Editor's Note:This article is the second in a series exploring the factors behind the success of Houston's homeless response system, as well as the current and future challenges the city faces in addressing homelessness.The first article in the serieshas been published.

Over the past few years, homelessness has risen sharply in many U.S. cities. In some cities where housing prices make it difficult for low-income residents to afford,existing shelter bedsare not enough to accommodate the number of people needing a place to stay each night. This shortage, along with other shelter problems, has led large numbers of homeless people to sleep on sidewalks, in parks, and in other public spaces.

In response to this prominent issue, which has become a political focus, cities have adopted different approaches. Some cities havemade camping in public spaces illegal; others have added moreshelter bedsand invested inmicro-homesand other solutions.

To address what was then the sixth-largest homeless population in the nation, Houston adopted the so-called "Housing First" strategy. This approach prioritizes providing permanent housing to homeless individuals as quickly as possible, while offering a range of voluntary support services to ensure their long-term housing stability.

"When we look at the data across all the different strategies, housing with wraparound support services is clearly the most effective," said Marc Eichenbaum, special assistant to the Houston mayor for homelessness.

The first article in this series described how the Houston metropolitan area has achieved a63% reduction in homelessness since 2011, a larger decrease than any other among the ten largest U.S. cities. Houston achieved this without using city funds (relying only on federal grants), and Eichenbaum said its spending was lower than what any other large city used to address the problem. He said the city had to use its limited resources "more smartly."

Other cities that have adopted the Housing First model have also reported declines in homelessness.

Sophie House, director of law and policy at the Housing Solutions Lab at New York University's Furman Center, said Salt Lake City, Utah, and Columbus, Ohio, were among the first large U.S. cities to adopt the Housing First approach to reduce homelessness.

According to a2021 reportfrom the Office of the Utah Legislative Auditor General, over a period of several years, more than 90% of people placed in permanent housing in Utah maintained stable housing.

Similarly, Atlanta—a city thatmodeled its policies after Houston's Housing First approach—has seen homelessnessdrop by nearly 40% since the start of the pandemic。

The U.S. Department of Housing and Urban Developmentandthe U.S. Department of Veterans Affairshave provided strong federal financial support for permanent housing and Housing First programs in recent years. According to the National Low Income Housing Coalition, through the Housing First model,three states and 82 communities(including Houston) achieved a net-zero goal for veteran homelessness in 2021.

Houston's success is significant because it provides a roadmap for other cities addressing the national homelessness crisis. According to Eichenbaum, Houston officials are working with officials from Los Angeles,New York City, Chicago, Denver, Dallas, Austin, Texas, Spokane, Washington, and other cities to jointly develop collaborative Housing First systems.

Why Housing First?

Eichenbaum said shelters play an important role in Houston's Housing First strategy because they are the largest entry point for getting people on the path to housing. But he noted that homeless people staying in shelters are still homeless—shelters are not a long-term solution to homelessness.

Before 2012, the community spent millions of dollars each year just managing the problem, Eichenbaum said. But when you're just managing it, more people continue to fall into homelessness, so the rate keeps rising.

"We said, we want to take all our money and actually put it toward solving the problem, rather than spinning our wheels and just coping," Eichenbaum said.

Alyse Oneto, a research associate at the Urban Institute's Metropolitan Housing and Communities Policy Center, said in an email that the Housing First approach is based on the theory that people need access to safe, stable housing to be in the best position to receive other care and services and make progress on other goals.

The National Alliance to End Homelessness, the National Low Income Housing Coalition, many scholars, other advocacy groups, andHUDhave all said Housing First works.

"Housing First is the most effective approach to ending homelessness for most individuals and families," Diane Yentel, president and CEO of the National Low Income Housing Coalition, said in an email. Because of a lack of federal resources, it is crucial that communities invest in this approach that has "proven most successful at moving people from the streets into housing," she added.

Yentel said that, as in Houston's case, Housing First programs provide a range of voluntary support services after people move in. Services such as substance use and mental health counseling and employment training can help people lead stable lives and maintain their housing, she said.

NYU's House said this approach is particularly effective in providing housing stability for people with severe and persistent mental illness and those experiencing longer periods of homelessness.

