by
Debra J. Rog, Ph.D.
C. Scott Holupka, Ph.D.
Homeless people are, by definition, isolated from mainstream society. They lack stable housing, and often lack connections with jobs, families, and communities. This paper summarizes what we know about reconnecting homeless people and individuals into the community and in turn fostering self-sufficiency, including improving their residential stability and employability, and reuniting them with family and friends.
Much has been learned in recent years about how to connect homeless people with stable housing. There have been several major housing initiatives and studies, the majority demonstrating that when homeless people obtain housing with appropriate supports—even those with multiple and severe problems—most stay stably housed. Furthermore, housing is best offered as the first step toward greater reconnection. Much less attention has been placed on testing ways to reconnect homeless people into the job market, with mixed results. The relative success of more comprehensive programs compared to approaches that concentrate only on employment suggests the need for efforts that integrate support services, housing, and job training and development services. Finally, although research continues to show that homeless people have few ties with families and friends, there have been no programs or efforts explicitly designed to improve the social capital of homeless individuals.
In addition to reviewing what is known in each area, this paper discusses the barriers and challenges that continue to challenge efforts to reconnect people back into our communities. The paper concludes with a discussion of the implications of our knowledge for policy, practice, and research.
The literature on reconnecting homeless people to housing, jobs, families, and the community reviewed in this paper provide a number of lessons that can be useful to service-providers, policy-makers, and researchers. The research and practice conducted to date provide some direction for individual housing and social service providers, including the following:
The policy implications from what has been learned so far are:
Finally, although much has been learned about effectively working with homeless people, many questions remain. Research questions highlighted by the material reviewed in this paper include:
Homelessness is typically more than being without a home (U. S. Department of Housing and Urban Development, 1995). In addition to being without housing, homeless people are often unattached from mainstream society on a number of other dimensions, including employment, health care, and connections with family, friends, and the broader community (Wright, Rubin, & Devine, 1998). This paper summarizes what we know about reconnecting homeless individuals and families into the community, including improving their residential stability and employability, and reuniting them with family and friends so that they can be as independent and self-sufficient as possible.
One of the challenges to reconnecting homeless individuals and families to the community is the extent to which homeless people today are disaffiliated from society. Comparing the characteristics of the “old homeless” who inhabited the Skid Rows of U.S. cities in the 1950s and 1960s to the “new homeless” of today, Peter Rossi notes that “what is striking is that homelessness today is a more severe condition of housing deprivation than in decades past” (Rossi, 1989). In the past, those who were considered homeless were able to find some shelter in flophouses, SROs, or cubicle hotels. By contrast, many of the today’s homeless are apt to be found in public places (such as building lobbies or train stations), homeless shelters, or on the street.
Similarly, most of the “old homeless” worked, either full-time or on an intermittent basis, whereas most homeless persons today are not working, have not worked for some time, and “suffer a much more profound degree of economic destitution” (Rossi, 1989). Finally, today’s homeless, like homeless persons in years past, lack strong support networks. Most report few ties with family and friends, and thus rarely have anyone to rely on to help out financially or emotionally (Wright et al., 1998).
The literature is replete with perspectives as to “why” disaffiliation and homelessness occur in today’s society. In the 1980s, two polar perspectives were offered. One perspective, expounded most strongly by Baum and Burnes (1993), is that people become disaffiliated of their own doing. Personal problems such as mental illness, substance abuse, and legal issues challenge a homeless person’s ability to attach, or remain attached, to the rest of society.
Others (see Koegel, Burnam, & Bauhmohl, 1996; U. S. Department of Housing and Urban Development, 1994; Wright et al., 1998) argue that structural changes in the economy and housing market have created more poor people and less low-income housing, making homelessness inevitable for some proportion of the population. According to this view, society abandoned the homeless.
A third view, and probably one that is most broadly accepted, is that “times had grown unforgiving” (Koegel et al., 1996, p. 30). Given the complexities in the overall structural context, people with personal limitations have a difficult time competing for the limited affordable housing and better-paying jobs available. This is especially true for people suffering from chronic disabilities, such as mental illness and HIV/AIDS, and those experiencing problems of substance abuse. Moreover, these risk factors are often bundled together, leading to a further marginalization of this segment of the poverty population (Koegel et al., 1996; Wright et al., 1998).
Efforts to reconnect homeless people with society have been influenced in varying degrees by these different perspectives. Most efforts to date have targeted individuals’ needs and limitations, attempting to strengthen their chances of competing successfully in today’s job and housing markets. A few efforts have focused on improving more systemic issues, such as increasing the affordability of housing or developing more employment opportunities. More recent approaches, however, have done a little of both, tackling individual issues while also intervening in the broader system. HUD’s concept of the Continuum of Care, for example, suggests that restructuring housing and service systems is needed to meet the needs of homeless persons, especially those suffering from disabilities.
This paper reviews what we know about reconnecting homeless people to housing, jobs, and family and friends. For the first two areas—housing and employment—we review the major programs and efforts that have been tested, followed by a summary of the lessons learned from studies of these efforts, and concluding with a discussion of the barriers and continuing challenges in each area. In the third area—reintegrating homeless people back into families and support systems—little intervention has taken place. Therefore, in this section, we review what is known about the nature of homeless individuals’ connections with families, friends, and the community, and what implications this knowledge has for action.
Much has been learned in recent years about how to reconnect homeless persons with housing. In particular, as another paper in this series describes, outreach and engagement efforts are sometimes critical in beginning the reconnection process, especially for individuals who have been homeless for long periods of time and are experiencing severe mental illness and/or chronic substance abuse (e.g., Barrow, Hellman, Lovell, Plapinger, & Struening, 1991). Developing trust through the provision of food and clothing, over long periods of time, often is key to sparking a person’s transition from homelessness to housing.
Getting people off the streets and out of shelters, and keeping them in the community requires that various housing options be available to meet their different shelter and support needs. Housing combined with services characterizes many of the interventions that have been developed and tested to improve residential stability, particularly for individuals with specific needs, such as mental health problems or substance abuse issues (Fosburg, Locke, Peck, & Ankel, 1997; Emerson & Twersky, 1996; Federal Task Force on Homelessness and Severe Mental Illness, 1992; Rog, Holupka, & Brito, 1996; U. S. Department of Housing and Urban Development, 1995). The term “supportive housing” is used to broadly define housing designed to help individuals reduce their need for more restrictive services and remain residentially stable, and in turn improve their quality of life and functioning (Newman, 1992).
Supportive housing, also called services-enriched housing (e.g., Friedmutter, 1989) and special needs housing (e.g., Community Information Exchange, 1995), refers to a wide range of housing interventions. For example, supportive housing can be transitional or permanent. Transitional housing is typically congregate housing with considerable services and supports provided on-site where a person can live a predetermined period of time. Permanent supportive housing has no set time limits, and typically includes access to services available in the community. Permanent housing options include single room occupancy (SRO) hotels, multi- and single-family rental housing, scattered-site apartments, and even homeownership. Community differences in the housing stock, together with what funding may be available, often result in differences in the types of supportive housing that are developed. SROs, for example are common in New York City, and can range in size from 30 units to over 500 units.
In supportive housing, housing is combined with access to services and supports to address the needs of homeless individuals so that they may live independently in the community rather than on the street or in institutional settings such as mental institutions, jails, and hospitals. Supportive housing is generally considered an option for individuals or families who have either lived on the streets or shelters for long periods of time and/or who have needs that may best be served by services that can be accessed through their housing. It is important to note, however, that not all homeless individuals require supportive housing to regain stability. Many, especially those who have experienced short-term homelessness due to a fire, loss of job, or temporary separation from family, may only need assistance in finding housing that is affordable, rather than ongoing services.
There is great variation in what is meant by services within supportive housing. Services may be provided on site or offsite, and may be available for restricted hours or on a 24-hour basis. Supports can be limited to basic security and case management services, or can include a host of health, mental health, and daily living supports. In some instances, the housing case manager facilitates the linkages with the mainstream service system. In other instances, especially when the needs of the residents are specialized and/or the system has gaps in certain service areas, some services may be provided directly on site.
The types and intensity of services and supports are generally influenced by many factors, such as the amount of funds available, staff-to-resident ratios, needs of the population being served (some buildings are targeted to individuals with a specific set of needs—such as individuals with severe and persistent mental illness or individuals with HIV/AIDS; others are open to a broad population of individuals with varying levels of service need), and so forth.
Transitional housing is designed as temporary housing (ranging from 3 months to 24 months or longer) typically with a high intensity of services. It is predicated on the notion that when homeless individuals initially transition into housing, they need a more structured setting with a range of services readily available, including employment readiness and education, mental health, substance abuse, health, and others. However, as the individual or family stabilizes, the concept is that the services will be needed less and the individual will be ready to move into more independent, permanent housing.
Transitional housing is considered a big component of the continuum of housing options (e.g., U. S. Department of Housing and Urban Development, 1994), but it is not a necessary step for all homeless people. Several studies (e.g., Center for Mental Health Services, 1994; Rog & Gutman, 1997) have indicated that some homeless people can move directly from the streets and shelters to various types of permanent housing, including SROs and multi/single family rental housing, and remain stable for considerable periods of time. There may be instances, however, especially with individuals who have been homeless for long periods of time, when transitional and interim housing may be needed as a preliminary step (Fosburg et al., 1997; Barrow & Soto, 1996). In some instances, the housing may be needed as a critical bridge for people who are ready to leave homelessness but do not yet have access to permanent housing.
There have been several major supportive housing initiatives over the last ten years or more. Some have been engineered primarily for funding new approaches, others mainly for knowledge-generation purposes, and others with some mix of purposes. A summary is provided below of each of the major initiatives that have been or are currently in operation with the purpose of improving the residential stability of homeless individuals and families.
