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Fix Homelessness How to rebuild human lives
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Examining the Scholarly Record

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The academic journal literature on homelessness is vast, but during the past decade oversimplification has ruled. The Obama administration made “Housing First!” the official U.S. policy, with homeless people to be given their own apartments. Programs that emphasized “Clean and Sober first” became ineligible for federal aid, and mental health issues became secondary. Typical academic analyses of homelessness found — surprise! — that “Housing First!” is great.

A lot of scholarly research up to 2009, though, revealed homelessness complexities. Here are four examples: 

  1. Michael Sosin and Maria Bruni, “Homelessness and Vulnerability among Adults With and Without Alcohol Problems,” Substance Use and Misuse (1997).

Key insights:Homeless adults who are alcoholics haveunusually high levels of mental health symptomatology…. Adults with alcohol problems are so debilitated that they readily become homeless (as compared to being domiciled under very trying circumstances) when also characterized by predispositions to disengage from society.”

  • Ellen Bassuk, John Buckner, Jennifer Perloff, Shari Bassuk, “Prevalence of Mental Health and Substance Use Disorders Among Homeless and Low-Income Housed Mothers,” American Journal of Psychiatry (1998).

Key insights: “Studies of homeless women rarely distinguish between women accompanied by children (“mothers”) and those who are alone (“solitary”)…. Homeless solitary women have higher rates of schizophrenia, bipolar disorder, and substance use disorders than homeless mothers do…. homeless mothers do not suffer disproportionately from schizophrenia, [but 72% have] a probable lifetime substance use disorder, mental disorder, or both, [such as] PTSD, major depression, and substance use disorders.”

  • Michael Sosin, “Explaining Adult Homelessness in the US by Stratification or Situation,” Journal of Community & Applied Social Psychology (2003).

Key insights: “The most widely accepted individual-level explanations of homelessness suggest that adults lose their dwellings when they cannot compete in the marketplace for the monetary resources needed to pay for housing…. However, the causal role of the problems and deficits is now known to be complex…. Disaffiliation, or a loosening of the bonds between an individual and society,… situationally (a result of bad marriages) or individually caused, [prompts] individuals to disengage from the use of potentially helpful social institutions. [Common factors are] high levels of distrust of institutions,

life-long alienation from society, or types of mental illness, combined with substance abuse.”

  • Yinghua He, Brendan O’Flaherty, and Robert Rosenheck, “Is shared housing a way to reduce homelessness? The effect of household arrangements on formerly homeless people,” Journal of Housing Economics (2009).

Key insights: “Most single adults share housing with other adults, and living alone is considerably more expensive than living with someone else. Yet policies that discourage shared housing for formerly homeless people or people at risk of becoming homeless are common, and those that encourage it are rare. This would be understandable if such housing adversely affected its users in some way,” but shared housing does not produce negative effects, based on data from a 5-year, study of more than 6,000 formerly homeless individuals.

The three authors pointed out that “most single adults share housing with other adults, and living alone is considerably more expensive than living with someone else. In 2005, of adults under 65 in the household population who were not living with spouses, only 23.8% lived alone (American Community Survey). The cost per person of maintaining the same standard of living is probably between 36% and 47% lower in a two-person household than in a one-person household. Yet policies that encourage shared housing for formerly homeless people or people at risk of becoming homeless are rare.”

The added cost of keeping homeless people apart could be worth it if the results were better, but “no significant coefficient indicates that living alone is associated with better outcomes than sharing…. sharing is significantly better than living alone for psychosis.” Sharers have “less psychotic symptomology…. Isolation leads people to dwell on their own internal thinking, while having contact with others fosters a focus on the interpersonal socialized world.” As I dive further into this subject, I’m seeing that calling a person “homeless” misses the bigger problem, which is hopelessness rather than homelessness. Receiving an A for Apartment does not outweigh four other A’s: Addicted. Alcoholic. Alienated from family. Alone. “Housing First” — end homelessness by giving homes — might seem almost common sense, but if “home is where the heart is,” it doesn’t work for an A-level person whose heart is focused on drugs or alcohol, or whose mind is flushed with fear.