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Pathways to housing the homeless

By Christina McCarrollStaff writer of The Christian Science Monitor / May 1, 2002



NEW YORK

In the hallway of Pathways to Housing, a loud, chaotic office in East Harlem, Hughes Smith can't stop talking about his furniture: "It's unbelievable," he says.

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It's not often that someone brags about 10-year-old futons. But for Mr. Smith, shuffling down the hall wearing a tan baseball cap and yellow headphones, permanence is something to celebrate. "After being homeless so long," he explains, "you just don't believe it." His L-shaped studio, blocks from the East River and boasting three big closets, still dumbfounds him.

Since 1993 – "nine years, March 31st," he announces – Smith has been a client of Pathways to Housing, which offers apartments to mentally ill homeless New Yorkers.

Pathways doesn't require medication, abstinence from drugs or alcohol, or use of social services – a leniency that flies in the face of conventional demands that the homeless demonstrate "housing readiness" through sobriety, psychiatric visits, even cooking skills before they're provided with a place to live.

Instead, Pathways runs on a "housing first" model, with the philosophy that before someone can work toward recovery or employment, a safe, comfortable home is necessary.

Such programs as Pathways, which offer permanent housing with optional support, gained a foothold in the 1990s – bursting from almost none in the 1980s to 114,000 beds nationally in 1996.

Sam Tsemberis launched his program in 1992 with 50 apartments, a PhD in clinical community psychology, and a $500,000 grant from the New York State Office of Mental Health.

Today, the grants total $7.2 million and the program has an 85 percent success rate, he says.

Struggle to obtain housing

Each night, about 800,000 Americans are homeless, and 31 percent of homeless adults report both mental-health and substance-abuse problems; an additional 32 percent struggle with one or the other. Those with addictions generally go through detoxification programs an average of 11 times. These are, typically, the hardest to house: Turned away by programs that demand sobriety or a clean bill of health, many people with these problems have spent years on the streets or in psychiatric hospitals.

All of Pathways clients are diagnosed as mentally ill, and 90 percent are considered addicted to either alcohol or drugs, which makes the program's success rate even more unusual.

Nationally, for every 100 individuals or families seeking affordable housing, there are only 37.84 available units. So programs that offer housing once clients are "clean" sometimes find they have no housing to give when clients are finally ready.

"There's no absolute promise that if you move through [the programs' requirements], you'll get housing," says Philip Mangano, executive director of the Interagency Homeless Council on the White House Domestic Policy Council. "You can do all the right things, make the right promises, perform well in the program. The promise of that is housing, and the difficulty is, there's a shortage."

The housing-first strategy, he continues, "puts the emphasis on the appropriate antidote to homelessness – housing. And that housing becomes the nexus point for the delivery of social services."

At Pathways, those social services include jobs at the five Pathways offices, adult education, alcohol and drug-abuse support, psychiatric and nutrition counseling, and soon, careers at a Pathways-run thrift store in Queens and a bakeshop in Harlem. Twenty percent of clients are working or in school, and 70 percent participate in some form of treatment for alcohol or drug abuse.

Those social services represent about 40 percent of the program's annual cost; apartment-rental fees soak up the rest.

Mr. Tsemberis grew up in tiny Srouka, a Greek village on the Peloponnesian peninsula where, he says, "mentally ill relatives are part of the family, live with you, have dinner with you, and are contributing to the family's well-being.

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