The largest efforts have been sparked by the support of the federal government through the Stewart B. McKinney Homeless Assistance Act and led by the U.S. Department of Housing and Urban Development (HUD). HUD has promoted the Continuum of Care approach as a way to shape a comprehensive and coordinated system of housing and services (Center for Mental Health Services, 1997). Since 1994, HUD has included the concept of the continuum of care in its homeless programs. The approach is intended to help communities plan and implement systems of emergency, transitional, and permanent housing resources to assist homeless individuals in moving from homelessness and reconnecting with the community. The components of the system include outreach and assessment, immediate shelter, transitional housing with supportive services, and permanent housing.
In addition to the Emergency Shelter Grant program, HUD’s Continuum of Care has three key housing programs: Supportive Housing Program (SHP), Shelter Plus Care (S+C), and Section 8 Moderate Rehabilitation Assistance Single Room Occupancy (SROs). Two of these programs (SHP and S+C) have completed evaluations that offer guidance in implementation as well as preliminary information on outcomes. All three programs provide funding for housing operating expenses, but only SHP provides funding for services. However, the projects funded under these programs encourage and provide access to supportive services (U. S. Department of Housing and Urban Development, 1995).
SHP was created to develop innovative approaches to combining housing and services for individuals and families who are homeless, especially those with special needs (Westat, 1995). The program has four basic components: transitional housing for up to 24 months, permanent housing with support services for homeless permanently disabled persons, supportive services without housing for homeless individuals, and supportive housing that is, or is part of, an innovative project to meet the needs of homeless persons and families (U.S. General Accounting Office, 1994).
Shelter Plus Care (S+C), like the permanent housing component of SHP, provides rental assistance for hard to serve homeless persons with disabilities. Supportive services are funded by outside sources. S+C rental assistance can be tenant-based, sponsor-based, project-based, or SRO-based.
With Section 8 moderate rehabilitation SRO, ten-year rental assistance is provided for homeless persons (not necessarily disabled) to live in moderately rehabilitated SROs. The SRO program covers the full operating expenses of the SRO housing—rehabilitation costs must be secured from other sources but the debt service for rehab financing can be covered.
Housing Opportunities for Persons with AIDS (HOPWA), also administered by HUD but not funded through the McKinney Act, provides funding for housing and services for low-income persons, including homeless individuals, living with HIV/AIDS and their families. HOPWA funds can be used for a wide range of housing, services, and planning and development costs.
Foundations and other entities also have been instrumental in fostering the development of efforts to curb homelessness and to study their outcomes. The Robert Wood Johnson Foundation (RWJF), in particular, has joined forces with HUD on two occasions to demonstrate the relationship between housing and services. Both programs—the Program for the Chronically Mentally Ill (Goldman, Morrissey, & Ridgely, 1994) and the Homeless Families Program (Rog & Gutman, 1997)—examined the implementation and outcomes of Section 8 certificates combined with services for two vulnerable populations—individuals with severe mental illness and families with multiple problems, including long-term instability, domestic violence, alcohol and drug issues, and others.
The growth of supportive housing also has been fostered by other national players, most notably the Corporation for Supportive Housing (CSH), a national nonprofit intermediary established in 1991 with funding from The Pew Charitable Trusts, The Robert Wood Johnson Foundation, and the Ford Foundation to expand the quantity and quality of supportive housing for special needs populations who are homeless or at risk of becoming homeless. CSH has supported the growth and development of supportive housing across the country, concentrating much of its efforts in ten metropolitan or state regions. CSH has been active in developing both housing and supports, including an employment initiative, Next Step: Jobs.
Of the three major areas addressed in this paper, the area involving efforts to reconnect individuals and families to housing and to keep them stably housed has received the most study. Yet, even in this area, the research has been somewhat limited (Newman, 1992; Rog et al., 1996).
The most rigorously studied interventions include those tested for individuals with severe mental illnesses and individuals with substance abuse problems through the efforts of the federal government (see Table 1). In 1990, the National Institute of Mental Health awarded $16.8 million with funds from the Stewart B. McKinney Homeless Assistance Act to fund five experimentally-designed studies of housing and services (including outreach and case management) for people with severe and persistent mental illness (U. S. Department of Health and Human Services, 1994). Although a range of housing alternatives was tested, most of the housing studied falls under the definition of “supported housing”—independent, permanent housing in the community provided with access to needed services. The Center for Mental Health Services is currently extending this area of research by funding a set of individual studies and a cross-site study examining the effectiveness of supported housing for persons with mental illness in relation to other types of housing models in improving residential stability, independence, quality of life, empowerment, and satisfaction (Center for Mental Health Services, 1997).
| Table 1
Major Research Studies and Evaluations on Supportive Housing |
Completed
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In Progress
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Also in 1990, the National Institute of Alcohol Abuse and Alcoholism (NIAAA) funded fourteen research demonstrations of interventions for homeless individuals with alcohol and/or other drug problems. All interventions were evaluated according to several primary objectives, including whether or not they increased the residential stability of the participants. Only a subset of these interventions, however, explicitly included housing programs.
As noted, two of the HUD interventions and others supported by The Robert Wood Johnson Foundation have been accompanied by large-scale evaluations that have provided information on the implementation and outcomes of these initiatives. CSH also has recently published the first year evaluation of the Minnesota Supportive Housing Demonstration Program, a program created by the Minnesota Legislature in 1996 to develop more cost-effective long-term housing solutions for persons with mental illnesses, chemical dependency, and/or HIV/AIDS (Wilder Research Center, 1998).
All of these studies, however, have been descriptive and thus provide only tentative findings on issues of outcome and impact. However, combining the findings across these various evaluations and more rigorous research studies, especially to the extent that they converge, increases their potency and provides clearer direction for policy makers and practitioners.
What Have We Learned About Reconnecting Homeless People to Housing?
Overall, the evidence from this growing body of research and practice indicates that the residential stability of homeless individuals and families can be fostered, largely through providing some combination of housing (or access to housing) and services and supports. Residential stability has been defined and measured in a variety of ways. Most studies have measured stability as accessing community-based housing and living stably (i.e., without moving residences) in that housing for some period of time (generally measured at 12 to 18 months after initially entering the housing).
Reconnecting with housing is often the first step in reconnecting individuals with the community. In fact, as noted below, getting stably housed is increasingly being recognized as a prerequisite to other steps in reconnecting with the community—that is, getting back into the job market, getting hooked up with needed services, and reestablishing or initially establishing ties with family and other sources of support. Therefore, identifying interventions that are effective in fostering residential stability is critical to understanding how community reintegration can begin. However, as noted later in this section, despite knowledge of what works, there continue to be significant barriers—structurally as well as those more personally faced by subgroups of homeless individuals—that challenge the ability of these interventions to have widespread effectiveness.
A number of lessons can be drawn from this existing body of knowledge. The specific lessons that have emerged to date, outlined in Table 2, are summarized below.
Table 2 What Have We Learned About Reconnecting Homeless People to Housing?
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Once in supportive housing, the majority of homeless people—regardless of their disabilities and other needs—stay in housing. Almost without exception, studies have found increased residential stability for people who enter housing. The majority of individuals entering some form of housing—generally those with supports—have remained in stable housing for at least one year. Families as well as those who are mentally ill tend to have the highest stability rates; those with substance abuse problems tend to have among the lowest rates.
In the evaluation of the HUD Supportive Housing Demonstration Program, 56% of the residents in transitional housing entered stable housing (including unsubsidized, subsidized, and privately owned housing) after leaving the program; of those who were considered “graduates” of the program, approximately 70% entered stable housing. Families appeared to have the most success in securing permanent housing of the subgroups studied. Similarly, more than two thirds (69%) of those who received permanent housing remained stably housed for at least a year (U. S. Department of Housing and Urban Development, 1995; Westat, 1995). Moreover, of those who left, nearly half (48%) moved into other stable housing situations.
Similar results to the SHP evaluation were found with evaluations of housing for special needs populations. The recent evaluation of Shelter Plus Care (1997) found that in the reporting grantee sites over half of the residents were housed 6 months or more in both operating years (51% in year 1, 59% in year 2). In the first 12 months of operation of the Minnesota Supportive Housing Demonstration Program, more than two thirds of the 168 individuals who entered the demonstration (most of whom had severe mental illness and/or dual diagnosis) were still in the program at the end of the first 12 months. Housing providers report that roughly 10-20% of the tenants who leave the program do so for positive reasons (e.g., voluntary relocation, receiving a Section 8 certificate, etc.).
In the McKinney supported projects for individuals with severe mental illness sponsored by CMHS (Shern et al., 1997), 78% of the participants in the experimental conditions (all involving some form of independent living coupled with case management and other services) were stably housed in the community at 12-18 months following receipt of housing and services. Similarly, over 85% of the families who received Section 8 housing and services in nine cities were still in permanent housing at an 18 month follow-up (Rog & Gutman, 1997).
In a study of four subtypes of homeless veterans—those with alcohol problems, those with psychiatric impairment, those with multiple problems and those who were considered the “best functioning”—Humphreys and Rosenheck (1998) found a significant increase in residential stability for all groups studied, with those being psychiatrically impaired showing the least improvement.
Access to and receipt of rental subsidies improves residential stability. The affordability (or lack thereof) of housing challenges poor people’s abilities to maintain decent housing. Individuals and families with limited incomes have few housing choices. Those who cannot or do not want to live with family and friends are faced with increasing difficulties finding affordable housing in ever tightening housing markets. In turn, high housing costs are one of the most common contributing factors to the loss of housing (Wood, Valdez, Hayashi, & Shen, 1990).
