How to Talk About Housing First

Very simply, we will not end homelessness without using Housing first strategies. Housing First is a proven method of ending all types of homelessness and is the most effective approach to ending chronic homelessness. Its effectiveness has been documented again and again. It’s based on providing individuals and families immediate access to permanent affordable or supportive housing without clinical prerequisites, like completion of a course of treatment or evidence of sobriety.

But, implementing Housing First practices and approaches is not like flipping a switch: one day you’re not doing it – flip – the next day you are.

To be successful, such change requires adapting policies and procedures, making adjustments to staffing patterns and positions, and investing in the capacity of staff to implement Housing First strategies well. And, it requires talking to one another, addressing questions, concerns, and needs for information.

I recently partnered with the San Diego Regional Continuum of Care Council (RCCC) to host a first-of-its kind discussion locally, billed as Housing First: A Community Conversation for San Diego. I was joined by 25 RCCC members and other stakeholders ready to engage in the dialogue – especially meaningful to me given I live and work in San Diego.

Recognizing that not everyone had the same understanding or support for Housing First approaches, our discussion was structured as a dialogue in which people could express any concerns, questions or disagreements. We wanted to make sure that we could get issues out on the table in a safe environment so that future conversations and trainings could be structured to address the issues raised and help more people, programs, and agencies move toward Housing First approaches in practice. To achieve that purpose, we established the following rules for the conversation:

1. Leave past conversations at the door.
2. People get to speak without being interrupted but must leave time for everyone to speak.
3. Everyone gets to share perspectives without being judged.
4. Focus on “I, me, my” statements (e.g., “I think…” “It seems to me…” “My understanding is…”).

We used USICH’s Housing First Checklist to define our understanding of Housing First at the program/project level and at the community level. And we discussed questions like: 

• What are the reasons that many programs / projects across country (and in San Diego) have or have not fully embraced Housing First?
• Why do I think it does or does not make sense for communities to adopt these practices and strategies?
• What makes it difficult for communities to align their practices with Housing First criteria?

I appreciated the openness and honesty—and respect—that everyone demonstrated during the discussion. We were able to surface many issues and questions that can sometimes create tension, such as:

• Will we incentivize lack of progress toward greater self-sufficiency by not requiring services participation?
• How do you implement Housing First in tight housing markets?
• What’s the impact of harm reduction strategies on children of parents who use substances?
• How do we deal with lease violations that result from behaviors that result from substance use?
• What’s the role of shelters and transitional housing within a community that has adopted a Housing First focus?

We left with a clear willingness to talk again, and we identified several topics that people wanted to learn more about, including:

• What is the evidence base for Housing First for both permanent supportive housing and rapid rehousing?
• What are the staffing and case load implications of moving to Housing First practices?
• How do we best educate elected officials and funders about these approaches?
• How have other communities and programs made such changes in approaches and focus?

We didn’t try to provide all the answers in this first discussion, and it wasn’t always an easy conversation. It was, however, a distinctly hopeful one. I feel confident that, as a community, San Diego can address these questions and greatly expand our implementation of Housing First practices.