Why Not Housing First?
In recent years, social service agencies across the nation have begun to focus on “housing first” as the best approach to homelessness. Clients are given their own apartments, paid for by the government, for as long as they are incapable of finding housing on their own. And there are successes with this approach. Being out of the cold or heat, having a sense of security, knowing that their housing is not temporary – all of these result in increased physical and psychological well-being. Social workers visit clients on a regular basis, checking on their welfare and encouraging them to follow through on therapy, education, and other pathways to a better life. The benefits to the homeless person are enormous and, moreover, the costs associated with supporting the homeless decrease, even factoring in the cost of rent.
So why does Open Doors not pursue “housing first” by buying homes for clients to share and provide all the same services by visiting social workers, rather than creating transitional housing? True, in Calvert County the lack of low cost housing undermines the “housing first” approach. But the real answer lies in our conviction that Open Doors can achieve a better outcome at no additional cost – that this particular transitional housing program would offer all the benefits of housing first (shelter from the elements, security, etc.), and other important benefits as well.
Following the model of successful programs elsewhere, we adhere to the principle that a communal living provides the opportunity for meaningful personal relationships among clients, and that these relationships enable progress in cases where individuals on their own would fail. As is the case in the treatment of drug or alcohol addiction, mutual encouragement and support, education and accountability, while they make demands on the person seeking recovery, also promote recovery. The challenges faced by homeless persons are no different. They can best be overcome within a loving, supportive community.
Proponents of the housing first approach are coming to recognize this also. In communities where homeless clients have been housed in individual apartments and live alone under the supervision of a visiting social worker, it has been found that their progress has been furthered by initiating programs that engage these clients in activities within a casual social setting where they can develop relationships.
Open Doors proposes a program that offers even more. Depth of caring develops only after extended periods of contact and engagement with others. Living in community with others whose problems and successes mirror ours generates relationships that become more than comraderie – those relationships become a cornerstone on which to build a life of security and trust in (and, perhaps, even love of) others and ourselves.
Inspiration for Open Doors comes from similar initiatives elsewhere:
San Patrignano
San Patrignano is a therapeutic community in Rimini on the eastern shore of Italy, about 150 miles north of Rome. In their own words:
San Patrignano is a community for life that welcomes those suffering from drug addiction and marginalization and helps them to once again find their way thanks to a rehabilitation programme that is above all, a programme based on love. It is free, because love is a gift.
It offers a new life for the families of those suffering, who find comfort and support in the reliable and expert guidance the community and its volunteers offer.
It is a commitment towards building a better society, thanks to numerous projects designed to prevent drug abuse. In its search for the common good, San Patrignano is open towards the outside world with specific activities in schools, international study events, special wide-ranging programmes and constantly battles against addiction.
From San Patrignano’s website, a brief description of the program:
An educational path
The therapeutic program is based on education and rehabilitation. The person is not considered afflicted by an “illness” and therefore, pharmacological treatments to combat drug abuse are not used. Instead physiotherapeutic and psychiatric interventions are implemented when deemed necessary, in order to treat specific individual problems.
An individual program
The rehabilitation program is tailored to each resident and varies depending on the characteristics and needs of every individual. There are no rigid therapeutic steps or a defined timescale. Instead, considering the problems and demands of a radical personal change, we offer a long-term residential rehabilitation program; in fact, the minimum duration is three years.
The importance of the group
When a person comes into the community, they are placed into one of the training sectors at San Patrignano. Here they are entrusted to a resident who becomes their mentor for the first year (the time varies from person to person) and follows their progress. The resident lives in the room together with the mentor and with other residents in the program. Each room has a resident in charge and each sector has one or more reference educators. These are mainly the groups within which the resident will spend their day-to-day life in the community.
The stages of the program
Personal growth occurs through the daily interaction with peers and supervisors of the sector (professional educators). By comparing the critical issues, their individual weaknesses are analysed and addressed. Each resident, along the way, are entrusted gradually with more responsibilities, both in the sector, and in the many activities that take place in community (sports, artistic, cultural. Over time, they in turn become tutors for others in need of help. In this way, community residents rediscover, day after day, the pleasure of feeling useful for themselves and for others, experiencing new forms of gratification that are the very opposite of the illusory gratification offered by drug use. The rules of community life are those of normal civil coexistence, respect of oneself, others and the environment.
training and study
San Patrignano has over 50 life and training sectors, where residents are placed according to the availability of people who can assist the newcomer and according to their characteristics. Learning a profession allows each resident to grow one’s self-esteem with interpersonal relationships. It is also the key to a full reintegration into society. Moreover, each resident is given the opportunity to return to his or her studies abandoned in the past, at any academic level.
