Housing First Approach May Best Serve Mentally Ill Homeless Population

In December, a new study from the University of Chicago that found that, in New York County, no matter the amount of counseling treatment given to homeless mothers transitioning into affordable housing, mental illness and distress only receded after significant time in permanent housing.

Across the country in Los Angeles, Mayor Eric Garcetti declared a state of emergency for homelessness, and the United Way of Greater Los Angeles declared a war on homelessness. Common rhetoric among advocates for fixing the homelessness problem is to build affordable housing units.

But what about the underlying population of homeless individuals who suffer from mental illness? Can Los Angeles County simply put these individuals in permanent housing or do they need further assistance?

Approximately one-third of homeless individuals suffer from mental illness across the nation, according to Virginia’s Treatment Advocacy Center. With the homeless population estimated at 44,359 in Los Angeles County, according to the Los Angeles Homeless Services Authority (LAHSA), that would mean around 12,000 of those individuals suffer from mental illness.

Among homeless women, 39.3 percent of women in Los Angeles reported to be experiencing chronic homelessness, according to the Downtown Women’s Center’s 2010 needs assessment. This assessment found that 99 percent of the women interviewed said the most important resource needed for those suffering from homelessness is permanent affordable housing.

Homeless population numbers have been steadily increasing since the LAHSA 2013 homeless count. More specifically, homeless women and children have been growing over the last seven years, according to the Downtown Women’s Center needs assessment. With a new focus on providing affordable housing in the “housing first” initiative, Los Angeles County’s approach appears to be in line with current research.

The University of Chicago’s study followed homeless mothers over a nine-month period as they went from homelessness to affordable housing. Treatment was given through the use of the Family Critical Time Intervention model, where families transitioning into affordable housing were offered wrap-around services such as case management and counseling.

The control group was to receive “homeless services-as-usual,” consisting of services for employment, child support, medical/home care, and temporary financial support. The trial size was over 200 participants and half the participants were chosen through a randomized controlled trial to receive counseling on top of the other services provided by the county.

While the researchers expected some decrease in the mental health problems in the experimental group, no significant change was revealed. Researchers concluded that transitioning mothers who suffered from mental illness and who received counseling on top of other offered services did not see any increased improvement in their mental illness symptoms. This conclusion supports the housing-first model of ending homelessness and can be applied to the city of Los Angeles.

Housing first is a national policy that was first implemented in Los Angeles through the nonprofit coalition P.A.T.H, which stands for People Assisting the Homeless. It focuses on directly housing homeless individuals rather than moving them through transitional housing programs or temporary shelters. One of the reasons this study was implemented was to investigate further if the housing-first approach was the most effective policy. The results of the study confirmed that permanent housing is the best solution for those transitioning out of homelessness with a mental illness, specifically the target population of indigent mothers.

“Over the last five years, the housing-first model has gained a lot of [national] attention, especially for chronic homelessness and severe mental illness,” said LAHSA Outcomes Specialist Ian Costello.

Based on his work evaluating the impact of federally funded dollars directed to homelessness, Costello explained that permanent housing is the most effective approach for addressing the homelessness problem in Los Angeles. The results of the University of Chicago study align with his experience in effectively housing those who are mentally ill and experiencing homelessness, Costello said.

LAHSA awaits a possible $128 million federal grant, some of which could be allocated towards permanent housing for the mentally ill.

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Maddie Keating is a candidate for a Master of Nonprofit Leadership and Management degree at USC’s Sol Price School of Public Policy. She wrote this article while taking the school’s Media for Policy Change course.

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1 Comment

  1. —-LAHSA awaits a possible $128 million federal grant, some of which could be allocated towards permanent housing for the mentally ill.
    You had me, right until the last sentence and the abstraction, “the” mentally ill. “Permanent housing for “the” Blacks” reveals the error.

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