Housing first vs. shelter first

As advocates debate a change in approach to homelessness in Minnesota, a lot is riding on the outcome.

The Minneapolis Star Tribune recently reported on a new trend in Minnesota regarding homelessness policy, “Housing First.” Under this approach, homeless persons would be initially offered stable housing arrangements, rather than placed in a temporary homeless shelter. The housing placement would come “without preconditions” for client sobriety, employment, or medical treatment.

The Star Tribune reports that county officials and nonprofit advocates are pushing for this shift in approach. The idea behind Housing First has a surface appeal: place the homeless into housing, then work on the underlying problem(s).

This long-running debate within the homeless advocate community is chronicled at length in author Michael Shellenberger’s best-selling book San Fransicko. In the debate, Shellenberger sides with “shelter first” over the “housing first” approach.

Housing First is the approach used by the city of San Francisco and other West Coast localities. Shellenberger attributes the approach to the rising share of the homeless population who live on the streets, rather than in shelters, by diverting resources to building more permanent housing. Minneapolis already has begun to resemble San Francisco in the tent encampments that have flourished in the past few years.

Furthermore, Shellenberger notes that once a homeless person obtains housing, their incentives to address underlying problems wane. He writes,

The problem with Housing First stems from the fact that is doesn’t require that people address their mental illness and substance abuse, which are often the underlying causes of homelessness. Several studies have found that people in Housing First-type housing showed no improvements in drug use from when they were first housed.

Under Shelter First, the immediate shelter needs of the homeless person are addressed. Using a carrot and stick approach, more permanent housing is something to be earned, by demonstrating progress in addressing the underlying causes.

How widespread are these underlying causes? The Amherst H. Wilder Foundation conducts a triennial study of Minnesota homelessness. Their last study from October 2018 showed that the state’s homeless population grew to 19,600. The 2021 survey was postponed due to the pandemic.

The 2018 Wilder study found that 60 percent of the Minnesota homeless population suffered from serious mental illness (not including anxiety or panic disorder). This was the highest share ever found in the state.

Wilder also found that 24 percent of the total homeless population suffered from a substance abuse disorder. And only 30 percent were engaged in any employment activity at the time. The Wilder data are worth a closer look.

Housing First represents enough of a radical departure from current policy as to warrant a more robust statewide debate. The resources that Federal, state, and local governments put into this area are considerable, and we all have in interest in seeing that they are effectively deployed.