Seems like they are over complicating it…
“Evan’s younger brother had experienced some serious mental health issues and he was awaiting news of a diagnosis.”
“his mother was a schizophrenic and a heroin addict who often paid for her drug habit with sex. They were homeless, moving constantly. Often she would head off for days at a time, leaving Evan with friends or relatives, or sometimes on his own, without food. When he was 11, she took her own life”
“Evan’s father began to suffer with mental health issues. By the time the pandemic arrived, he was in full crisis, using drugs and worried enough about Covid that he had locked himself inside his house. For a week, Evan stayed with him, and they shuttled back and forth to hospital as his father experienced mounting phobias and suicidal thoughts, but refused treatment. At the end of that week, his father took his own life.”
Dude literally had the deck stacked against him.
“The real problem came when Evan inherited his share of his father’s estate – $170,000. He used some of the money to rent an apartment. “But I had extreme schizophrenia and I just filled it with trash because I was so out of my mind,” he says. “I was seeing faces dripping down the walls, I couldn’t even be in there.””
And this, kids, is why the “Housing First” model won’t work. Mental Health and addiction treatment have to come first THEN housing.
Mental Health and addiction treatment have to come first THEN housing.
Some people will struggle with mental illness and addiction their entire lives. Would you think it’d be easier to fight those things when you’re homeless or when you aren’t?
I’m Finnish. It’s hard to even speak to some Americans, because I genuinely can’t fathom some people who consider others to “belong on the street”, “they deserve it” and one that has even made it some of my dumbo liberalist Finnish acquaintances “homelessness is a choice”.
Ofc housing first works. Because it’s not “housing first” in the sense that it purposefully houses people before getting them mental health or addiction help. It’s “housing first” as in “having a place so you don’t need to sleep on the street is a priority”.
We have “housing first” (we don’t call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you’d obviously go through a ward to handle the most acute effects and get you on a basic functional level, during which they’d probably communicate with social workers who’d get them some sort of housing.
The system is good but in practice people aren’t perfect and both sides make mistakes; some people are too addicted and have problems and hard to be helped, but also sometimes the bureaucracy is fucked or some social workers / doctors suck.
Still, as long as those people have an apartment to go to, it’s more or less fine.
People are rarely as fucked up as that, even actively schizophrenic people. (Like literally my upstairs neighbour. No joke.) You shouldn’t use a psychotic episode to argue that housing being prioritised is a bad thing. That’s just a non-sequitur.
We have “housing first” (we don’t call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you’d obviously go through a ward to handle the most acute effects and get you on a basic functional level,
Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century. So far there hasn’t been much legislative movement to change this. There are also nowhere near enough psych ward beds nationwide to stabilize the existing number of homeless who are obviously severely mentally ill.
Should all these things be fixed? Yes.
The chance of the federal government or any state governments fixing it is absolute zero.
In fact, the federal government and the vast majority of state governments are making absolutely no attempt whatsoever.
Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century.
You’re talking about indefinite holds. I’m talking about a definite hold of 72 hours, which isn’t uncommon in the states either, being a de facto medical necessity, seeing how psychotic people exist. It’s called an psychiatric emergency hold.
We’re not talking about people taking over someone’s whole life and their rights a la Britney or some much worse case. We’re talking about taking someone who’s having an episode and treating that episode, then letting them back out again. Sometimes that takes longer than a few days, but usually those people understand enough to actually voluntarily stay after the three days they’ve had to stay. And if not, and they actually refused medical care, one could take them to jail if they were being disruptive. I believe putting people in jail is something you also do in Aaaamericaa?
(the video isn’t related just I imagined saying that with the same accent and incredulity as in the video)
You put them in permanent medical care to treat their mental health and addiction, THEN, once they’re stable, you move them to housing.
If they are too mentally ill to become stable, you keep them in medical care.
You don’t understand how long-term psychiatric care works.
You don’t “cure” schizophrenia, buddy. Most patients are mostly stable.
I know people with mental illness who sometimes stop taking their meds and start fucking about and being manic, and once they get to be too disruptive, someone calls the cops, the cops go check it out (ours don’t murder the mentally ill — which is a massive difference between our countries — ours are bastards still, but less murdery ones), and take him to the ER from which people who can’t be helped right away because they’re psychotic due to drugs go to a closed ward and people who are psychotic for non-substance reasons go another closed ward.
