Opinion: How Houston’s homelessness breakthrough could be a national game-changer

When our homeless response outreach teams first met Curtis, he had been living on the streets for nearly 20 years. He was sleeping in a tent under a freeway near downtown Houston. Following the unexpected death of his mother, he had fallen into a deep depression. A lack of adequate mental health support had led him to self-medication, then drug-related incarceration, then homelessness.

Marc Eichenbaum - City of Houston

But one day last November, Curtis couldn’t stop smiling. He was moving into permanent supportive housing — his own apartment with a bright blue door. These days, Curtis enjoys watching movies and reading books in his home, which he now shares with a new companion: a kitten named Bella.

In Houston, we believe our most difficult issues, including homelessness, are solvable. We know that people like Curtis are not beyond help, so long as we work collaboratively and strategically to assist them. Our approach to tackling this seemingly intractable problem can serve as a guide to other American cities seeking to address growing homeless populations.

Michael Nichols - 1133 Studios

We should note that homelessness got worse here before it got better. In 2011, the Houston area had one of the largest homeless populations in the country. With the threat of homelessness only increasing, and dismay over decades of substantial investments without results, our community was propelled into action.

Since 2012, more than 28,000 people who have experienced homelessness in the greater Houston area have been housed. This has resulted in a more than a 60% decrease in overall homelessness in just over a decade.

So, what changed? In 2012, we came together as a unified, regional, homeless response system called The Way Home and chose the nonprofit Coalition for the Homeless of Houston/Harris County as our lead agency.

Then we made three crucial decisions. First, we decided to work together as a collaborative system, aligned around a standardized set of goals, processes and strategies, rather than as individual organizations and government entities each trying to chip away at the problem. Today, more than 100 entities in the Houston area are working together and combining their efforts and resources to move the needle on reducing homelessness. Our collaboration includes using a centralized database to capture information and track the service needs of people experiencing homelessness and using a standardized assessment to determine which housing and/or service interventions best suit each household.

Second, we embraced the data-proven best practices of Housing First, a strategy focused on getting individuals and families out of homelessness and into permanent housing before helping them address any other problems. We do this via voluntary wraparound support services, e.g., mental health or substance abuse counseling, health care, job training and so on. The services help keep the person housed, and the housing is what makes the services effective.

Third, we housed the most vulnerable people first. When the average person sees someone experiencing homelessness and struggling with mental illness, they assume that individual is dangerous or needs hospitalization. Our experience is that most of these folks stabilize in housing with the appropriate level of services.

Moreover, we have found that most people fall into homelessness because of rapid and unexpected financial losses — those that needn’t result in catastrophe, if only we had the right policies in place  — and that homelessness often exacerbates mental health deterioration and the need to self-medicate. In other words, mental illness is not the driver of homelessness in most cases.

That’s why housing in our homeless response system has three components. First, we provide an actual home – most often an apartment – with a key, a lease in the person’s name and everything needed to stay in that unit for the long haul. Second, we give them a subsidy for the rent. Depending on the program, residents may still contribute 30% of their income. Finally, we ensure support services to help the person move forward psychologically, emotionally and financially.

Our success is deeply intertwined with our collaborative approach – bringing together the city of Houston, Harris County, public housing authorities, major philanthropic foundations, faith groups, the private sector and more than 100 nonprofit agencies.

This became particularly critical during Covid-19, when homelessness became a present danger to many people who were already living on the brink. As challenging as it was, we reframed this crisis as an opportunity to do more to assist them. The city of Houston and Harris County strategically invested federal pandemic aid, alongside contributions from private philanthropy, allowing our system to house, or offer homelessness diversion services to, more than 12,000 people during the pandemic.

We have also found that housing with supportive services is the solution to encampments — sites where unhoused people set up groups of tents. We have holistically decommissioned dozens of encampments by placing close to 400 people on the path to housing.

We are doing this difficult work not just because it is the moral thing to do, but also because it is the fiscally responsible thing to do. It is less expensive to house an individual and provide services (we estimate about $18,000 per year) than the multiple of costs of putting people in jail or allowing them to suffer on the streets and being forced to make regular use of our emergency rooms (which national estimates range from $30,000 to $50,000 and up).

As communities focus on reducing homelessness, our experience is that often the last remaining people on our streets are those suffering from severe behavioral health issues who need a higher level of care. From the local mental health authority, the local Veterans Affairs office and law enforcement to the public health and homeless response systems, many organizations have responded and attempted to help with limited, sustained success.

We’ve observed that, too often, each organization engaged in this work independently exhausts all the tools at their disposal and either succumbs to despair and accepts defeat, or absolves themselves of accountability, pointing to another system that should be responsible. Meanwhile, our neighbors are left to suffer and languish on our streets.

Houston Mayor Sylvester Turner and county leaders have said we cannot become complacent and accept the streets as the ultimate destination for our most vulnerable neighbors. It is our collective responsibility to act. A diverse group of cross-system leaders now regularly meet to strategically develop, coordinate and implement tailored, client-based interventions to stabilize and house our most challenged individuals suffering from chronic and acute behavioral health issues.

Houston has not solved homelessness in its entirety. But by investing in proven, effective intervention — housing — we are making homelessness rare, brief and nonrecurring for people. In fact, in our latest performance evaluation period, approximately 90% of people we helped house did not fall back into homelessness for at least two years.

As Curtis himself explained, his being on the street wasn’t for lack of trying to get to a better place. But without our outreach teams, he believes he would not have found housing. “They never gave up on me,” he said.

Yes, we have ongoing challenges, yet our commitment to persistence, innovation and collaboration remains strong. Just as Houston learned effective strategies for addressing homelessness from other cities like Denver and Salt Lake City when we were creating The Way Home, other cities can learn from Houston. We are stronger when cities and counties across the nation unite and work together on the pressing challenges ahead.

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