Rental subsidies, such as Section 8 certificates, provide payment for housing that is generally based on some proportion of an individual’s income. A Section 8 certificate, for example, allows an individual or family to go into the private housing market and rent an apartment or house from a landlord who agrees to participate. The household pays approximately 30% of its income toward rent, and the federal government subsidizes the remainder.
A number of studies have shown that receipt of rental subsidies improves the housing outcomes of homeless persons (Rog & Gutman, 1997; Shinn et al., 1998; Zlotnick, Robertson, & Lahiff, in press). In a 15 month prospective study of a county-wide probability sample of homeless adults, for example, Zlotnick and colleagues found that economic resources—specifically consistent receipt of entitlement benefits and government subsidized housing—were key variables associated with stable housing (Zlotnick, et al., in press).
As noted earlier, Rog and colleagues found that, in each of the nine cities involved in the Homeless Families Program, over 85% of the participating families successfully maintained housing with Section 8 certificates for at least 18 months. Although all families also received some amount of case management and access to other services, the level of service provision varied greatly across and within each of the nine sites and did not appear to differentially affect housing stability.
Shinn and colleagues also studied the stability of families in New York City who had been homeless and found that at least three years from shelter entry stability was predicted only by receipt of subsidized housing (with an odds ratio of 20.6). Eighty percent of the homeless families who received subsidized housing were stable (in their own apartment without a move for at least 12 months) compared to only 18% of those who did not receive subsidized housing. Families generally did not receive services. The authors conclude that for their cohort, subsidized housing was very clearly both necessary and sufficient for families to be residentially stable (Shinn et al., 1998).
For individuals with mental illness, subsidies are instrumental in getting individuals into independent housing in the community as compared to other treatment-oriented housing options (Hurlburt, Wood, & Hough, 1996; Newman, Reschovsky, Kaneda, & Hendrick, 1994). In The Robert Wood Johnson Foundation Program for the Chronically Mentally Ill (CMI), for example, Newman and colleagues found Section 8 certificates to have positive effects on the housing outcomes for persons with severe mental illness, about a third of whom were previously homeless or living in institutional settings.
Part of the success of subsidies is that they not only allow homeless people to live affordably, but that they also allow them to live in safer, more decent housing. In the CMI evaluation, Newman and her associates found that the Section 8 certificates were associated with improved housing affordability and improved physical dwelling conditions. The quality of the physical housing, in turn, is related to other outcomes, especially residential stability (Newman et al., 1994).
The dilemma, as noted below, is that the availability of Section 8 and other subsidies is woefully inadequate to meet the need that exists. A recent report by HUD (1997) indicates that in 1995, the number of very-low income renters (those with incomes below 50 percent of the area median income) with worst case housing needs was at an all-time high of 5.3 million people. These are very low income renters who lack housing assistance and who pay more than half of their income for rent or live in severely substandard housing. Moreover, those households with the lowest incomes (i.e., below 30 percent of the area median income) are most likely to have worst case housing needs (U. S. Department of Housing and Urban Development, 1997). At the same time that need for housing assistance is high, both tenant-based rental assistance and programs to create and rehabilitate affordable housing have declined. HUD (1997) indicates that the stock of rental housing affordable to very low-income families dropped by 9% between 1993 and 1995 (with a 16% drop in the units affordable for extremely low-income renters).
Moreover, no federal funding for new rental assistance or for new incremental rental assistance had been authorized until 1998, when HUD requested 50,000 new Section 8 certificates for families moving from welfare-to-work (U. S. Department of Housing and Urban Development, 1997). An additional 100,000 new Section 8 certificates have also been requested for the FY 2000 budget including 25,000 certificates for Welfare-to-Work participants, 18,000 for homeless persons, and 15,000 for elderly residents (U.S. Department of Housing and Urban Development, 1999).
Provision of housing is often not enough to fully reconnect people into society. Housing is an essential part of the remedy for homelessness, but may not always be sufficient to meet the full spectrum of needs homeless persons have (Buckner, Bassuk, & Zima, 1993). In the five CMHS research projects examining housing and supports for individuals with mental illness, individuals in the comparison groups as well as the experimental groups improved their stability over time, but the greater improvement was for those who received more intensive services than for those who received services as usual (Shern et al., 1997). In the Baltimore study, for example, those who received access to housing and more intensive services spent significantly more time living in the community than those receiving access to housing and regular community services. Similarly, in the New York Critical Time Intervention Program, individuals who received housing and intensive case management spent significantly less time on the streets than those who were only assigned housing and told about possible community services.
Case management, in particular, is highlighted as a key service in housing (Rog et al., 1996; Westat unpublished; Westat, 1995). SHP found that 95% of grantees used case management and that providers believed was key to helping with personal stability (U. S. Department of Housing and Urban Development, 1995; Westat, 1995). Several studies also have shown that case management improves housing stability, particularly for those with serious mental illnesses and dual diagnoses (Morse, 1998) . A variety of models of case management have been used, but most provide some brokering of services inside and outside housing and assistance in daily living, such as money management, assistance in accessing transportation, problem solving, and other areas of assistance that help a person live independently (see Morse, 1998 for a review of models and approaches).
Other housing-related assistance, during the outreach process, the housing search process, and while housed can help homeless persons find and maintain housing in the community. In addition to receiving general case management and subsidies, there are specific areas of assistance that can help a person connect and stay connected to housing. When a homeless person with special needs receives a subsidy such as a Section 8 certificate, for example, it is helpful to have a housing specialist who is sensitive to the individual’s situation and limitations. This person can provide individualized attention in processing the application, helping to ensure that the homeless individual follows through with what can be an intimidating and lengthy process (e.g. Dixon, Krauss, Myers, & Lehman, 1994) and serving as a bridge to others in the housing agency. Housing specialists have been reportedly helpful in facilitating the Section 8 process for individuals with severe mental illness (Hurlburt et al., 1997) and families with multiple problems (Rog, McCombs-Thornton, Gilbert-Mongelli, Brito, & Holupka, 1994).
Hiring formerly homeless people as volunteers or paid staff in housing programs also appears to be helpful (Center for Mental Health Services, 1994; Rog et al., 1998). In the CMHS research demonstration efforts studying housing and supports for individuals with severe mental illness, four of the projects used formerly homeless persons with mental illnesses as volunteers or paid staff, as outreach workers, case aides, or respite program staff. In these positions, the individuals were reportedly helpful in locating and engaging clients, serving as role models, and educating other staff members. The researchers noted the positive results and recommended that the programs explore ways to use their services. Similar success was reported in hiring supportive housing tenants in staff roles in the housing and related employment efforts as part of CSH’s Next Step: Jobs initiative (Rog et al., 1998).
Assistance in the housing search process, provided either by case managers or specific housing locators, also can be valuable especially when individuals are searching for market housing (Rog et al., 1994). Housing locators can serve as an advocate to landlords, helping to vouch for the individual’s or family’s ability to pay the rent and that they are linked with supports in the community. In addition, landlords have been found to be more willing to rent to individuals they otherwise may have found too risky but who now have case management support (e.g., Fosburg et al., 1997; Rog, et al., 1994). They view the case manager as back-up support and a person to call upon when crises arise. Finally, transportation to housing prospects as well as day-care, if applicable, can be an invaluable service to allow a person access to a greater range of housing.
Assistance during the transition process also can be critical. Help in obtaining and moving furniture, for example, is often needed at the time of move-in. More emotional support is often needed in the few months after leaving the shelter or streets, a time often reported to be stressful for any tenant but particularly for those who have not lived on their own for some time.
Getting housing first, before tackling other issues, is important to reconnection. Growing research shows that meeting basic needs first is critical to tackling any of the other issues a person or family may have. Wright and colleagues (1998) assert that treatment for alcohol, drug, and mental health issues is rarely effective because it does not address the more fundamental issues of poverty, housing, welfare, and employment. In turn, treatment may be most effective when combined with housing.
Sosin and colleagues have found housing to be a major incentive for remaining in substance abuse treatment for homeless persons with substance abuse problems (Sosin, Bruni, & Reidy, 1995). In a randomized study of substance abuse treatment, clients who received supportive housing and case management were more likely to remain in treatment for at least three months than those who received case management only (78% vs. 42%). In addition, it is also likely that without housing, clients cannot fully focus on recovery when they have concerns about their basic needs. The challenge, however, is to design interventions that can retain homeless individuals long enough to make the treatment work (Wright et al., 1998), which can take over a period of 4 years to achieve high rates of abstinence (Drake, McHugo, & Noordsy, 1993). Some (Burnam et al., 1995) believe that low demand settings have the best prospects of facilitating and maintaining treatment involvement, especially in the first phase of engagement.
Housing may be best tailored to people’s needs and preferences; a range of options continues to be warranted. Much of the study of housing for individuals for severe mental illness has focused on their preferences for housing (Rog et al., 1996). Mental health consumers most often prefer to have a choice in their housing and their preference is for independent living. Goldfinger and Schutt (1996) have found, however, that the desire for independent living does not necessarily mean that the individuals do not want staff support; rather, the desire is more commonly related to the desire to live alone and not with others. To date, published findings on the relationship between outcomes and housing preferences indicate that housing choice is related to residential stability (e.g., Srebnik, Livingston, Gordon, & King, 1995.)
Independent, permanent housing in the community is not an immediately viable option for all persons, however, nor is it always one’s choice (Hurlburt et al., 1997). Some individuals with severe mental illness, for example, prefer community living. Others, especially individuals who have been living on the streets for extended periods of time, may need to transition into more permanent housing options. The S+C evaluation found, for example, that both housing and services need to be tailored to the needs and capacity of each household; that is, the appropriate place in the continuum for an individual is determined by the level of independence an individual can live with what level of supervision and services to ensure stability (Fosburg et al., 1997).
