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This policy change is v problematic. Don't be fooled by talk of 
mental health. The reason homelessness has is bc the fundamental drivers of homelessness: income inequality, lack of deeply affordable ("ELI") housing & racism-- have worsened. A 
1/x https://bit.ly/3dF5Sdn
mental health. The reason homelessness has is bc the fundamental drivers of homelessness: income inequality, lack of deeply affordable ("ELI") housing & racism-- have worsened. A 1/x https://bit.ly/3dF5Sdn
Housing First has a strong evidence base. Our recent study showed it successfully housed 86% of the "most difficult" to house chronically homeless ppl w high rates of substance use and mental health disabilities. https://www.hsr.org/node/664701 2/x
Programs that require substance use or mental health tx have poor track records of housing retention--the new policy is a false dichotomy. Housing First programs are NOT Housing Only--they work bc they are coupled w robust treatment for mental health & substance use probs 3/x
But--robust evidence-base that making housing contingent on starting w treatment leads to poor outcomes. Why would you promote a program that doesn't work? Because it plays into the worst stigma about mental health & substance use problems--4/x
& places blame for homelessness on individual problems--instead of bad policies that have led to their being 36 units of housing affordable & available for every 100 households that make less than 30% of area median income (poor ppl) https://reports.nlihc.org/gap @NLIHC 5/x
Policies that have contributed to rising levels of income inequality (wages stagnant for low wage workers) & the continued effects of structural racism that leave Black Americans. https://www.washingtonpost.com/business/2020/06/04/economic-divide-black-households/ 6/x
As an MD, we learn that to treat problems, you have to diagnose the problem so you know what you are treating & the follow the evidence for what works. This policy is wrong on both counts. If we want to solve homelessness, we need to produce, protect and preserve ELI housing 7/x
Expand access to housing assistance (only 1/4 households who meet criteria receive it!). Most ppl who are homeless just need housing they can afford. Others, need housing they can afford & VOLUNTARY services that go with it. (Permanent Supportive Housing). 8/x
We know how to end homelessness--all we lack is the will. (And now, it seems, the willingness to follow the evidence). 9/fin
