Thursday, April 2, 2009

Housing First

The American Medical Association just published a study examining one year in the lives of the chronic street drunks who have been given permanent shelter in Seattle's 1811 Eastlake building. The novel and humane program gives homeless alcoholics a place to live without placing restrictions on their drinking or drug use. And according to the study, the program is not only saving lives, but is also saving more than $4 million a year in tax money.

Mary Larimer, a professor of psychiatry and behavior sciences at the University of Washington, worked with a team of researchers who followed 95 chronic alcoholics before and after they moved into the apartment building in downtown Seattle. The study examined records of the time each person spent in detox, in hospitals, in court and in jail, and compared how much government spent on them compared with those still living on the streets. Researchers found that the average monthly cost to taxpayers was $4,832 when each resident lived on the street. Six months after residents moved into supportive housing, those costs dropped to $1,492 per person per month.

People working with homeless populations in Seattle remember that this program received a LOT of resistance when it was proposed and while it was being built. Many different groups and politicians were up in arms about the project, but the two main arguments arguments against the program were: 1) that it "rewards" people often considered to be engaging in bad behavior; and 2) that it would be outrageously expensive.

The careful study by the AMA debunks both of those arguments. First, researchers learned that the non-punitive nature of the program is one of its biggest strengths. People's chances of learning to control their addictions are a lot better when they are in a warm, safe environment with access to care and services. And second, it turns out that the program saves money overall. For the lawmakers who are looking for ways to save money during a cash strapped time, this should be a winning argument for preserving and creating social service programs, but I'm not kidding myself that the world is so reasonable.

We can only hope that programs like 1811, like so many other innovative, useful programs, cost- saving programs, can get the word out about their effectiveness and that we can maintain a little pressure on our representatives to keep their damned priorities straight.

Thank you Jean Luc Weber for the photo!

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