One interesting model that has been examined in New York City is interim housing (Barrow & Soto, 1996). This model of housing has been shown to be successfully implemented to meet the needs of groups within the street population in New York City who do not have access to existing housing resources. Interim housing consists of shared apartments and single or double rooms in SRO buildings and YMCAs that provide more privacy, protection, and stability than living in the streets or shelters as well as a means of engaging persons into services and housing. A three month follow-up of residents found that most (62%) went on to some form of long-term transitional or permanent housing at exit and were still there at the follow-up; only one third of a matched control sample who received similar drop in services, but were not provided with case management, was housed in the same time frame.
Despite the evidence showing increased residential stability for homeless people who enter housing, a number of barriers exist to insuring that all homeless people have access to adequate shelter. These barriers, outlined in Table 3, are described below.
Table 3 Barriers to Housing
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The lack of affordable housing and limited supply of Section 8 subsidies threatens the promise that supportive housing offers. Dolbeare (1996), as well as others (e.g., Wright et al., 1998) makes a convincing argument that unless we grapple with the gaps between housing costs and income, there is no way to effectively eliminate homelessness. The lack of affordable housing and the limited supply of subsidies to compensate for the high rental costs especially for those with the lowest of incomes (U. S. Department of Housing and Urban Development, 1997) makes expansions in supportive housing difficult. Increases in McKinney allocations for these programs over the last decade have helped, but much goes to continue existing housing rather than create new housing. Thus, they are recognized as far from meeting the need that exists.
Various policy changes in public housing promises to further exacerbate the limited housing situation. These policy changes, such as zero tolerance for drug users, allowing local housing authorities to develop their own preferences, and the desire/need to create more “mixed-income” public housing are all likely to reduce the number of units available to poor families with the greatest housing need (Daskal, 1998).
Community opposition to housing programs complicates the housing development process and often stalls efforts to increase the supply of housing needed. Even with funding, supportive housing providers continue to battle community opposition to siting housing, especially for homeless and special needs populations. Although this type of community conflict is not specific to supportive housing, NIMBY-ism (Not in My Back Yard) and related opposition (e.g., NOOS—Not On Our Street) continue to challenge providers efforts to increase the stock of affordable housing. Efforts at community outreach before and throughout the development process are reportedly critical to trying to avert this type of opposition. Broader efforts at changing public perceptions of the homeless and special needs populations are also called for to deal with the more systemic problems of stigma and prejudice that block these efforts. Finally, more vigorous enforcement of federal Fair Housing laws may be indicated to forge ahead in developing and siting housing.
Substance abuse is a major barrier to gaining residential stability. Substance abuse problems challenge a person’s ability to obtain and maintain stable housing. The studies sponsored by the NIAAA provide the most extensive examination of the effectiveness of supportive housing for individuals experiencing substance abuse problems and report limited success in fostering stability (e.g., Burnam et al., 1995; Wright et al., 1998). Other studies have also attested to the interference of substance abuse in maintaining one’s housing. The five CMHS projects all reported clinical observations that substance abuse is a major factor in housing instability. The view is that substance abuse, not mental illness, is the primary cause of housing loss (Center for Mental Health Services, 1994). In the Minnesota Supportive Housing program, the rate of exit was disproportionately high for those who were chemically dependent and not mentally ill (Wilder Research Center, 1998). Similarly, Caton and colleagues (1993), attributed the deterioration in housing successes over time for individuals with mental illness to the concurrent diagnosis of SA for many of the residents.
The vast majority of the homeless are unemployed and extremely poor. In a survey of Chicago homeless, for example, it was found that most respondents had not had any “steady” job for at least four or five years, and that 60% had not worked at any type of job in the last month (Rossi, 1989). A review of sixty homeless studies conducted in the 1980s and the early 1990s found an average unemployment rate of 81% and a median monthly income of only $103 (Shlay & Rossi, 1992). Similarly, less than one-quarter of tenants participating in the federal Shelter Plus Care program were working for pay or as volunteers when they were assessed for the program (U. S. Department of Housing and Urban Development, 1997). Among participants of a federal employment program for the homeless, only 10% had any type of job when they entered the program (U. S. Department of Labor, 1998).
Furthermore, homeless persons today are more isolated from the labor market than those who were considered homeless 30 or 40 years ago. Studies of the homeless in Chicago in the 1960s, for example, found that as many as 28% of the respondents were working full-time, compared to only 3% among current Chicago homeless (Wenzel, 1992).
Although most homeless people are not currently connected to the labor market, it would be a mistake to conclude that most of these people have never worked. In fact, just the opposite appears to be true. Among the more than 45,000 participants in the federal Job Training for the Homeless Demonstration Program, for example, 97% reported that they had held at job at some point in the past. A study of supportive housing tenants from selected buildings involved in CSH’s Next Step: Jobs employment initiative in three cities found that over three-quarters had been employed at some point in the past, although less than one-third were working at the time they entered supported housing (Hopper et al., 1997; Rog et al., 1998). Similarly, a study of supportive housing tenants in Minneapolis reported that 94% of the tenants examined had worked in the past (Wilder Research Center, 1998).
Although the vast majority of homeless persons have worked, the types of jobs they have typically held have not provided much income or security (Rossi, 1989). Most of the participants in the U.S. Department of Labor’s Job Training for the Homeless Demonstration Program, for example, reported that their most recent job had been as service workers (32%), laborers (28%), or office/clerical workers (10%) (U. S. Department of Labor, 1998). Likewise, employment histories obtained from supportive housing tenants involved in the Corporation for Supportive Housing’s employment initiative, Next Step: Jobs, (Hopper et al., 1997) and those in the Minnesota Supportive Housing Demonstration program (Wilder Research Center, 1998) showed that tenants generally held part-time, low paying jobs—generally less than $6 an hour—that did not provide health or other benefits. Data from the histories of mothers participating in the Homeless Families Program (Rog et al., 1995) paint the same picture.
Ethnographic studies have been able to provide even more details about the work patterns of homeless people. Wagner, in a study of homeless people in the early 1990s in a Northeastern city, found that, at any given time, approximately 20% of homeless people were working in the “formal economy”, typically in such jobs as security guards, waiters or waitresses, cashiers, or housekeepers (Wagner, 1994). Even more people—one-quarter to one-third—were found to have casual jobs, or performed “casual work,” such as collecting recyclable bottles and cans, day labor, working at carnivals and fairs, or giving blood. Similar employment histories and work patterns were noted by Snow and Anderson in their ethnographic work with homeless persons in Texas (Snow & Anderson, 1993).
Despite the substantial employment problems faced by homeless people, few programs or projects have been developed or evaluated to address this need. Although there’s a preponderance of evidence that homeless people face problems finding and keeping jobs, particularly jobs that pay enough to get people into housing, few programs have been developed that explicitly focus on improving the job prospects of homeless people (Johnson & Cnaan, 1995; Whiting, 1994). A substantial number of organizations involved in the federal Supportive Housing Demonstration Program, for instance, reported that the most frequently unmet need of participants in the transitional housing programs was employment-related services, particularly transitional employment or paid internships, job placement, or job training, largely because of difficulties identifying opportunities and programs in their communities (Westat, 1995).
One major exception has been the Job Training for the Homeless Demonstration Program (JTHDP), sponsored and evaluated by the U.S. Department of Labor. This program, begun in 1988 as part of the McKinney Act, was the first comprehensive federal program designed to provide employment and training services for homeless individuals (U. S. Department of Labor, 1998). It began by funding 32 projects across the country, and eventually supported 63 programs, with over 45,000 participants.
Another major, recent employment program is Next Step: Jobs, a multi-dimensional, multi-disciplinary initiative begun by the Corporation for Supportive Housing in 1995 with a three-year grant from the Rockefeller Foundation. This program is intended to increase the rate of employment among residents of supportive housing, often formerly homeless and chronically unemployed or under-employed. Next Step: Jobs provided grants to 22 organizations in New York City, Chicago, and the San Francisco Bay Area to develop employment programs for supportive housing tenants. Over 3,200 tenants, living in more than 40 supportive housing buildings, were directly targeted by the initiative (with additional tenants in other housing often involved indirectly). A three-year evaluation was designed to provide a descriptive analysis of Next Step: Jobs, concentrating most of the data collection in nine across the three sites.
The Next Step: Jobs initiative supported a flexible set of strategies that organizations could tailor to their own resources, circumstances, and tenants’ needs. The result was an initiative with three main components:
4. Housing based strategies, including: providing pre-vocational and ongoing support activities; hiring tenants in-house; improving linkages to existing training and job programs; and identifying and developing competitive job placements;
5. Job creation strategies that supply seed capital and technical assistance for new businesses and special initiatives that create new job opportunities for tenants, such as developing and operating a thrift store, or developing a food services/catering operation;
6. System innovation efforts, such as identifying and developing funding streams and mechanisms to integrate employment programs with supportive housing or addressing entitlement regulations that discourage tenants from entering the work force (Hopper et al., 1997; Rog et al., 1999).
What Have We Learned About Reconnecting Homeless People to Employment?
Although less research has been conducted on employment programs than on housing efforts, the work that has been done provides some lessons about efforts to reconnect homeless people to the labor market. These lessons, summarized in Table 4, include:
Table 4 What Have We Learned About Reconnecting Homeless People to the Job Market?
