Housing-First and Assertive Community Treatment Take Time and Investment

By Terrence Sharrer, WOTS Issue 39

Terrence Sharrer, Project Recovery Supervisor at Interfaith Sanctuary

Housing-First is a policy that offers permanent housing for those experiencing chronic homelessness, unconditionally. Services are wrapped around those suffering from addiction, mental illness, disability, etc. The policy has shown great promise in more progressive communities. However, although performed correctly in the beginning within the city of Boise, Ada County lost sight of how Housing-First is a long term solution – meaning that positive results in reducing unsheltered homelessness are not always clear in the beginning.

The initial year of Housing-First saved taxpayers $2 million dollars in emergency services, jailing, police and emergency calls alone. More conservative voices pointed out that it did not work and argued that it was a waste of money with few results for the unhoused. The county decided to cut a third of the new budget for Housing-First and suggested that we change to a merit-based model that has been the norm for 50 years.

I run Project Recovery at Interfaith Sanctuary and my educational background focuses on Assertive Community Treatment, a crucial but often forgotten component of Housing-First. In my experience, ACT is the only model that works to keep people who are chronically unhoused with addiction and mental health challenges in housing of their own. ACT works because it wraps services long-term (five years minimum) around those that are given housing. These are our most housing-challenged community members. They need individualized and consistent support in day-to-day life. ACT helps these people develop independence over time, but never disconnects them from a trusted community when they begin living alone. ACT is more comprehensive than permanent supportive housing. At our shelter, we often move guests who have gone through recovery into permanent supportive housing, but when they’re removed from community and on their own, the services provided under the existing model are frequently not comprehensive or individualized enough. We do what we can here at the shelter to stay connected, but our resources are limited.

Long-term and comprehensive ACT services are an investment in reducing negative health outcomes, improving care, and giving our most vulnerable the respect and safety they deserve. Housing-First is a wonderful and effective way to address homelessness for the chronically unhoused. The framework just needs the care provided through ACT baked into the model, with an expectation that those services never go away. Our officials should exercise patience and keep open minds, not fall back on an old merit-based system that has failed many.