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How to House the Homeless

How to House the Homeless

Copyright Date: 2010
Published by: Russell Sage Foundation
Pages: 200
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  • Book Info
    How to House the Homeless
    Book Description:

    How to House the Homeless, editors Ingrid Gould Ellen and Brendan O’Flaherty propose that the answers entail rethinking how housing markets operate and developing more efficient interventions in existing service programs. The book critically reassesses where we are now, analyzes the most promising policies and programs going forward, and offers a new agenda for future research. How to House the Homeless makes clear the inextricable link between homelessness and housing policy. Contributor Jill Khadduri reviews the current residential services system and housing subsidy programs. For the chronically homeless, she argues, a combination of assisted housing approaches can reach the greatest number of people and, specifically, an expanded Housing Choice Voucher system structured by location, income, and housing type can more efficiently reach people at-risk of becoming homeless and reduce time spent homeless. Robert Rosenheck examines the options available to homeless people with mental health problems and reviews the cost-effectiveness of five service models: system integration, supported housing, clinical case management, benefits outreach, and supported employment. He finds that only programs that subsidize housing make a noticeable dent in homelessness, and that no one program shows significant benefits in multiple domains of life. Contributor Sam Tsemberis assesses the development and cost-effectiveness of the Housing First program, which serves mentally ill homeless people in more than four hundred cities. He asserts that the program’s high housing retention rate and general effectiveness make it a viable candidate for replication across the country. Steven Raphael makes the case for a strong link between homelessness and local housing market regulations—which affect housing affordability—and shows that the problem is more prevalent in markets with stricter zoning laws. Finally, Brendan O’Flaherty bridges the theoretical gap between the worlds of public health and housing research, evaluating the pros and cons of subsidized housing programs and the economics at work in the rental housing market and home ownership. Ultimately, he suggests, the most viable strategies will serve as safety nets—“social insurance”—to reach people who are homeless now and to prevent homelessness in the future. It is crucial that the links between effective policy and the whole cycle of homelessness—life conditions, service systems, and housing markets—be made clear now. With a keen eye on the big picture of housing policy, How to House the Homeless shows what works and what doesn’t in reducing the numbers of homeless and reaching those most at risk.

    eISBN: 978-1-61044-729-4
    Subjects: Sociology, Political Science

Table of Contents

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  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. About the Authors
    (pp. vii-viii)
  4. Acknowledgments
    (pp. ix-x)
  5. Chapter 1 Introduction
    (pp. 1-14)
    Ingrid Gould Ellen and Brendan O’Flaherty

    Eliminating homelessness or reducing its volume substantially will take certain changes in how housing markets operate. Homelessness, after all, is ultimately a housing market condition. People who leave homelessness have to live somewhere they weren’t living before. It is less clear which housing policies will do the best job of reducing homelessness.

    We organized a conference in the fall of 2008 to help identify those policies. We invited leading researchers, with backgrounds ranging from psychiatry to economics and policy, and challenged them to consider how housing policies influence homelessness. The papers collectively consider homelessness both among single adults and families....


    • Chapter 2 Service Models and Mental Health Problems: Cost-Effectiveness and Policy Relevance
      (pp. 17-36)
      Robert Rosenheck

      A recent analysis of data from the National Comorbidity Study Replication, a representative national epidemiological survey, found that 5 percent of U.S. adults reported a past episode of homelessness lasting a week or more. In comparison to other adults, those who had been homeless were six times more likely to have had an alcohol or drug problem and three times more likely to have had a psychiatric illness (Greenberg and Rosenheck n.d). Although it is thus clear that many homeless people have mental illnesses or problems with alcohol or drug use, the link between housing homeless people with such problems...

    • Chapter 3 Housing First: Ending Homelessness, Promoting Recovery, and Reducing Costs
      (pp. 37-56)
      Sam Tsemberis

      Candice, a fifty-three-year-old native New Yorker, was homeless for more than fifteen years when she was referred to Pathways. She stayed on the streets but slept in a tent that she frequently pitched in an Upper West Side park. Other campsites included the meridian that separates the northbound and southbound lanes of Broadway above 72nd Street. Her highly visible blue tent drew immediate attention from concerned citizens, outreach teams, and the police and typically resulted in a hasty involuntary transport and admission to one of the local psychiatric hospitals. A few weeks later, after discharge, this cycle would repeat.



    • Chapter 4 Rental Subsidies: Reducing Homelessness
      (pp. 59-88)
      Jill Khadduri

      A growing literature on the relationship between housing markets and homelessness suggests that subsidies to make housing more affordable for poor individuals and families can play an important role in reducing homelessness in the United States. Several recent papers show that rates of homelessness are higher in high-cost housing markets. For example, John Quigley, Steven Raphael, and Eugene Smolensky (2001) demonstrate that homelessness is more extensive in areas with low vacancy rates and high rents, based on counts of people homeless in various U.S. cities and metropolitan areas and in California counties. They conclude that “homelessnessmay be combated by modest...

    • Chapter 5 Fundamental Housing Policy Reforms to End Homelessness
      (pp. 89-109)
      Edgar O. Olsen

      The failure to offer assistance to all who become homeless is a major defect of the current system of low-income housing assistance. Replacing this system with an equally costly entitlement housing voucher program would ensure that housing assistance is available to all individuals who would otherwise be homeless. Such fundamental reform is justified on other grounds as well. Plausible assumptions about taxpayer preferences argue strongly for replacing the current patchwork of nonentitlement lowincome housing programs with an entitlement housing assistance program for the poorest individuals. Evidence on the excessive costs of all forms of project-based housing assistance argues for exclusive...

    • Chapter 6 Housing Market Regulation and Homelessness
      (pp. 110-140)
      Steven Raphael

      Local housing markets throughout the United States are subject to a host of regulations that tend to increase the cost of housing. Minimum lotsize requirements, quality standards, density restrictions, and other such municipally imposed regulation tend to limit the overall stock of available housing, increase average as well as minimum quality, and shift the overall distribution of housing prices toward higher levels. For the lowest income households, such factors will increase the proportion of household resources that one would need to devote toward housing. For the poorest of the poor, excessive regulation may push the price of even the minimum-quality...


    • Chapter 7 Homelessness as Bad Luck: Implications for Research and Policy
      (pp. 143-182)
      Brendan O’Flaherty

      Sometimes bad things happen to people. They lose their jobs; companions walk out on them; their health—physical or mental—deteriorates; they get evicted; prices of goods they rely on rise; they lose their benefits. Sometimes they are blameless in these calamities; sometimes they are not. Good things happen to people, too.

      Stochastic processes are a major consideration in the study of homelessness. Individual narratives of how people become homeless emphasize bad luck, and good luck often figures in how people leave homelessness. More objective studies support this subjective view. Predicting who will become homeless on the basis of observable...

  9. Index
    (pp. 183-190)