Chapter 1 – Pretreatment Considerations for Homeless Outreach& Housing First
“The most important human endeavor is the striving for morality in our actions. Our inner balance and even our very existence depend on it.”
– Albert Einstein (1950)
Over the past 20 years, efforts have become more focused toward significantly reducing, or perhaps even ending chronic homelessness among unaccompanied adults. This began on a national level with the development of outreach teams across the US, which are currently supported by both federal and state dollars– most notably via PATH outreach teams (Projects for Assistance in Transitions from Homelessness) and Healthcare for the Homeless projects. Tireless advocacy by groups like the National Coalition for the Homeless and the National Alliance to End Homelessness have been crucial toward galvanizing support for proven practices and policies necessary to end or significantly reduce homelessness. These efforts have continued, and in many respects have matured via the US Interagency Council on Homelessness and the Department of Housing and Urban Development (HUD). Targeted federal and state funds have been used to develop affordable housing resources, Housing First initiatives, and the formation of community based regional and/or Continuum of Care networks. Communities and larger geographical regions now have specific plans that address resource, access and prevention issues, as well as supporting and utilizing research to inform best practices. In many places, outreach teams and shelter staff have direct and improved access to housing resources. Some strides have been made toward providing housing plus support services for those most in need. Nevertheless, serious challenges remain and every day the health and safety of many people experiencing homelessness are at considerable risk.
Throughout my career, I have worked very closely with outreach teams, shelter staff, residential programs, and Housing First initiatives. There is a fundamental relationship betweenHomeless Outreach andHousing First. Homeless Outreach is an essential step toward meeting people experiencing long-term or episodic (multiple episodes) homelessness. It is the means for developing the critical trusting relationships necessary for supporting transitions to affordable housing and/or needed treatment. The greater our success in implementing Housing First, the more our need for high quality outreach-based support services that promote housing stabilization. We have seen a major shift over time. Some of the formerly hardest to reach folks are now successfully housed, but still have chronic medical, mental health, and substance abuse issues that negatively impact their overall sense of health and wellbeing, including their ability to effectively connect with their neighbors and community.
Whether we are providing Homeless Outreach or housing stabilization services for people with longstanding difficulties, the central challenges remain the same. It all begins with the formation of a trusting relationship. Whether outreach is done on the streets or in an apartment, the helping process is always interpersonal. Our hope is that two people, who are often from vastly different worlds and experiences, can come together to successfully work on mutually agreed goals to bring about positive change. It is important that we recognize that it is the client who has owner