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There is a need for a comprehensive approach towards employment, particularly involving the provision of housing and services prior to or together with any employment effort. Programs designed to employ people who are homeless, or were recently homeless, have used a variety of approaches, including job training, “transitional work programs,” and entrepreneurial efforts to create “affirmative enterprises” (Whiting, 1994). A consistent finding from all of these types of efforts is the need to coordinate and combine employment services with other types of services and supports, particularly housing. As aptly summarized by Emerson and Twersky, it is now recognized that efforts to move the homeless into the mainstream must rest on “the three legs of a stool: housing, services, and jobs” (Emerson & Twersky, 1996; Whiting, 1994).
A central finding from the evaluations of the JTHDP programs, for example, is the need to provide a comprehensive set of services in order to break the cycle of homelessness (U. S. Department of Labor, 1998). Core services that need to be available include: case management; assessment and employability development planning; alcohol and other substance abuse assessment and counseling; other support services (e.g., child care, transportation, mental health assessment/counseling, health services); job training services; job development and placement services; post-placement follow-up and support; and housing services. Furthermore, the JTHDP experience suggests that many of these services need to be provided before people are enrolled or participate in employment and training efforts. JTHDP participants were more likely to complete the program if, during the assessment stage, housing and support service needs were identified and addressed. For example, retention rates at 13 weeks were highest for those participants who received housing placements and obtained a job (80%). High retention rates were also reported for those people who received security deposit/rental assistance (76%) and people who received assistance with furnishings/moving (75%).
Similarly, the design of CSH’s Next Step: Jobs was based on the premise that employment programs in supportive housing need to provide more than training (and housing) to be successful. Projects also must offer a flexible array of services to meet tenants’ needs, and to respond appropriately as those needs change. Ethnographic observations and interviews conducted with a number of tenants indicated that those tenants who were able to access a variety of services—such as substance abuse or mental health counseling as well as various employment services—and who had credible “standing offers” of work opportunities, were often the ones who realized the most employment changes (Rog et al., 1998).
Job training and development efforts have shown mixed results. Since the beginning of the War on Poverty in the 1960s, the United States has implemented a variety of programs to address the problems of unemployment and poverty. These programs have generally included a mix of job search assistance, short-term classroom training, long-term classroom training, and subsidized employment. Unfortunately, most of the job training and development efforts have not had much impact on people who are homeless, in large part because traditional training programs, such as JTPA, have not been accessible to, or focused on the needs of, homeless people Fosburg et al., 1997; Emerson & Twersky, 1996).
In a survey of 55 JTPA programs, for example, over half of the agencies indicated that they had made only modest efforts to recruit homeless persons, and two-thirds said that they did not offer services aimed at addressing the multiple needs of homeless people (reported in Institute for Children and Poverty, 1994). Barriers that homeless people have faced working with traditional employment programs include lack of flexibility, lengthy periods to determine eligibility, and unrealistic limits on funding and duration of services.
Although it is unfortunate that homeless people have not had access to traditional training programs, studies have generally found that most of these programs only have a modest impact, at best, on their participants. A recent assessment of over thirty years of job training programs came to the conclusion that “the results are very discouraging: thirty years of experimentation with job training programs have created a substantial number of programs whose benefits—for individuals in dire need of employment and economic independence—are quite trivial, and are completely inadequate to the task of moving them out of poverty, off of welfare, or into stable employment over the long run” (Grubb, 1995).
Speculating why such poor results have been obtained, Grubb identified a number of possible factors, including: programs that are too small and brief; too much emphasis on short-term results; the poor quality of many programs; lack of follow-up and long-term support; poor matching of people into jobs; and possible lack of appropriate jobs in the labor market. Grubb’s recommendation is to create more comprehensive and coordinated employment-related services. The goal would be to create an education and training “ladder” that people could access at any level, with “vertical” linkages so people could move into a succession of more demanding, better paying jobs, instead of being limited to jobs that are often boring, low-paying, and offer few prospects for advancement.
More recent training and development programs, designed specifically for homeless people, appear to have already taken some of this advice, and have created more comprehensive programs, with mixed results thus far. The JTHDP project, for example, brought together a number of employment and support services, including housing, mental health counseling, and substance abuse treatment, in order to address the multitude of needs faced by participants. In JTHDP, over one-third of the participants were able to obtain a job, and half of those people were still employed 13 weeks after placement. The evaluators concluded that, with the appropriate blend of supports, “a substantial proportion of homeless individuals can secure and retain jobs, and improve their housing condition” (U. S. Department of Labor, 1998).
Another comprehensive program was the Demonstration Employment Project—Training and Housing (DEPTH), also funded by the U. S Department of Labor and combining services concerned with job training and placement with services to locate permanent housing and support services (Toro, Passero Rabideau, Bellavia, et al., 1997). At the core was intensive case management. An evaluation of its outcomes over an 18-month follow-up period did not reveal any changes in job income or other income over time. The absence of results on employment-related outcomes could be in part due to the immaturity of the program and the amount of cases lost to attrition.
In the Heart Project, an employment program for homeless individuals in Oregon, however, 87% of the participants finished the program, and 81% of those who graduated were able to obtain a job (Goetz & Schmiege, 1996). Part of the success of the program was attributed to providing an array of services to participants, including intensive case management, substance abuse and mental health counseling, and stable housing. Furthermore, the program worked closely with local industry to develop job skills needed by local businesses, in this case, construction work. Similarly, in a pilot employment program operated by Homes for the Homeless that integrated intensive forms of skills training and education with a strong network of support services, 75% of the initial participants finished the program, and 60% of those who graduated were able to obtain work (Institute for Children and Poverty, 1994).
The Next Step: Jobs employment initiative was designed to provide comprehensive services by weaving employment activities into supportive housing (Rog et al., 1998; 1999). Because the initiative was designed to change the culture of opportunity within supportive housing, the evaluation examined changes in the rate of employment for all tenants (not just those receiving some level of direct employment service or intervention) in each of the buildings selected for the evaluation. Using two different measures of employment change, the evaluation found that the rate of employment increased significantly over time in a few buildings, but in most buildings there were no significant changes in employment rates.
Job development is a labor intensive activity, requiring a great deal of time on job search assistance. For a nine-month period, for example, Gervey and Kowal tallied a total of 1255 job leads that were pursued in an employment program for people with mental illness, with 188 resulting in job interviews and 27 resulting in job offers (Gervey & Kowal, 1996). Cook and her associates (1990) also documented the labor intensity of the job developer role. Over 11 months, a part-time job developer made 305 phone calls, sent 45 letters, and made 16 presentations, all of which led to 4 jobs.
Though labor intensive, job search assistance has been noted as one of the least expensive and most successful employment strategies. As alluded to in the HEART Project, the most useful job search and development strategies have been those that involve contacts and links with employers. Even minimal prior contact with an employer can help to establish a relationship between job developers and employers that can have long-term benefits (Kirszner, Baron, & Donegan, 1992).
Supported employment programs have been successfully used in some programs. Although not widely used in employment programs designed for the general homeless population, transitional and supported employment represent the most widespread approaches used with individuals with mental illness, including those who have been formerly homeless. Transitional employment is most commonly found in psychosocial rehabilitation programs (Bond & Boyer, 1988), and has been implemented in a myriad of ways, ranging from sheltered non-paid work to placement in paid positions in integrated community settings. The most common feature across transitional employment approaches has been the limits placed on the amount of time a person can work at a given job (Bond, 1987).
Supported employment is based on a philosophy that individuals with disabilities can perform meaningful work in competitive settings if provided support (e.g., Block, 1992; Drake et al., 1994; Drake, McHugo, Becker, Anthony, & Clark, 1996). The key characteristic of supported employment is that it assists an individual in obtaining and maintaining a job in the regular work force. The support includes assistance in obtaining a job, in training, and in staying on the job (Wehman & Kregel, 1985). The role of job coach is a central feature of supported employment.
Rigorous research on supported employment has been limited but growing. A 1988 review of vocational rehabilitation (Bond & Boyer, 1988) found only three controlled evaluations of supported employment. Since this review, only a few additional studies have been conducted (Blankertz & Robinson, 1995; Bond et al., 1995; Drake et al., 1996). Two key themes emerge from this literature:
These results are consistent with the findings of some broader, welfare-to-work initiatives. The success of programs which involve mandatory jobs searches for a broad number of people—best exemplified by the Project GAIN program in Riverside, California—indicates that long-term education and training may not be needed to get people employed, although there is some debate about the types of jobs people are able to get in these circumstances (Gueron & Pauly, 1991). The importance of providing long-term, flexible follow-up supports has also been a finding of Project Match, a welfare-to-work program operating in Chicago (Berg, Olson, & Conrad, 1991; Herr, Halpern, & Wagner, 1995).
Faced with problems placing people in “regular” jobs, more programs are trying to develop their own affirmative businesses and in-house opportunities. In recent years, a number of nonprofit organizations have started to develop business ventures for both disabled and non-disabled populations. According to a recent report from the Roberts Foundation (Emerson & Twersky, 1996), which has supported a number of these ventures in the San Francisco Bay area, nonprofit organizations have started businesses for several reasons:
Likewise, the recent national evaluation of the Shelter Plus Care program noted that some programs are considering the development of alternatives to traditional employment, such as affirmative businesses, particularly for tenants with mental illnesses, in order to provide a work environment where they would not be held to the same expectations they would encounter in the regular labor market (Fosburg et al., 1997).
Based on their experience in fostering affirmative businesses, the Roberts Foundation concluded that nonprofit organizations are capable of operating business ventures, but it can be very difficult and challenging. In addition to the normal start-up problems faced by any new business, nonprofit business ventures face unique pressures and challenges. For example, the desire to create a business in order to provide on-the-job training can conflict with the need to maintain a stable, permanent workforce that can ensure quality and meet customer needs (Emerson & Twersky, 1996).
