5 ms·

A big one is drug/alcohol use. One of the understandings behind "housing first" policies is that when you treat chronic homelessness as a public health problem

by duped 3y ago

A big one is drug/alcohol use. One of the understandings behind "housing first" policies is that when you treat chronic homelessness as a public health problem, you need to attack the big symptoms first (being unhoused) before you can see the outcomes you want (being a productive member of society). Housing isn't a reward, it's a basic human need. And it's the baseline for treating people - because you cannot treat people if you cannot find them.

bumby 3y ago
Don’t you think it makes sense to attack the root problem (addiction) as well as the “big symptoms”? Wouldn’t that look like a rule to be in a treatment program or be otherwise clean? I can get on board with housing being a basic human need that society helps supply. But that’s subtly different than the OP’s claim of housing with virtually the same freedom from rules. I’m not sure “unfettered housing” is a human right.
- toddmorey 3y ago
  Well don’t frame it as a right, think in terms of desired outcome. If a user relapses, does removing their housing help in recovery?
  - bumby 3y ago
    I think we’re in agreement. The two are coupled. This is contrary to the OP, where housing would be completely decoupled, no-strings-attached.
    - vidarh 3y ago
      How do you expect to get. an addict to voluntarily accept housings with strings that experience is that a lot of them actively avoid? The pint of the Finnish approach is that the old approach of attaching strings fails at both addressing homelessness and addiction.
      - bumby 3y ago
        Ah, ok. I think I see the confusion. I think you're applying a false dichotomy here. It's not an "either you are clean or you don't get housing" in most places. But, if a therapist sees that addiction is a contributing factor, they will often make the free housing contingent on being part of a drug rehab program. So it's not "clean or else you're back on the street" but it's looking at it as part of the overall problem that's keeping a person from being self-sufficient. They aren't even generally piss tested as part of that. The cases where they are forced to be clean prior is when they are referred to housing services by a probation or parole officer. But that "remain clean" condition is more a function of the probation/parole than the housing program.
- abofh 3y ago
  Addiction isn't a root problem of anything, it's a symptom of other things that led you to become addicted to whatever (gambling, drugs, etc) If you address only the symptoms and not the sociatal issues that exacerbate them, you won't actually solve the problem.
  - bumby 3y ago
    Fair enough, but doesn’t the same principle apply? Namely, that if we really want to solve the problem, the root issues need to be the priority? You seem to agree with this, but that doesn’t necessarily align with the OP. Giving no strings attached housing isn’t fixing root issues.
    - cutemonster 3y ago
      They didn't say that housing fixes root issues. They said it's a "baseline for treating people".
      - bumby 3y ago
        But they also framed it as simply a means to an end: "finding people so you can treat them." I can sympathize with the "baseline for treating people" argument, but that, by itself, doesn't address the fact that there is a fundamental symmetry missing. If people want "freedom" they also need to demonstrate "responsibility" for a society to work. There is no free lunch, unfortunately. Literally every "baseline" right guaranteed by the US Constitution can be framed in this same give/take dynamic. The OP was conflating the issue IMO. They are saying basic shelter isn't enough; people have a right to free housing with no strings attached. I think those are two very different mental frameworks to view this problem.
  - throw9away6 3y ago
    Addiction is the problem homeless is a symptom. Homelessness is a temporary state that one can move in and out of based on access to economic resources but addiction is a permanent state that though great willpower some can occasionally be suppressed.
- liveoneggs 3y ago
  Addicts will choose the streets over housing to feed the addiction.
- TheCleric 3y ago
  For me it boils down to this, which is more successful: treating addiction without houselessness as a factor or treating it with houselessness as a factor? If it's the former, then you provide the home to increase efficacy.
  - bumby 3y ago
    I understand this point; I think where most people take issue is that it doesn't seem very effective. (or maybe it is, and people are just ignorant of the impact). And once you give people a benefit, it's exceedingly hard to take it away, potentially leaving society worse off than before.
    - vidarh 3y ago
      Where other than Finland is it being tried? What is systematically failing is to expect people to get clean before providing housing. It doesn't get people clean and it doesn't get people off the streets.
      - bumby 3y ago