Oneto of the Urban Institute said programs operating on Housing First principles retain higher housing retention rates, help people exit homelessness more quickly, and reduce people's interactions with emergency service systems such as hospitals, jails, and shelters.

Anevaluation of Denver's Housing First programreleased last year by the Urban Institute showed that over a three-year period, 77% of participants maintained stable housing. The report said their shelter visits decreased by 40%, arrests decreased by 40%, jail stays decreased by 30%, and emergency room visits decreased by 40%.

Oneto said about half of the total cost per participant was offset by avoided costs associated with these "positive outcomes."

"Beyond being a proven strategy to end homelessness, Housing First is a responsible and accountable use of taxpayer dollars to address homelessness," Yentel said.

Providing housing without conditions, along with support services that participants choose voluntarily, makes this strategy more attractive to homeless individuals, Eichenbaum said. This has led to exponential increases in participation in support services.

"We found that when a person feels forced to do something, they're less likely to do it," Eichenbaum said, whereas it's different if they seek services voluntarily—even under the "strategic encouragement" of trained social workers.

Challenges facing Housing First

Not everyone believes the Housing First model is the best solution to homelessness.

Christopher Rufo, a conservative activist and senior fellow at the Manhattan Institute, has been critical of Housing First policies. In a2020 reportfor the conservative think tank The Heritage Foundation, Rufo said that although Housing First policies show high short-term housing retention rates, they have not "improved symptoms related to drug addiction, mental illness, and overall well-being—and have failed to reduce overall homelessness rates."

Rufo argued that policymakers should redirect federal homelessness policy toward better outcomes, prioritizing programs that require treatment, accountability, and a path to self-sufficiency.

Even experts who believe Housing First is the best approach to homelessness say such programs come with challenges.

House said the feasibility of the Housing First approach depends on access to affordable rental housing that meets the needs of a broad population.

Despite its large population, Houston is less densely populated than other major U.S. cities. Factors such as permissive zoning restrictions make buying a home in Houstonmuch cheaper。

than in cities like New York, San Francisco, or Los Angeles, which are still working to serve homeless populations.

"In cities with tighter, more expensive housing markets and limited rental housing supply, implementing the Housing First approach may be more challenging," House said. Still, Houston is a growing city with high demand, so studying its successful implementation "can provide valuable lessons for similar large cities," House said.

Eichenbaum said Houston received significant federal funding through the CARES Act and the American Rescue Plan Act, which local leaders have used to support the homeless response system. But since the pandemic, finding housing for homeless individuals has become increasingly difficult, he said. Recently, occupancy rates for affordable housing have reached 95% or higher, slowing progress, said Sara Martinez, vice president of communications and development at the Coalition for the Homeless.The coalition is the lead agency for "The Way Home"—Houston's HUD-designatedContinuum of Care program

—which oversees a dedicated landlord team that works with property owners to ensure their participation, and has a cross-departmental working group focused on finding innovative ideas for accessing affordable housing units, Martinez said.

Still, "actually finding multifamily units where landlords are willing to rent to clients with complex backgrounds," Eichenbaum said, "is becoming very difficult, and it's a crisis for homeless response systems in Houston and across the nation."Eichenbaum said city officials and coalition liaisons work with groups like theHouston Apartment Association

to arrange meetings with landlords, sometimes even making cold calls and door-knocking, to try to find new units in the area. They also offer landlords incentive fees and non-refundable property damage deposits."The housing market is very strong right now, which makes it very, very challenging," Eichenbaum said in August. "It's an uphill battle." Although there have beensigns of a housing market slowdown this fall due to rising interest rates

, the tight housing situation in Houston has not changed, he said last week.

According to Oneto, cities adopting Housing First policies also face a range of other challenges: such policies often do not address the rate at which people enter homelessness, so cities need to develop prevention strategies to help people before they begin experiencing homelessness.

Ultimately, in Houston, the political will of city leaders and mayors, along with the willingness of agencies and funders to collaborate, made the effort successful, Costis said.

The biggest challenge Houston faced when rolling out its Housing First strategy was "getting everyone to understand the concept and participate as a system," rather than individual agencies deciding on their own which clients could access housing, said Thao Costis, president and CEO of SEARCH Homeless Services in Houston. The agency is a member of The Way Home system.