Little research currently exists on affirmative businesses (Emerson & Twersky, 1996). The research that has been conducted has focused mainly on affirmative businesses for people with mental illness. Studies indicate that while cooperatives or affirmative businesses might pay better than sheltered work settings, and come closer to the goal of competitive employment than sheltered work shops or enclaves, competitive work may pay higher wages and provide greater potential for social integration (Clark, 1995). However, affirmative businesses may offer more reasonable accommodations for individuals with mental illnesses than competitive workplaces and thus may be an alternative to private employment for some individuals.
Many of the organizations involved in CSH’s employment initiative for supportive housing tenants, Next Step: Jobs, also have created internal labor markets in order to offer flexible jobs complementing other site-based employment and support services (Rog et al., 1998). Organizations have offered a variety of job opportunities, from informal, stipend work to transitional employment, to permanent employment within the agency, or within businesses created by the agency. These employment opportunities seem to be particularly useful for buildings serving individuals with severe mental illnesses. One of the unique features of these “in-house” jobs is the ability to make the work atmosphere more inviting, particularly for people who may not have had much success in the past working in mainstream jobs. Along with these opportunities, however, in-house employment also presents some unique challenges. Tenants sometimes have problems distinguishing between their roles as an employee and as a tenant. This can create conflicts of interest at times, as tenants must balance their work responsibilities against their loyalties and roles as tenants. Tenants who work in-house can also find that they are treated differently by both other tenants and other staff.
Expect and plan for job turnover. One of the most consistent findings in the job development literature, for both the general population as well as with more focused groups, such as the homeless, is that job turnover is likely to be quite high. One study found that of those people who are able to leave welfare by obtaining a job, 60% later return to the welfare rolls (Edin, Harris, & Sandefur, 1997). A follow-up study of job holders in the Massachusetts Employment and Training Program found that 62% of those employed were no longer at their initial jobs 12 to 16 months later (reported in Berg et al., 1991). Reports from Enterprise Job, a program initiated by the Enterprise Foundation in 12 cities across the country, found that of those who found jobs, 31% lost their jobs in one month, and 77% lost their jobs within six months (Berg et al., 1991).
Some of the most detailed job retention studies among welfare recipients have been conducted by Project Match. In one study they found that 61% of those employed lost their first job within six months (Herr et al., 1995). In a second study of Project Match participants, it was found that 46% lost their job within 3 months, 60% in 6 months, and 73% in 12 months (Berg et al., 1991). Examining the reasons why people lost or left their jobs, the researchers found evidence of a social mismatch between the attitudes and behaviors of people living in isolated, urban ghettos and the requirements of many workplaces. In particular, while many entry-level jobs do not require high levels of technical skills, they often demand well-developed interpersonal skills, particularly for the service sector jobs most likely to be available in urban centers.
Employment programs focusing on homeless people have also found high rates of job loss. The JTHDP project found that many people did not stay too long in their initial job placement, with the evaluators speculating that participants may have been too anxious to start a job and thus did not obtain an appropriate match with their skills and interests (U. S. Department of Labor, 1998).
In the evaluation of Next Step: Jobs, 50% or more of the tenants in each building examined were employed at some point during the 15-21 month monitoring period although rates at any one point in time were often substantially lower, indicating a substantial degree of job turnover (Rog et al., 1998). Ethnographic observations and interviews conducted with a subset of tenants in three buildings found that some tenants participated in a number of jobs or training and employment programs, thus explaining some of the sporadic work patterns. Furthermore, it was noted that some tenants stopped work due to personal difficulties, such as substance abuse relapse or mental health problems.
Even when people are successful obtaining jobs they are likely to remain economically vulnerable. A corollary of expecting high job turnover rates is to also expect that improvements in employment rates and income levels will not occur quickly, if they occur at all. The evaluation of the Supportive Housing Demonstration program, for instance, found only minimal increases in employment rates among participants of its permanent housing programs, and no meaningful changes in income levels (Westat, 1995). Increases were noted in the employment rates for transitional housing program participants—from 18% to 38% working full or part-time—but only modest improvements were reported in personal income, and concern was expressed in the final evaluation that a majority of graduates remained vulnerable to experiencing homelessness again.
The Job Training for the Homeless Demonstration Program reported a gradual increase in average wages, but only from $5.04 to $6.62 an hour (U. S. Department of Labor, 1998). These hourly wages reflected the predominance of low skill jobs, such as service worker positions (35% of all job placements), laborer (27%), and office/clerical positions (10%). Furthermore, about the same percentage of participants placed in jobs had health insurance after they obtained work (34%) as they did at intake (31%), although the percentage of people with private health insurance did increase from 3% to 13%. Other employment efforts with homeless or formerly homeless people have also noted little, if any, increases in employment rates, and little change in the types of jobs obtained (Rog et al., 1998; Wilder Research Center, 1998).
All of these findings are consistent with the larger body of research on job training programs discussed earlier, which shows that success in obtaining employment, when it occurs, is rarely able to move a person out of poverty, even if the person is able to obtain continuous, full-time employment (Edin et al., 1997; Grubb, 1995; Hardin, 1996). As Hardin urges, this does not mean that employment and training programs should be abandoned. Instead, it means that these efforts need to be complemented by efforts to increase wage levels (such as raising the minimum wage), or expanding the scope of programs like the Earned Income Tax Credit (Hardin, 1996).
Homeless people face numerous personal, logistical, and economic obstacles to obtaining employment. As noted above, numerous studies have shown that homeless people have worked in the past, and that most are interested in finding a job. However, numerous obstacles exist that make it difficult for these people to find and/or keep jobs. In the JTHDP program, for instance, case managers and participants identified such problems as (U. S. Department of Labor, 1998):
The JTHDP program found that active substance abuse was also a major barrier for people completing training and obtaining jobs, although clients in recovery were often highly-motivated and successful (U. S. Department of Labor, 1998; Rog et al., 1998).
Those receiving or entitled to social and medical insurance, such as Social Security Disability Insurance or Supplemental Security Income, also face economic disincentives to work. Based on data collected on income and expenses from a sample of individuals with mental illnesses, it was found that most individuals would need to make at least $5 an hour plus health insurance to make it economically viable to give up social and medical insurance. For people working part-time, losses in Social Security, food stamps, and non-cash sources of income would amount to an implicit tax of more than 60% on earned income (Warner & Polak, 1995).
Other obstacles involve the social stigmas and stereotypes associated with homelessness and the disabilities of many homeless people, such as mental illness (Ratcliff, Shillito, & Poppe, 1996). Some JTHDP participants were considered difficult to present to employers, for example, due to strange work histories with large gaps caused by hospitalizations, incarceration, or time spent on the street (U. S. Department of Labor, 1998). Similar concerns have been raised by mental health consumers in explaining gaps in job histories due to periods of mental illness or hospitalization (Freedman & Fesko, 1996). Issues related to physical appearance, both clothes and personal hygiene, can also pose problems when trying to find a job.
As discussed later in this report, various studies have shown that becoming “acculturated” to a homeless lifestyle can create additional impediments to getting off the streets (Grigsby, Baumann, Gregorich, & Roberts-Gray, 1990; Rowe & Wolch, 1990; Snow & Anderson, 1993). With respect to employment, Wenzel found that the length of time spent homeless was significantly and negatively associated with leaving an employment program prematurely (Wenzel, 1992).
The job prospects of homeless people are also affected—if not, to some degree, caused—by changes in labor markets and industries that has disproportionately affected people who are less educated and less skilled (Hardin, 1996). The decline of blue-collar industries and their replacement with service-sector jobs, the globalization of the economy, the rapid pace of technological change, and the relocation of firms outside the boundaries of inner-cities have all erected additional barriers to employment, particularly for less-educated workers (Harrison, Bennet, & Bluestone, 1996; Holzer, 1996; Moss & Tilly, 1995).
In the Skid Row studies conducted in the 1950s and 1960s (see, for instance, Bahr, 1973; Bogue, 1963; Blumberg, et al., 1960), the people who were homeless were characterized by three general conditions: poverty; disability (e.g., old age, physical or mental health problem, substance abuse issues); and disaffiliation (La Gory, Ritchey, & Fitzpatrick, 1991; Rossi, 1989) prior to the research that began in the 1980s, homelessness was almost synonymous with disaffiliation.
Those studying the homeless in the 1950s and 1960s “all remarked on the social isolation of the homeless” (Rossi, 1989). Studies found that most of these men—and the homeless population consisted almost entirely of men—were single and had never been married. Kinship ties were tenuous, and few maintained contact with family or kin. Most had no one they considered a good friend, and while there was camaraderie amongst themselves, researchers generally remarked on the superficiality of such ties (Rossi, 1989).
Although more recent studies have shown some differences between the “new” homeless and the “old” homeless of the 1950s and 1960s, such as less access to housing and jobs, research continues to show that homeless people are relatively socially isolated (Rossi, 1989; Shlay & Rossi, 1992). A review of sixty homelessness studies conducted in the 1980s and early 1990s by Shlay and Rossi found that, on average, 36% of the people studied reported having no friends, and 31% reported no contact with family members (Shlay & Rossi, 1992). Furthermore, among the homeless, people with severe mental illnesses and/or street disabilities have been found to be among the most isolated (Cohen & Sokolovsky, 1979; Goering et al., 1992; Interagency Council on the Homeless, 1992; Kroll, Carey, Hagedorn, Fire Dog, & Benavides, 1986; Rossi, 1989; Wolch, Rahiman, & Koegel, 1993).