        See my response to your comment below. It's the general case (where I live, at least) that people aren't required to be clean to get housing. But they are required to be part of a rehab program is a therapist/counselor/case worker has deemed addiction to be a contributing factor to their circumstances. They don't have to be clean in those cases, but working toward being cured of their addiction.
- duped 3y ago
  > Wouldn’t that look like a rule to be in a treatment program or be otherwise clean? It looks more like using permanent supportive housing as a way to get people into treatment programs and stick with them.
- dragonwriter 3y ago
  > Don’t you think it makes sense to attack the root problem (addiction) as well as the “big symptoms”? Addiction very often isn’t the root problem, there may not even be a unique root problem. Addiction is a difficult to manage persistent condition that complicates, is conplicated by, reinforces, and co-occurs with other problems, which may be caused by it, may cause it, or may be linked by more distant causal connections or not, at root, commonly caused despite interacting and reinforcing each other once present. You need to deal with the complex situation presented, not try to solve a tricky and generally unsolvable chicken-and-egg problem that is usually irrelevant to the path forward.
  - bumby 3y ago
    Let me be clear: I’m not advocating an either-or solution. My point is that the complex problem must be treated as exactly that. To me, just focusing on giving people housing is the antithesis of treating it as a complex problem.
dragonwriter 3y ago
> One of the understandings behind "housing first" policies is that when you treat chronic homelessness as a public health problem, you need to attack the big symptoms first (being unhoused) before you can see the outcomes you want (being a productive member of society). That’s somewhat inaccurate; housing is attacked not because it is a big symptom, but because it (1) grratly complicates addressing the other problems, and (2) admits of a fairly direct solution. If we could just simply give people thr absence of addiction or mental health problems, that’d be a stronger contender for a first intervention where the problems are cooccurring, but factually we can’t so its not an option.
bumby 3y ago
(Devils advocate bc I don’t actually believe this but think it illustrates an important point): Why don’t we just give them money? Because, ultimately, housing need is there largely because they can’t afford housing right? So the deeper cause is a financial one. I suspect most people exist be onboard with this because they know it won’t solve the underlying problems. It’s also the same with simply giving “free” housing. Most people who deal in processes understand treating the root cause it paramount and should be their priority. Getting sidetracked by proximate causes is a good way to squander resources that can also tend to make things worse.
- felurx 3y ago
  One benefit of meeting basic needs (like housing, food, utilities) directly is that it's easier for the people who need it. Some others here have pointed out that many homeless people have something that keeps them from managing a household, and taking as much of that off their shoulders is helpful in that it allows them to build a life step-by-step, for example by focusing on mental and physical health first and at some point education, instead of having to adjust to a lot of stuff at once. Also, yeah, addictions are a thing. And I don't mean that as in "Oh, those people are so irresponsible! We can't trust them to spend their money right!". Addiction fucks you up (and/or is a result of the world fucking you up), and if what has been your only way to feel not-completely-terrible for a while is the other option, I don't think I can personally blame anyone who isn't able to take steps along a long and difficult road with uncertain outcomes, with their basic needs still not met. In short: Money is a tool that can be used to meet basic needs, but by itself it does not meet basic needs. Using it to do that is not easy, especially if you're not used to that, and double-especially if you're addicted to something as a result of your shitty living conditions. (I should note that I'm _not_ speaking from experience here. If someone who has some, ideally someone who has second-hand experience with many people, please correct me!)
- Fluorescence 3y ago
  You can follow GiveDirectly, currently run by Rory Stewart to see unconditional cash payments in action: https://en.wikipedia.org/wiki/GiveDirectly https://en.wikipedia.org/wiki/GiveDirectly > Most people who deal in processes understand treating the root cause it paramount I think that over-simplifies this type of wicked problem where consequences become causes. For example, poverty and under-housing causes abusive childhoods, mental health and substance use issues. The challenge is not to identify a leaky pipe to stop a flood but to intervene in a complex dynamical system and convert doom cycles into virtuous upward spirals of improvement.

