homelessness for high need populations, such as chronically homeless individuals.
Practical Solutions and Recommendations
Addressing Barriers to Healthcare Access
Barriers to healthcare access often trigger cascading crises that can lead to homelessness. When people can’t access or afford necessary medical care, they face impossible choices between paying for treatment or rent. Medical debt, job loss due to untreated health conditions, and the draining of savings for emergency care can quickly destabilize housing security.
Strategies for improving access to healthcare services include:
- Expanding Medicaid coverage to ensure that low-income individuals have access to healthcare services.
- Increasing funding for community health centers and other outpatient facilities that provide culturally competent care.
- Implementing patient navigation programs to help individuals navigate the healthcare system and access necessary services.
- Food banks and pantries that provide essential food items.
- Shelters and transitional housing that provide temporary housing and support services.
- Health clinics and wellness programs that provide medical and mental health services.
The Role of Voluntary Services in Supporting Homeless Individuals
Voluntary services can play a critical role in supporting homeless individuals, including:
Implementing Housing First Programs
The Core Components of Rapid Re-Housing Programs
Rapid re-housing programs often provide rental assistance that varies in duration depending on the household’s needs. Consumers sign a standard lease and are able to access supports as necessary to help them do so.
A variety of voluntary services may be used to promote housing stability and well-being during and following housing placement. Two common program models follow the Housing First approach but differ in implementation. Permanent supportive housing (PSH) is targeted to individuals and families with chronic illnesses, disabilities, mental health issues, or substance use disorders who have experienced long-term or repeated homelessness. It provides long-term rental assistance and supportive services.
The Evidence Base for Housing First: Does it Work?
There is a large and growing evidence base demonstrating that Housing First is an effective solution to homelessness. Consumers in a Housing First model access housing faster and are more likely to remain stably housed. This is true for both PSH and rapid re-housing programs.
PSH has a one-year housing retention rate of up to 98 percent. Studies have shown that rapid re-housing helps people exit homelessness quickly—in one study, 83% of participants were successfully housed within 30 days. Housing First has been shown to be particularly effective among populations with high needs, such as those experiencing chronic homelessness or suffering from mental health and substance use disorders.
Conclusion
In conclusion, the article “What Causes Homelessness: Limited Access to Healthcare and Voluntary Services” by the National Alliance to End Homelessness sheds light on a crucial aspect of the complex issue of homelessness – the interplay between limited access to healthcare and voluntary services. The article argues that these two factors are interconnected and contribute significantly to the persistence of homelessness. By highlighting the inadequate healthcare infrastructure, lack of affordable housing options, and limited availability of mental health services, the article emphasizes that addressing homelessness requires a comprehensive approach that addresses these underlying issues. Furthermore, the article stresses the importance of voluntary services, such as housing first initiatives and peer support programs, in providing essential support to individuals experiencing homelessness.
The significance of this topic cannot be overstated, as it underscores the need for policymakers, healthcare providers, and social service organizations to work together to address the root causes of homelessness. The article’s findings have far-reaching implications for the development of effective solutions, including the need to increase funding for healthcare services, improve access to affordable housing, and expand voluntary services. By prioritizing the needs of individuals experiencing homelessness, we can work towards creating a society that values human dignity and provides essential support to those who need it most.