Pathways' Housing First Program
This program is for individuals who are homeless and who have complex needs, such as severe psychiatric disabilities and/or substance use disorders.
The Pathways' Housing First Program is designed to immediately supply housing for individuals who are homeless and then introduce participants to supportive services that could address mental and physical health issues, substance use problems, and employment concerns.
Several internal and external randomized controlled and quasi-experimental trials of this program foundand sustained results for outcomes of housing stability and homelessness. Participants spent less time homeless compared to , showed a faster decrease in homelessness over time as compared to , or spent more days in their own home as compared to . There were positive results for several other outcomes. One trial found a reduction in convicted offenses as compared to a . Another study found decreases in suicidal ideation and intent from baseline to a 2-year follow-up. However, across all studies, there was no effect or mixed effects on secondary outcomes including drug or alcohol abuse, psychiatric symptoms, quality of life, community functioning, employment, or satisfaction with housing.
The Pathways' Housing First Program provides an alternative approach to homelessness by first offering participants housing and then support services. The program seeks to house individuals who have trouble maintaining housing under traditional treatment programs, and it prioritizes elderly or female individuals, who can be at greater risk for victimization. There are five key principles to the Housing First model, which is the foundation for all Housing First programs:
- Immediate access to housing with no housing readiness conditions - Provide housing regardless of mental health condition or substance use behaviors.
- Consumer choice and self-determination - Promote self-sustainability and provide a supported learning environment in which participants are able to make productive changes in their lives.
- Recovery orientation - Allow participants to define their own recovery goals and work at their own pace.
- Individualized and person-driven supports - Provide support services that fit the individual.
- Social and community integration - Help participants build community connections, provide education about Housing First to communities, and dispel negative stereotypes about homelessness.
All Housing First programs follow these principles; however, individual programs can be modified to focus on specific locations or populations. Outreach teams on the street and shelter staff distribute program information and approach possible participants. Staff locate housing for individuals upon admission, help in lease execution, facilitate apartment furnishing, and assist with moving. Tenants are given a choice of available apartments and decide if they want a roommate. If apartments are not available, tenants are housed in hotels or YMCA locations until housing is obtained. Program staff use an assertive community treatment (ACT) team format to provide social and health-related services and resources.
Initiated in 1992, the Housing First model has been implemented across the United States and internationally. The program has also been implemented and evaluated among homeless Veterans.
Considerations for implementing this program include recruiting outreach staff, creating relationships with shelters, engaging assertive community treatment (ACT) staff to implement treatment, coordinating available housing units, obtaining apartment building administration buy-in and consent to house individuals receiving Pathways' Housing First Program support, understanding this program could be expensive to facilitate and some tenants may not have stable incomes, and realizing funds will need to be acquired.
The Clearinghouse can help address these considerations. Please call 1-877-382-9185 or email Clearinghouse@psu.edu
If you are interested in implementing Pathways' Housing First Program, the Clearinghouse is interested in helping you!
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
This program provides ongoing support for an undetermined length of time, and the treatment team works with participants through periods of housing loss, hospitalization, or incarceration. If an individual refuses formal services, a treatment team member meets with that individual four to six times per month to check on him or her and monitor his or her safety and well-being.
www.hazelden.org/OA_HTML/ibeCCtpItmDspRte.jsp?item=385155&sitex=10020:22372:US The manual and DVD set is $189; the manual is available separately for $49.95. A set of 10 manuals and 1 DVD costs $499. Other costs will vary and could be extensive depending on housing used and amount of time support is needed. The developer provided a cost estimation of $1.6 to $2 million to house 40 people. Approximately half of that cost goes to rent stipend, and the other half is for a service support team.materials can be purchased online
To move the Pathways' Housing First Program to the Effective category on the Clearinghouse Continuum of Evidence, at least onemust be conducted that demonstrates sustained, positive outcomes. This study must be conducted independently of the program developer.
The Clearinghouse can help you develop an evaluation plan to ensure the program components are meeting your goals.
Please call 1-877-382-9185 or email Clearinghouse@psu.edu
http://legacy.nreppadmin.net/ViewIntervention.aspx?id=365, www.pathwayshousingfirst.org/, www.endhomelessness.org/pages/housing_first, and Tsemberis and Eisenberg (2000).
*Resources and associated costs reflect those identified at the time of fact sheet publication.