by duped 3y ago

bumby 3y ago

Don’t you think it makes sense to attack the root problem (addiction) as well as the “big symptoms”? Wouldn’t that look like a rule to be in a treatment program or be otherwise clean? I can get on board with housing being a basic human need that society helps supply. But that’s subtly different than the OP’s claim of housing with virtually the same freedom from rules. I’m not sure “unfettered housing” is a human right.

toddmorey 3y ago
Well don’t frame it as a right, think in terms of desired outcome. If a user relapses, does removing their housing help in recovery?
- bumby 3y ago
  I think we’re in agreement. The two are coupled. This is contrary to the OP, where housing would be completely decoupled, no-strings-attached.
  - vidarh 3y ago
    How do you expect to get. an addict to voluntarily accept housings with strings that experience is that a lot of them actively avoid? The pint of the Finnish approach is that the old approach of attaching strings fails at both addressing homelessness and addiction.
    - bumby 3y ago
      Ah, ok. I think I see the confusion. I think you're applying a false dichotomy here. It's not an "either you are clean or you don't get housing" in most places. But, if a therapist sees that addiction is a contributing factor, they will often make the free housing contingent on being part of a drug rehab program. So it's not "clean or else you're back on the street" but it's looking at it as part of the overall problem that's keeping a person from being self-sufficient. They aren't even generally piss tested as part of that. The cases where they are forced to be clean prior is when they are referred to housing services by a probation or parole officer. But that "remain clean" condition is more a function of the probation/parole than the housing program.
abofh 3y ago
Addiction isn't a root problem of anything, it's a symptom of other things that led you to become addicted to whatever (gambling, drugs, etc) If you address only the symptoms and not the sociatal issues that exacerbate them, you won't actually solve the problem.
- bumby 3y ago
  Fair enough, but doesn’t the same principle apply? Namely, that if we really want to solve the problem, the root issues need to be the priority? You seem to agree with this, but that doesn’t necessarily align with the OP. Giving no strings attached housing isn’t fixing root issues.
  - cutemonster 3y ago
    They didn't say that housing fixes root issues. They said it's a "baseline for treating people".
    - bumby 3y ago
      But they also framed it as simply a means to an end: "finding people so you can treat them." I can sympathize with the "baseline for treating people" argument, but that, by itself, doesn't address the fact that there is a fundamental symmetry missing. If people want "freedom" they also need to demonstrate "responsibility" for a society to work. There is no free lunch, unfortunately. Literally every "baseline" right guaranteed by the US Constitution can be framed in this same give/take dynamic. The OP was conflating the issue IMO. They are saying basic shelter isn't enough; people have a right to free housing with no strings attached. I think those are two very different mental frameworks to view this problem.
- throw9away6 3y ago
  Addiction is the problem homeless is a symptom. Homelessness is a temporary state that one can move in and out of based on access to economic resources but addiction is a permanent state that though great willpower some can occasionally be suppressed.
liveoneggs 3y ago
Addicts will choose the streets over housing to feed the addiction.
TheCleric 3y ago
For me it boils down to this, which is more successful: treating addiction without houselessness as a factor or treating it with houselessness as a factor? If it's the former, then you provide the home to increase efficacy.
- bumby 3y ago
  I understand this point; I think where most people take issue is that it doesn't seem very effective. (or maybe it is, and people are just ignorant of the impact). And once you give people a benefit, it's exceedingly hard to take it away, potentially leaving society worse off than before.
  - vidarh 3y ago
    Where other than Finland is it being tried? What is systematically failing is to expect people to get clean before providing housing. It doesn't get people clean and it doesn't get people off the streets.
    - bumby 3y ago
      See my response to your comment below. It's the general case (where I live, at least) that people aren't required to be clean to get housing. But they are required to be part of a rehab program is a therapist/counselor/case worker has deemed addiction to be a contributing factor to their circumstances. They don't have to be clean in those cases, but working toward being cured of their addiction.
duped 3y ago
> Wouldn’t that look like a rule to be in a treatment program or be otherwise clean? It looks more like using permanent supportive housing as a way to get people into treatment programs and stick with them.
dragonwriter 3y ago
> Don’t you think it makes sense to attack the root problem (addiction) as well as the “big symptoms”? Addiction very often isn’t the root problem, there may not even be a unique root problem. Addiction is a difficult to manage persistent condition that complicates, is conplicated by, reinforces, and co-occurs with other problems, which may be caused by it, may cause it, or may be linked by more distant causal connections or not, at root, commonly caused despite interacting and reinforcing each other once present. You need to deal with the complex situation presented, not try to solve a tricky and generally unsolvable chicken-and-egg problem that is usually irrelevant to the path forward.
- bumby 3y ago
  Let me be clear: I’m not advocating an either-or solution. My point is that the complex problem must be treated as exactly that. To me, just focusing on giving people housing is the antithesis of treating it as a complex problem.