Relationships with families
During rehabilitation, the aim is to rebuild the relationships between residents and their family. Initially a separation period is envisaged, with the exception of correspondence by letters. The family is advised to follow a path parallel to that of their family member in the program by frequenting one of the many associations located all over Italy and the world. After about a year (this depends on the individual) the family is able to visit the community for the first time. These meetings subsequently increase to three or four a year and then after the first three years approximately, residents return home for the first time for seven to ten days.
San Patrignano’s Success
The following excerpt is from a follow-up study of clients (underlining added):
We noted a vast difference between subjects which left the community with consent and those without, both in terms of participation and results indicated by the samples.
Of the subjects which left San Patrignano with the community’s consent, an average of 61% participated, with a peak of 70% of the former residents which left in 2002 (2 year follow-up) and a minimum of 53% in 2001 (3 year follow-up).
The percentage of subjects involved in the study which resulted negative for drug use at the time of the research was of 78% two years after leaving the community, 62.3% after three years, and 70% after four years.
The percentage of those who left the community without consent and who participated in the study was considerably smaller (39%) than those who completed the program and left the community with consent.
The percentage of those within this group who participated in the study who relapsed was 51%, with a slight variation in the three years examined (60%, 44%, and 50% in 2000, 2001, and 2002 respectively).
Eva’s
Eva’s is a program in Toronto, Canada, serving homeless youth. From Eva’s website:
We operate three unique facilities in Toronto, providing safe shelter and diverse programs and services to 123 homeless and at-risk youth every night. Our programs are designed to help them with their unique circumstances so they can transition out of homelessness and on to independent living.
Eva’s Place, Emergency shelter for youth 16-24
The first youth shelter in North York, Toronto,
providing a range of services and supports to prevent and reduce youth homelessness.
Eva’s Place is home to the Family Reconnect program which offers proactive, long-term solutions to prevent and reduce homelessness by helping youth re-establish and maintain contact with their families. Its Early Intervention component supports families staying together rather than having at-risk youth enter the shelter system.
Over the years, we have seen a significant increase in the number of youth coming to our shelter with mental health issues. Finding the resources they need has become one of our biggest challenges. In order to expand our capacity to support these youth and give them what they need to succeed, we have fostered relationships with groups such as New Outlook and East Metro Youth Services that provide counselling and referral services. We also receive supports from Inner City Health Associates which provides our residents with access to a physician and psychiatrist to address their health and mental health needs.
Through the Independent Living Program, Eva’s Place provides a variety of life skills, education and employment related activities that help young people gain the skills they need to transition to community living. This includes workshops on cooking, financial literacy, job search, as well as assistance in obtaining identification and legal supports and help in finding and keeping housing.
Eva’s Satellite, Emergency shelter for youth 16-24
Canada’s first harm reduction shelter for youth,
providing support for youth with substance use and mental health needs.
At Eva’s Satellite, youth take the first crucial steps toward rebuilding their lives by receiving counselling, life skills training and participating in healthy recreation programs. With services provided by Inner City Health Associates, and partnerships with Central Toronto Youth Services and many other community agencies, Eva’s Satellite is developing innovative programming to respond to the needs of youth who actively use drugs and alcohol.
Some would define success as connecting with a youth for the first time while others say that success is helping youth maintain their sobriety. When looking at youth who use drugs and alcohol to cope, success comes in many shapes and forms. Our Harm Reduction Program continues to be a much needed service for marginalized, homeless, street-involved youth.
In association with the Inner City Health Associates, we are able to provide a comprehensive Clinical Program on-site that includes psychiatric services and primary and preventative health care.
Eva’s Phoenix, Transitional Housing for Youth 16-24
Transitional housing and employment training facility providing skills and support for
employment, education, and long-term housing.
Eva’s Phoenix is an award-winning transitional housing and employment training facility for youth experiencing homelessness. It’s located in downtown Toronto.
What does Eva’s Phoenix offer?
• Residence for 50 youth for up to 1 year
• 10 townhouse-style units (private bedrooms and shared kitchens/living areas)
• Shared teaching kitchen
• Housing and counselling supports
• Educational program and study spaces
• Employment training (construction, print & graphic communications, Youth Succeeding in Employment Program)
• Dress to Impress Studio for free career clothing
• Technology Training Centre
• Programs for financial literacy, life skills, finding/keeping housing. cooking/nutrition, health, hygiene, conflict resolution, and more
Transitional Housing
At Eva’s Phoenix, 50 young people live in 10 shared townhouse-style units. They get their own bedroom with a key and access to shared spaces such as bathrooms, kitchens, and study areas. While there, young people develop critical skills to live independently through caring individual support, workshops, and hands-on programs.