How to end homelessness: Housing First founder Dr. Sam Tsemberis to speak in Grand Rapids

What does it take to ensure everyone in Grand Rapids has a place to call home? Dr. Sam Tsemberis, a clinical psychologist who founded the Housing First model that has significantly reduced homelessness in cities across the country, will tackle that question and more when he speaks in our city on Nov. 16.
When Dr. Sam Tsemberis first began working with individuals who were homeless in New York City in the late 1980s, he was doing so as a clinical psychologist who wanted to help address such issues as mental health. As he witnessed the same people who were homeless returning for mental health services time and again, he realized the way our country attempted to end homelessness was dramatically failing. So, he began to reach out to people often not included in homeless policies -- including the people the policies affect the most: those who are homeless. Tsemberis and his team came up with a new plan to get people off the streets, and to do it in a permanent way.

This plan, a model called
Housing First, prioritizes placing people who are homeless into housing, after which they can focus on topics like access to mental health. The model has gone on to be implemented in cities across the country, and world, with great success: using this model, Utah has reduced its rate of chronic homelessness by 91 percent, and cities such as Denver, Boston, Seattle, and New Orleans are all reporting significant drops in homelessness after incorporating the “Housing First” model into their public policy.
Tsemberis also runs the New York City-based organization he began in 1992, Pathways to Housing, which trains direct service organizations, conducts research projects, and influences policy related to Housing First. Also on the faculty of the Department of Psychiatry at Columbia University Medical Center, he travels the globe to engage with communities and their work to end homelessness and is participating in national studies of homelessness, mental illness and addiction.
Next week, Grand Rapids will welcome Tsemberis to our city, where he’ll spend two days meeting with local and state leaders to advise them on Housing First. On Wednesday, Nov. 16 at 6pm, Grand Rapidians will have a chance to see him speak at the Fountain Street Church (24 Fountain St. NE). The Nov. 16 event is free and open to the public.
Numerous city organizations are supporting Tsemberis’s trip, including Well House, a Grand Rapids-based nonprofit that uses the Housing First model to address homelessness in the city (something which Well House Executive Director Tami VandenBerg wrote about for Rapid Growth), Downtown Grand Rapids Inc., Bistro Bella Vita, Lambert, Edwards & Associates, Fountain Street Church, and San Chez Bistro.
Before Tsemberis arrives in Grand Rapids, we got a chance to speak with him about his work, the importance of increasing access to affordable housing, and more.
You have a background in clinical psychology. How did that lead you to focus on homelessness?
I got my degree from New York University, and in the early 1980s I was working at Bellevue Psychiatric Hospital in New York City. It was a time when homelessness was beginning to become a part of the regular landscape of New York City, and, of course, every other city in the country. The thing about being old, like I am, is you can actually remember there was a time when there weren’t many homeless people, especially homeless people with mental illness, on the streets. We have a whole generation of people growing up believing that homelessness is part of life.
Several things happened in the early 80s that really began the income disparity we talk about today. It wasn’t always 1 percent and 99 percent; it was more evenly distributed. We had more of a middle class; we had a tax structure where more people were paying into it. In the 1980s, there was the election of Ronald Reagan, and more policies of less government. That meant they stopped the building of affordable housing in America; they thought somehow the market would take care of things. We stopped building affordable housing, and we’ve never gone back.
People who need Section 8 or other supports aren’t making enough; they’re working, but the minimum wage isn’t high enough so they can afford rent. For some segment of our population, even with work, they can’t generate enough to get into a house.
The people most affected by this are people who are disabled or on welfare or disability. They can’t work or find jobs. With disability, it’s insufficient to make a month’s rent. Even if you spent your entire benefit on getting an apartment, it would be difficult [to afford housing].
And not only were people not making enough, but there was a diminishing number of rental units. It was at that time that the value of apartments and houses were on the rise. We began to see among the people on the street a great many number of them with some kind of problem, like addiction or mental health problems. We drew the conclusion that, oh my God, these people are homeless because they are mentally ill. We put one and one together and got three. We’d assume it had to do with their mental health or addiction -- but no, they’re on the street because there isn’t affordable housing.

When you first were working with individuals who were homeless, did you think housing should be a priority, or was that an idea that you came to later?
I thought, like everybody else, ‘We better get this person of the street. Can we get you somewhere you can get treatment and get stable?’ Housing from a clinical perspective is the last thing you’re thinking about. You’re thinking this person needs help, and that help is in the form of treatment. I worked in an outreach program, and we had the legal authority to take someone to the hospital involuntarily if they were a danger to themselves or others [if, for example, temperatures were dipping below freezing]. I did that for three or four years. Then, what began to become clear to me is, for some people, [going to the hospital] was a useful thing, but many, many people returned to the streets and bringing them to the hospital wasn’t helping them. We were seeing them again and again.
I began talking to a lot of people who were homeless, and not people trained to think clinically. We basically began to listen in a different way and acknowledged that our way of doing things wasn’t getting us where we wanted to go. We weren’t quite certain where that would be. We canvassed people we were working with. That’s what led us to Housing First… Previously, we had spent so much time to persuade people to get into [mental health or substance abuse treatment], but once they got housing, then they’d, on their own, want to get treatment.
You’ve seen dramatic results with the Housing First model -- it’s credited with essentially ending chronic homelessness in Salt Lake City and reducing homelessness in such cities as Denver, Boston, Seattle, and New Orleans, among many others. Why is it that Housing First has been able to be replicated, regardless of geography?
I think it just speaks to the coherence of the model. The model works well because it was designed from the ground up; it was designed primarily by the people who were going to use the programs. It’s a consumer kind of product…It was designed by people who were homeless but valued their independence and self-determination. Why the program works well is it speaks tot he people it intends to serve in a way that’s empowering.
The program also afforded them an inclusiveness in the community -- they didn’t want to be identified as being different than anyone else. They pay only up to 30 percent of their income towards rent. That allows you to have discretionary funding. You pay 30 percent, but you can shop, live your life, have guests -- it allows you to have a life. It’s not like living in a program.
What have you found to be most important when implementing a Housing First model in a city?
What’s most successful really varies tremendously by community. One of the things that matters a lot is having someone who’s really a champion for the program. You need an organization that’s got the kind of values I’m talking about, who believes in the rights of clients to have a voice. You need the support of local, municipal and state government. You need money for rent and services. And you need partnerships. You need other providers -- the faith community, families to come back and connect, landlords to be cooperative so they rent to people. When it works well, it’s because of a decision by every member of our community that the people in our community who are homeless shouldn’t be homeless. Denial [of homelessness] doesn’t work, and embracing it without a plan is only frustrating.
What do you believe are some of the root causes of homelessness, and how can we better address those as a society?
I think most of the writing about root causes of homelessness has focused on individual psychopathology. People have talked about addiction, for example. There’s often a judgement; they say [people who are homeless] are not like us, as though it’s a failing of the individual. The root causes are systemic; it’s about a lack of affordable housing, benefits that don’t pay enough for rent, incorrect judgements about what people need first. Instead of running a program that allows the person the dignity to make their own decisions, they’ll say, ‘We’ll determine what you need.’”
Is there anything else you’d like people to think about before your talk in Grand Rapids?

I would love it if people think about the issue of homelessness and think about it in a way that helps us all have a common vision of a Grand Rapids without people who are homeless.

Dr. Sam Tsemberis will speak on
 Wednesday, Nov. 16 at 6pm at the Fountain Street Church (24 Fountain St. NE). The event is free and open to the public. To find out more information, please go here.
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