Usually though, with cases such as I know, it’s quite enough for the cops to take the person to the ER where they give a slow-release IM injection of some antipsychotics, and the people won’t be as bothersome for a week or two (there definitely are side effects to these meds, context really matters), but they will be able to go home and won’t need to be taken into a ward — because outpatient care is a lot cheaper than inpatient care.
Stable being “no longer collecting garbage and seeing faces on the walls”.
In the case cited above, the guy had housing but was still in a mental health crisis. Housing First cannot and will not provide that stability, only professional mental health care can do that.
And why do you think them not being homeless somehow excludes the option of mental health care?
It doesn’t here. Where we actually use this policy.
Because right now, Housing First doesn’t demand treatment. That’s why it doesn’t work.
It doesn’t even demand you fill prescribed medication and take it on schedule, hell, it doesn’t even require you get evaluated for prescribed medication.
So you get stories like the above, a housed undiagnosed mental patient filling their home with garbage and living in terror from things that aren’t there.
You’ll get those no matter what, until you manage to cure ALL undiagnosed mental illness. And undiagnosed mental illness is by definition undiagnosed.
Without “housing first” (again, a bullshit name) you’d have those people living on the street. You may not understand this, clearly living a sheltered life and having little to no actual experience on the matter, but homeless crazy people are a lot more dangerous than crazy people who get to go crazy in an apartment.
Oh no, did an undiagnosed mental illness result in an apartment that will take two men at least an hour and a half to fix? Oh no, that’s acceptable, clearly we should not house people at all and toss everyone on the street to get even sicker and literally die.
“Housing first” is preventative. Living on the street creates mental illness, and a person NOT being homeless does NOT prevent them from getting mental health care. The main point of my last comment, nay, all my comments. Yet you can’t answer it.
The fix for this is super simple, you get people healthy BEFORE getting them into housing.
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You collect up all the homeless people and evaluate them.
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Folks with mental illness are diverted to treatment.
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Folks with addiction issues are diverted to treatment.
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Folks with outstanding warrants are sent to corrections.
NOW…
Once people successfully complete treatment or have served their prison time, there needs to be a re-integration system, this applies also to homeless people who aren’t part of 2-4.
- Job and clothing assistance. Resume building, job skills, access to laundry, a mailing address, phone, email and internet.
There needs to be specialists here specifically to help people with criminal records.
- NOW you bring in the housing assistance. You’ve given people the skills they need to get healthy, avoid addiction, and get a job. Now they’re ready for housing. Not before.
As in step 5, there needs to be housing specialists just for people with criminal records.
If you put housing first, with no requirements for mental health or addiction services, it fails. Over and over and over again, it fails.
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Do you think there’s no professional managing the case? That they just give them keys, a pat on the back, and proclaim “Figure it out!” It’s naive to think either solution is a magic bullet, but one approach has statistically better outcomes.
That’s EXACTLY the problem with Housing First. Legally they are prevented from placing restrictions on the housing.
So they can’t demand residents enter treatment, remain sober, take their meds or even obtain proper meds.
It’s housing without restrictions and that plainly does not work if the people you are housing have severe mental illness and addiction issues.
Some dude inherited a lot of money and had no support in addition to his addictions and mental health issues so therefore housing first won’t work?
Obviously not, we should just let them rot on the street getting worse!
/S
Housing First doesn’t mean there’s no support services. You obviously know that. I will grant that many talk about Housing First as the only solution for everyone, but this isn’t looking true from the research.
Throwing out Housing First because you found an edge case doesn’t mean it isn’t valuable for many.
This is simply the latest case, it’s not an edge case.
https://ciceroinstitute.org/research/housing-first-is-a-failure/
“We’ve built over 200,000 new PSH units for the homeless, as they’re known, and, since 2013, the federal government has mandated the Housing First strategy nationwide. Yet since that nationwide mandate has gone into effect, we’ve seen street homelessness increase by almost a fourth. While some advocates cite the overall decline in homelessness since the early 2000s, they ignore that the entire decline was the result of moving people from “transitional” government housing, which was counted as homeless, to “permanent” government housing, which was counted as not homeless. In effect, if one ignores this statistical smoke show, homelessness has gone up almost one-to-one with the increase in permanent housing.”
https://www.thepublicdiscourse.com/2023/07/90060/
"Housing First forbids requiring beneficiaries, as a condition of receiving assistance, to attend drug rehabilitation programs, look for work, or even take their mental health medicines as directed by a doctor. They can accept services that might be—and often are—offered, but they are under no enforceable obligation to do so. If they take drugs, refuse work, or even are charged with crimes, housing is still available to them.
