Why the ‘housing first’ approach has struggled to fulfil its promise of ending homelessness

Over the past 15 years, the Housing First approach has gained traction as an evidence-based solution to tackling homelessness in many developed countries, including Canada.

The idea is simple: people experiencing homelessness should be given access to housing without any conditions.

Numerous studies have shown its effectiveness in reducing homelessness and providing long-term housing stability, especially for people experiencing chronic homelessness. Yet, many countries still see rising levels of homelessness despite claiming to implement the approach.

Data from Statistics Canada indicates that between 2018 and 2022 homelessness across the country increased by around 20 per cent. The biggest contributor to that rise was unsheltered homelessness — people sleeping in streets, vehicles or encampments. In the United States, the number of people experiencing homelessness jumped 12 per cent between 2022 and 2023.

This raises important questions about the limitations of this globally popular homelessness approach. The problem is not its core philosophy, but rather the way it’s implemented.

What is Housing First?

The idea emerged from the Pathways to Housing program founded in New York City in 1992. The program provided immediate housing through rental subsidies along with voluntary support services.

It emerged as an alternative to Treatment First approaches which require people to abstain from drugs and alcohol and adhere to treatment programs to become eligible for independent housing. That approach has generally failed because it is extremely difficult for people to get treatment and recover from addiction if they don’t have stable housing. Many people also refuse to participate in treatment programs which make them ineligible for obtaining housing.

Housing First is seen as a better alternative because having a safe and permanent home provides a necessary foundation for addressing other needs. Rather than compelling people to treatment services, Housing First provides housing as quickly as possible and the choice to avail of supportive services.

Housing First has significantly evolved throughout the decades. It has received extensive evidence-based program evaluations, including the large $110 million cross-national Health Canada research project “At Home/Chez Soi.”

The current Canadian federal government homelessness strategy claims to follow the principles of Housing First. Yet, despite its apparent success and global appeal, Housing First has not solved our national homelessness crisis.

In our recently published paper, sociology professor Andrew Clarke and I identified three key reasons the approach has struggled to fulfil its promise of ending homelessness. We offer suggestions to overcome the shortcomings of its implementation.

Elevating Housing First beyond a ‘program’

Housing First is popular because it is seen as a ready-made program that can be adopted by non-profits or government agencies. But treating it merely as a program overlooks whether there are the resources and political will to achieve its core principle — providing unhoused people with housing.

In both Canada and the U.S., Housing First programs often rely on the private rental market. This creates challenges, as the rental subsidies provided typically do not cover high rent costs, and affordable housing is limited and often in poor condition.

For Housing First to truly succeed, governments must recognize housing as a human right. It must be accompanied by investments in safe and stable affordable housing. It also requires tackling other systemic issues such as low social assistance rates, unlivable minimum wages and inadequate mental health resources.

Housing for all

Housing First is often promoted as a cost-effective solution by targeting chronically homeless individuals who rely heavily on public services. A survey called the Vulnerability Index – Service Prioritization Decision Assistance Tool is frequently used to identify and prioritize people for Housing First services. This survey asks people personal questions about their traumas, coping methods, fears, health issues, substance use and criminal justice involvement.

Critics argue that this approach ranks people experiencing homelessness by their perceived cost to taxpayer dollars. This is evaluated by how often they have interacted with public services such as homeless shelters, hospitals, paramedics as well as the police.

This raises ethical concerns because access to housing is conditional on only those who incur the most cost to public dollars rather than housing being recognized as a basic human right for all.

Removing disciplinary measures

Although Housing First is supposed to give people a choice over the housing and support they receive, critics argue that it can be coercive. Many people living in homeless encampments face pressure to enroll in Housing First programs, sometimes under police threats of eviction, arrest and dispossession of property.

Housing First assumes that everyone will prefer stable housing over life on the streets. However, this neglects the sense of community and security people might have developed after living with other unhoused people. Moving into housing could mean separation from one’s community and being isolated in a new living environment. For Housing First to be successful, it should resemble the sense of community and strong social relations that people forge living with others on the streets.

For those that do move into housing, they work with caseworkers who make routine home visits. In an effort to reduce potential tensions with landlords, caseworkers mentor tenants on how to take care of their new home. When issues arise such as property damage or noise complaints, caseworkers use the threat of eviction as a tactic to get tenants to comply with the rental agreement.

Since many Housing First programs operate within a private rental market, the key role of caseworkers is to ensure landlord satisfaction to retain them as housing providers. Providing genuine support to tenants becomes secondary. Governments must provide non-market housing options for Housing First to reach its potential.

Finland’s experience with Housing First

Despite shortcomings, the principle behind Housing First (housing as a human right) remains vital. This principle can still be realized through thoughtful reforms. Studies on Housing First provide a useful framework for addressing the systemic barriers that hinder its success.

Finland’s experience offers valuable lessons. Rather than treating Housing First as a standalone program, Finland has focused on ensuring a robust supply of secure, affordable housing. The government converted temporary shelters into long-term homes and made significant investments in social housing. In Helsinki, this led to a remarkable 72 per cent reduction in people sleeping rough and in temporary accommodation.

Canada can draw from Finland’s example. Broadening the target population for Housing First beyond those chronically homeless and investing in social and supportive housing, rather than merely subsidizing market rents, is essential.

Furthermore, coercive tactics should not be used to compel people to live independently. Instead, service providers should meaningfully interact with the unhoused to create housing that suits their needs.

While Finland’s model is not without flaws, it demonstrates that tackling systemic issues is crucial for transforming homelessness policy. Housing First can still achieve its promise, but it requires a deeper commitment to social change.