A review of research on homeless families conducted in the early 1990s reported that several research groups had shown that social isolation is even a problem for homeless families (McChesney, 1993). Studies by Bassuk and her colleagues, for example, repeatedly found that homeless mothers have smaller, and more fragmented social networks, and that many experienced major family disruptions when they were children (Bassuk & Rosenberg, 1988; Bassuk, Rubin, & Lauriat, 1986). Similarly, a study comparing homeless mothers to stably-housed poor mothers found that two-thirds of the homeless mothers named only one or no adult supports, compared to one-half of the non-homeless mothers, and that they were more likely to rely on their minor children for support (Wood et al., 1990). In a more recent study, about half (53%) of the homeless mothers reported two or fewer persons to whom they could turn for support, and 14% reported only their children as social supports (Zima, Wells, Benjamin, & Duan, 1996).
The lack of strong ties to family and friends is important because it means few have the social and economic support to move off the streets. Helping homeless people re-establish ties to family and friends, or create new ties, may therefore either prevent homelessness or its reoccurrence.
Most homeless people are single, often never married. Although homeless families represent a new, and growing segment of the homeless population, studies find that the majority of homeless persons are single men. For instance, Rossi’s survey of the homeless in Chicago found that less than 10% of the respondents were ever married, although women were more likely to have been married than men (Rossi, 1989). La Gory and his colleagues found only 7% were married in a sample of the homeless in a major Southern city (La Gory et al., 1991). A national study of over 45,000 participants in an employment initiative for the homeless found that only 10% of the participants were married (U. S. Department of Labor, 1998), and the recent evaluation of the federal Shelter Plus Care program found that 84% of its participants were single individuals (Fosburg et al., 1997). Two recent studies of supportive housing residents, one conducted with tenants from buildings in New York, Chicago, and San Francisco (Hopper et al., 1997; Rog et al., 1998), and the other conducted in Minneapolis (Wilder Research Center, 1998), found that a majority of the tenants were single, and most (51% to 91%) reported never having been married. Indeed, Shlay and Rossi’s review of homelessness studies found that, on average, 87% of the respondents were unmarried (Shlay & Rossi, 1992).
Even though most homeless people are not married, many do have children. Marital status may only have a weak relationship to actual family status. For example, a majority (54%) of the respondents in Rossi’s Chicago study of homelessness reported having children (Rossi, 1989), while over two-thirds (67%) of the homeless people in a study done by La Gory and his colleagues had children (La Gory et al., 1991). Among the participants of the federal Job Training for the Homeless Demonstration Program, 29% reported having dependent children (U. S. Department of Labor, 1998). Finally, in the buildings examined as part of an evaluation of an employment initiative operated by the Corporation for Supportive Housing, the proportion of tenants who reported having children ranged from a little less than a third to over two-thirds (Rog et al., 1998).
Many homeless people report either having “worn out their welcome” with their family and friends prior to becoming homeless, or never having had much familial support. One interesting question concerning the family and social networks of homeless people is whether their reported lack of ties represents a long-term condition or is a more recent phenomenon. There are at least three arguments that can be made about the family relations of people who are homeless, all three supported by research to some degree (Snow & Anderson, 1993):
Poor adults usually exhaust resources and aid provided by family, friends, and social welfare agencies before becoming homeless (Wong & Piliavin, 1997). In an ethnographic study of 80 homeless families, McChesney found that lack of friends and relatives, or the withdrawal of their support, is an important factor in determining which poor families become homeless (McChesney, 1992). Similarly, Shinn and Weitzman note that studies of homeless families seeking shelter in New York find that nearly all have spent some time doubled up before requesting shelter; it appears that many exhausted the resources in their social network (Shinn & Weitzman, 1996). Toro and colleagues (Toro, Goldstein, Rowland, et al., in press), in a longitudinal study of urban homeless adults, further show that the strained family and other support relationships significantly decline overtime.
Based on the length of time people reported being homeless, and the time since they last had a stable income, Rossi suggests that the average length of time families are willing to tolerate or give help is about four years (Rossi, 1989). Furthermore, he speculates that any generosity may be limited by the impoverished conditions that friends and family are often likely to be in, and be limited by personal problems experienced by many people who become homeless—e.g., substance abuse and/or mental health disorders. In turn, however, those among the homeless who have relatively more financial resources were found to have larger social networks, especially including families, regardless of their mental health issues (Segal, Silverman, & Temkin, 1997). The people who become homeless, unless they have material resources, therefore, often make poor housemates and consequently are more likely to be eased out of a household over time.
There is also support for the argument that many of the people who are on the streets became homeless because they were never associated with stable and supportive familial networks (Nyamathi, Bennet, & Leake, 1997; Reilly, 1993; Snow & Anderson, 1993). Several studies have found that most of the homeless people contacted came either from families that had little economic or emotional support to offer in times of need, or came from no families at all.
Many studies have shown that homeless persons are more likely to have spent time in their youth in a foster care situation and/or to have had other types of adverse childhood experiences, such as physical or sexual abuse (Koegel, Melamid, & Burnam, 1995; Sosin, Colson, & Grossman, 1988; Susser, Lin, Conover, & Struening, 1991; Toro, Bellavia, Daeschler, et al., 1995). Recent data showing that a large proportion of children in foster care in one county were born to parents who had histories of homelessness further suggests an intergenerational cycle between foster care and homelessness (Zlotnick, Kronstadt, & Klee, 1998).
As a consequence of having adverse childhood experiences, many of these people may have little or no family support upon which to draw. For instance, over one-third of the homeless mothers in one study reported being placed either with relatives or in foster care as children compared to only one-fourth of the housed mothers examined (Wood et al., 1990). A study of homeless families from nine major cities found that 15% of the mothers from the participating families had been in foster care (Rog et al., 1995). A comparative study of homeless and housed poor families found that while both homeless and housed low-income mothers experienced high rates of early family disruption, trauma, and loss, only foster care placement and drug use by the respondent’s primary female caretaker were significant predictors of homelessness in a multivariate analysis (Bassuk et al., 1997). It is also interesting to note that while homeless mothers have experienced more childhood disruptions than mothers in poor but housed families, they experienced more stable childhoods than women in shelters for single adults (Shinn & Weitzman, 1996).
A study of people who face three distinct problems—homelessness, mental illness, and substance abuse—found that many of these people grew up in families lacking one or both parents (Rahav et al., 1995). Furthermore, even when parents were present, a majority of fathers and a large proportion of mothers as well as siblings were reported to be substance abusers and/or had psychiatric problems. According to the authors, many of these “triply-diagnosed” people were deprived of traditional social development and socialization growing up, and lack the needed support structures and social controls generally provided by families.
Whether its due to straining ties before becoming homeless, coming from a dysfunctional family, or not having any family ties to begin with, taken together all of these findings indicate that many people who are homeless may have few family resources that they can rely upon once they are on the streets. Perhaps even more distressing, the growth in the number of homeless families, and, by extension, children growing up homeless, may presage even more problems in the future. As Blankertz and colleagues note, we may be witnessing an intergenerational transmission of co-morbidity, with second-generation dually-diagnosed individuals revealing substantial social deficits, even when compared to other people with multiple diagnoses (Blankertz, Cnaan, & Freedman, 1993).
As noted earlier, studies have consistently shown that homeless people do not have extensive ties to relatives or friends, and that they generally have fewer social ties than the non-homeless (Rossi, 1989; Shlay & Rossi, 1992). However, these same studies show that homeless people are not “totally isolated,” as might be inferred from some discussions of disaffiliation among the homeless (La Gory et al., 1991) and none suggest that there is a virtual absence of any ties (Shlay & Rossi, 1992).
Although homeless people typically have some social connections, these ties are not very strong and may not provide much support. The social ties of homeless people have been found to be weaker and less efficacious than the social support obtained by people who are housed (La Gory et al., 1991; Snow & Anderson, 1990). As summarized by Snow and Anderson, social relationships developed between homeless people are “plagued by contradictory characteristics.” On the one hand, friendships are often quickly formed, and there is generally an ethos of sharing whatever modest resources are available. Yet at the same time, there is also a chronic distrust of one another, and a fragility and impermanence to these social bonds, perhaps best exemplified by the fact that many people cannot provide the last names of those they consider friends (Rowe & Wolch, 1990; Snow & Anderson, 1993). The reasons for these weak ties may stem more from the precarious conditions under which the bonds are formed than from any personal characteristics. More specifically, the ability to quickly establish and sever weak ties may have important survival value, particularly in the “resource-depleted context” of being homeless (Snow & Anderson, 1993).
Homeless people who have more social ties with other homeless people may have a harder time moving off the streets. Making friends and ties with others living on the streets may act as “a double-edged sword” (Grigsby et al., 1990). In particular, although they may help with survival on the streets, these ties may block efforts to move out of homelessness. Developing coping skills for the street may inadvertently reinforce an identity of “self-as-homeless” (Rowe & Wolch, 1990) that increases the difficulty of transitioning into housing.
People who become enmeshed in daily street routines and activities with other homeless people often have a hard time exiting from the streets (Snow & Anderson, 1993). Moving off the streets often requires severing ties with other homeless people, an act that is difficult when these individuals are an important, if not the only, part of one’s social network. Developing alternative networks, ideally from “reconnection” venues such as job training programs or housing programs, may help in making the transition from the street and from homeless networks. The evaluation of the Job Training for the Homeless Demonstration Program, for example, found that relationships made by the participants through their involvement in the employment program were a critical, and perhaps only, source of support in their search for employment. Most of the individuals lacked family supports, and their peer supports were not always good influences on maintaining employment (U. S. Department of Labor, 1998). Similarly, an evaluation of an employment program for supportive housing tenants found that many tenants who decided to use employment services or obtain a job often experienced changes in their social networks, focusing more on their colleagues at work or on other tenants participating in the employment effort (Rog et al., 1998).