That’s like putting a bandage on an inflamed wound without also applying medicine to heal the underlying infection. As a result, many of the unhoused receiving Housing First benefits make no effort to turn their lives around, leaving them mired in dysfunction and dependence."
"In its worst iteration, Housing First is a no-strings-attached approach. Beneficiaries receive housing and don’t need to attend job training programs or agree to a sober lifestyle. It’s a well-intentioned approach, but it simply isn’t working.
Since 2019, California has spent $24 billion on homelessness programs, even mandating all state-funded programs to adopt the Housing First model. Homeless resource centers aren’t allowed to make housing conditional on participation in addiction recovery or job training programs. Yet chronic homelessness in the state keeps climbing.
In Utah, Housing First has been the de facto approach since 2005. Yet from 2017 to 2022, the number of chronically homeless skyrocketed 328%. "
Two right wing think tanks and a mayor of a suburban town are hardly strong evidence. That mayor was a congress person who wanted to repeal the ACA, denied that Obama was born in the US, ad cut military veteran healthcare benefits.
From the Wikipedia entry for the institute that publishes Public Discourse
The Witherspoon Institute is a conservative think tank in Princeton, New Jersey founded in 2003 … The Witherspoon Institute opposes abortion and same-sex marriage
From the Wikipedia page for the founder of the Cicero Institute
Lonsdale founded the Cicero Institute conservative think tank in 2016, and he runs it along with his wife, Tayler. The group has pushed for criminalizing homelessness and rejecting Housing First policies. The group publishes a template for state legislation that includes fines of up to $5,000 for repeatedly violating encampment bans and language to facilitate involuntary psychiatric commitments. As of August 2024, bills based on the template have been introduced in fifteen states and passed in eight. According to Rolling Stone, the Cicero Institute “helped transform homelessness policing from a niche fixation of a segment of Silicon Valley into a rallying cry in the culture war”.
If you want me to take you seriously, provide a meta-analysis or a systematic review in a well regarded peer reviewed journal.
Would you prefer a local take? It’s the same story over and over again:
You bring a bunch of people with mental illness and addiction issues into one place, without mandating treatment, you are CONCENTRATING the problem, not solving it.
Me: please provide a scientific study published in a reputable journal.
You: here’s a local article that continues to prove my point!
Me: 😓You rejected the other sources on this, you reject a local source on this, I’m not sure how many sources you want before you’ll accept Housing First doesn’t work.
If you want a journal, they’re out there too…
In fact, if you had bothered to look at the footnotes on the very first source I gave you:
https://ciceroinstitute.org/research/housing-first-is-a-failure/
“Yet studies have now shown that simply providing people subsidized housing does not reduce drug use, and often encourages it, which makes sense because there is no mandated treatment in PSH and the free unit provides people with more money to pursue their habits.[10]”
You would have seen the sources cited such as:
[10] “Rebecca A. Cherner, et. al., “Housing First for Adults with Problematic Substance Use,” Journal of Dual Diagnosis 13 (2017); Tsai, J., Kasprow, W.J., & Rosenheck, R.A. Alcohol and drug use disorders among homeless veterans: Prevalence and association with supported housing outcomes. Addictive Behaviors, 39 (2014): 455-460;”
But you aren’t interested in the articles telling you what the papers say, you definitely won’t be reading the papers either.
The study they use to support that quote does not actually support that quote. You should read the discussion section of the cited study. Did you ever wonder why they only cited one seven year old journal article? And then misrepresent it’s findings?
Housing first is a gift to developers and designed to appeal to middle class baby boomer understanding of the economy. But where is the organized lobbying industry group (doctors? Hospitals?) to accept a gift of treatment centers that appeals to the increasingly numerous friends/relatives-of-mentally-ill-people and others who realize this abundance of disorder is a symptom of global changes and not just a ridiculous number of individuals lacking “character”?
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