Rates of alcoholism are extremely high in the homeless population. The cost to communities to shelter, feed, and medically treat these individuals is enormous. Most programs designed to provide permanent housing to homeless individuals require strict adherence to psychiatric treatment or treatment for drug and alcohol misuse. These strict guidelines are often too rigid for many homeless people to maintain. Therefore, implementing a more flexible housing program that offers lower barriers to inclusion could potentially give homeless individuals struggling with psychological problems a solid foundation on which to rebuild their lives at their own pace. Housing First is just such a program. This nonabstinence housing program offers homeless individuals the opportunity to permanently reside in a single housing community and receive health and social services through available on-site resources, if they choose.
Policymakers have suggested that Housing First, which does not insist on abstinence or treatment for its residents, would enable residents to continue their drug or alcohol use and could potentially result in increased misuse. However, findings from a recent study conducted by Susan E. Collins of the University of Washington’s Harborview Medical Center demonstrate that this low-threshold program actually decreases alcohol use. Collins followed 95 homeless individuals as they were admitted into Housing First and for 2 years after. All of the individuals had alcohol addiction problems at entrance.
Collins discovered that contrary to the theory that Housing First would enable the participants, every 3 months that the participants were in the permanent homes, they decreased their alcohol intake by 7%. Additionally, the level of delirium tremens experienced during withdrawal from alcohol was reduced by 50%. The participants also reported fewer instances of complete intoxication. Overall, the levels of alcohol-dependent symptoms dropped from an average of five symptoms at entrance into the program to an average of two symptoms 2 years later. This represented a 4% decrease for every 3 months the participants remained in the housing program. Collins believes these findings are important and should be considered in planning and designing of future housing programs for alcohol-dependent homeless individuals. Rather than force people to completely abstain and receive treatment, Collins points to prior research that supports her findings for positive outcomes with less stringent guidelines. She added, “Recent studies have suggested that the autonomy and sense of stability afforded by Housing First provide a foundation upon which residents may take their own steps toward positive behavior change, including changes in their alcohol use.”
Collins, S. E., Malone, D. K., Clifasefi, S. L., Ginzler, J. A., Garner, M. D., Burlingham, B., et al. Project-based housing first for chronically homeless individuals with alcohol problems: Within-subjects analyses of 2-year alcohol trajectories. American Journal of Public Health 102.3 (2012): 511-19.
© Copyright 2012 GoodTherapy.org. All rights reserved.
The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.