The New Freedom Commission is aware that housing and supportive services would go a long way toward preventing this cycle. "We need more housing, not just more Haldol [haloperidol]," said one patient, commenting on the commission's interim report.
Confirming what many already know, the report said that affordable, safe housing is difficult to come by in the public sector. The wait for subsidized housing is two years or longer. Transitional housing is lacking, forcing many people released from psychiatric institutions to live in the streets.
Tanya Tull, president and CEO of Los Angeles-based Beyond Shelter Inc., told participants at the commission's November forum that Americans have come to look on homelessness as an inevitable and acceptable problem. The country's patchwork of emergency shelters and transitional housing perpetuate homelessness, which can only be addressed with permanent housing.
Tull embraces a housing first philosophy. Getting homeless people into permanent housing should be a program's central goal, she said. Providing permanent housing assistance up front can significantly reduce the time people spend being homeless. Necessary services include crisis intervention and stabilization, intake and assessment, targeted assistance for moving into permanent housing, and home-based case management.
Studies have demonstrated that supportive housing produces a number of positive outcomes, Carol Wilkins, director of intergovernmental policy at the Oakland, Calif.-based Corporation for Supportive Housing, told the commission.
Emergency department and hospital visits can drop by more than 50%, Wilkins said, and the use of primary care services to address substance abuse problems increases. Supportive housing also improves participation in work and employment services.