dragonwriter 3y ago

> One of the understandings behind "housing first" policies is that when you treat chronic homelessness as a public health problem, you need to attack the big symptoms first (being unhoused) before you can see the outcomes you want (being a productive member of society). That’s somewhat inaccurate; housing is attacked not because it is a big symptom, but because it (1) grratly complicates addressing the other problems, and (2) admits of a fairly direct solution. If we could just simply give people thr absence of addiction or mental health problems, that’d be a stronger contender for a first intervention where the problems are cooccurring, but factually we can’t so its not an option.

bumby 3y ago

(Devils advocate bc I don’t actually believe this but think it illustrates an important point): Why don’t we just give them money? Because, ultimately, housing need is there largely because they can’t afford housing right? So the deeper cause is a financial one. I suspect most people exist be onboard with this because they know it won’t solve the underlying problems. It’s also the same with simply giving “free” housing. Most people who deal in processes understand treating the root cause it paramount and should be their priority. Getting sidetracked by proximate causes is a good way to squander resources that can also tend to make things worse.

felurx 3y ago
One benefit of meeting basic needs (like housing, food, utilities) directly is that it's easier for the people who need it. Some others here have pointed out that many homeless people have something that keeps them from managing a household, and taking as much of that off their shoulders is helpful in that it allows them to build a life step-by-step, for example by focusing on mental and physical health first and at some point education, instead of having to adjust to a lot of stuff at once. Also, yeah, addictions are a thing. And I don't mean that as in "Oh, those people are so irresponsible! We can't trust them to spend their money right!". Addiction fucks you up (and/or is a result of the world fucking you up), and if what has been your only way to feel not-completely-terrible for a while is the other option, I don't think I can personally blame anyone who isn't able to take steps along a long and difficult road with uncertain outcomes, with their basic needs still not met. In short: Money is a tool that can be used to meet basic needs, but by itself it does not meet basic needs. Using it to do that is not easy, especially if you're not used to that, and double-especially if you're addicted to something as a result of your shitty living conditions. (I should note that I'm _not_ speaking from experience here. If someone who has some, ideally someone who has second-hand experience with many people, please correct me!)
Fluorescence 3y ago
You can follow GiveDirectly, currently run by Rory Stewart to see unconditional cash payments in action: https://en.wikipedia.org/wiki/GiveDirectly https://en.wikipedia.org/wiki/GiveDirectly > Most people who deal in processes understand treating the root cause it paramount I think that over-simplifies this type of wicked problem where consequences become causes. For example, poverty and under-housing causes abusive childhoods, mental health and substance use issues. The challenge is not to identify a leaky pipe to stop a flood but to intervene in a complex dynamical system and convert doom cycles into virtuous upward spirals of improvement.