Because homeless people often lack many social ties, particularly with family and kin, it has been suggested that efforts that would support existing relationships, and promote new ones, might be beneficial, particularly for homeless people with mental illnesses (Interagency Council on the Homeless, 1992; Lehman, Kernan, & DeForge, 1995; Toro et al., in press). Among the strategies proposed include a case management approach that also provides activities to assist people in expanding their networks in healthy ways (Grigsby et al., 1990); drop-in centers as a way to promote the formation of new social networks (Rowe, 1990), and social network therapy (Buchanan, 1995; Drake et al., 1993).
Despite the evidence for the need for integration, no programs have been explicitly developed to help people re-connect with their family and friends, or help establish new ties. This is one area that requires much more work and development (Johnson & Cnaan, 1995). Research that examines whether programs that influence self-esteem, such as supportive housing, indirectly affect the ability and likelihood of formerly homeless people to reconnect to their communities, also needs to be done. In addition, more work needs to be done to explicitly examine the place of families and friendship networks in the process of becoming homeless (Shlay & Rossi, 1992). Understanding how such ties deteriorate under adversity, and what might be done to strengthen them before people become homeless, could be important to homelessness prevention efforts.
Studies are also needed to determine whether some programs, such as supportive housing, create artificial networks that may not be beneficial in the long run. A study of discharged mental health patients, for example, found that many described a support system that was rooted mainly in the mental health system. Patients were able to successfully live in the community, but they did not demonstrate greater community integration (Dewees, Pulice, & McCormick, 1996). Some research in supportive housing, however, (Goering et al., 1992) found that the social networks of tenants was comparable in size to the social networks of people living in other types of community settings but the composition of the networks varied. In particular, staff and co-residents appeared to have replaced, rather than added to, the role of family and friends for supportive housing tenants (Goering et al., 1992). These findings suggest that helping people to establish more functional social networks may be a complicated process.
Homeless people are, by definition, isolated from mainstream society. They lack stable housing, and often lack connections with jobs, families, and communities. The disaffiliation is complicated, with both structural and personal factors contributing to a homeless person’s disconnectedness. Likewise, successfully reconnecting homeless individuals and families back into society requires addressing these same structural and personal issues. Efforts at tackling some of these elements often result in no more than a temporary patching of problems (e.g., providing transitional housing with supports) because the other causal factors are still in operation (e.g., the continued lack of affordable permanent housing).
However, if the homelessness cycle can be broken through successful and sustainable reconnection efforts, even for a segment of the homeless population, then there can be an incremental reduction in the population. Research suggests that this type of successful reconnection involves coordinated efforts of getting someone stably housed, back into the competitive job market, and into a network of “positive” support.
The development of supportive housing, in particular, is based upon the premise that some homeless people need more than housing in order to stay residentially stable. Likewise, the experience from various job and training programs designed for homeless people suggests that employment needs to be addressed in conjunction with a number of other issues, particularly housing, if it is to be successful. Calls to assist homeless people by providing all “three legs of a stool—housing, services, and jobs” thus seem to be justified (Emerson & Twersky, 1996).
The best ways to design this stool, however, still need to be determined though they are likely to involve some form of customized approach. What we know about “how” to reintegrate people into communities is limited. If we examine each of the three areas reviewed– housing, then employment, and finally social supports— we realize that there is progressively less information on how to successfully reconnect people to these areas.
Reconnecting to housing has received the most study and efforts in this area have been overwhelmingly successful. Most homeless people who enter supportive housing, even those with multiple and severe problems, stay stably housed for extended periods of time. Housing is best offered as the first step toward greater reconnection, with supports that can assist in the transitioning process and in fostering long term stability. The experiences of employment and training programs, for example, indicate that they are likely to be more successful if social support and housing services are provided before people become involved in work-related activities.
However, virtually all of the successful housing efforts have involved closing the affordability gaps for a segment of the population, most often targeted to individuals with specific disabilities or needs. These efforts rarely have the chance to affect entire systems or populations of need, but rather constitute “fixes” to the system that are based on insufficient resources (Rog et al., 1994). The feasibility of expanding these efforts on a broad scale is questionable at best, however. Despite the forecasted federal budget surpluses, financial resources for discretionary domestic spending are still limited by the budget caps enacted as part of the 1997 federal budget. Moreover, there has been a general shift in public sentiment away from any sort of “entitlement” programs. Perhaps the best that can be envisioned for the near future is developing and funding comprehensive, albeit time-limited, efforts that can help homeless persons and families become stable and self-sufficient.
Only a few efforts have been tested to explicitly reconnect homeless people into the job market and they have achieved mixed success. Numerous obstacles exist that make it difficult for homeless, or formerly homeless people, to find or keep jobs, even with assistance and support. Some of these obstacles are clearly beyond the control of homeless individuals or programs, such as the changes that have occurred in the labor market and the loss of low-skilled jobs. Others are resource problems, such as lack of transportation or affordable child-care. Finally, some are personal or individual problems, such as lack of education or competitive work skills, family-related problems, mental illnesses, physical disabilities, or substance abuse problems. Resource and personal problems can be addressed, but may be difficult and time-consuming to overcome.
The relative success of more comprehensive employment and service programs suggests the need for more integrated efforts that can offer support services, housing, and job training and development services. However, even when successful obtaining jobs, homeless and formerly homeless people are likely to remain economically vulnerable. Part of the problem is that job turnover is normally quite high, so many people will not be continuously employed once they start work. In addition, the types of jobs homeless or formerly homeless people are likely to obtain normally pay around the minimum wage, are often part-time and/or temporary positions, and rarely provide health insurance or other benefits.
Finally, there is virtually no published literature on how best to improve the social capital of homeless individuals. To date, the attention in this area has focused on documenting the size and strength of family and social relationships when people are homeless, and there have been recent attempts to explore the role of these ties in initially keeping people, particularly families, from becoming homeless. Overall, the research has found that homeless people have few ties with families and friends, often having “used up” the goodwill of their families. In addition, significant numbers of homeless people came from families that never offered much economic or emotional support, and many came from no families at all. To date, despite this developing body of knowledge, no programs have been explicitly developed to help people improve their social networks.
Reconnecting homeless people to the community rests, at least initially, on the ability to link them successfully to housing. Much has been learned about how to effectively do this for specific populations of the homeless. How to replicate these efforts on a broader scale is the supreme challenge, given tight budgets and the relative lack of public will to spend the money it would take to meet the need that exists. The dramatic loss of housing during the 1970s and 1980s, coupled with growth in poverty for larger and larger segments of society has created an imbalance that is daunting at best.
In the face of limited resources, therefore, it is important that the resources that are available be used to chip away at the problem with solutions that have staying power. Efforts at developing and restoring low-cost housing, such as SROs, and providing incentives for investors that can help in developing affordable housing are all critical in the fight toward balance.
Enabling people to live in and maintain independent housing over the long run also may take systemic as well as individual action, particularly with respect to returning to the workforce. Although some of the reluctance to enter the job force stems from personal problems, such as mental illness, and from macro-structural changes in the economy—such as declines in blue-collar jobs—other barriers result from disincentives built into social and medical insurance programs. Greater flexibility should be built into these programs to encourage people to try to work. Furthermore, any changes made to these programs also need to be flexible enough to recognize that most people are likely to experience job turnover. It cannot be assumed that once a person finds a job that he or she will stay in that job for a long period of time. Programs that cut-off benefits once a person starts to work and that make it difficult to re-obtain them once dropped, will therefore also discourage people from trying to work.
In addition, because most jobs obtained by homeless and formerly homeless people are low-paying and lack benefits and room for advancement, employment and training efforts need to be complemented by efforts to increase wage levels and/or expand the scope of programs like the Earned Income Tax Credit to supplement earnings.
The research and practice conducted to date provides some direction for individual housing and social service providers. Overall, a coordinated approach to reconnection—the “three-legged stool”—offers the best prospects for getting people stably housed and working. Offering a range of housing options as well as a variety of opportunities for work (e.g., affirmative businesses; in-house employment, etc.) increases the probability of people remaining in housing and furthering their independence in the community.
It is not clear, however, what can be done to encourage or strengthen ties to family, friends, and the broader community. What is important to recognize is that many homeless people are likely to have already used up much of the “goodwill” that existed in these networks, may never have been able to obtain such support from their networks, or may never have had such networks to begin. Given these circumstances, helping homeless people re-establish ties may be difficult. However, efforts to establish functional social networks, such as in drop-in centers, housing programs, employment programs, and so forth may have greater long-term benefit for individuals. Furthermore, even without specifically trying to achieve it, efforts to stabilize the housing and employment opportunities of people may make it more likely that people will be able to re-establish these networks.
Although current evidence suggests that combinations of support services, housing supports, and employment programs are more effective than any single intervention, research is needed to determine which combinations of services are most effective, and with what types of people. For example, when is transitional housing a necessary step in one’s path toward residential stability? What types of support services are essential to provide? What types of employment services are most effective?
It is particularly important to determine what housing services are needed for people with special needs, such as people with mental illnesses, substance abusers, and those with dual or triple-diagnoses. With respect to housing, in particular, identifying options that can effectively serve individuals with active substance abuse is critically needed. With respect to employment, more research is needed on how to develop and operate affirmative businesses, particularly to understand under what conditions these enterprises can be self-supporting (if not income-producing). Actively involving formerly homeless people in the research who have become reconnected may be one useful way to examine many of these issues. It will also be important to determine how well these types of jobs and businesses can prepare people for more mainstream jobs, or if this represents the development of a segregated job market.
No programs have been explicitly designed to improve the social networks of homeless or formerly homeless people. Developing programs and methods to build reliable social support systems for homeless people is therefore an area that needs to be addressed (Johnson & Cnaan, 1995). In addition, research is needed on the effects that existing efforts, particularly programs such as supportive housing, have on social networks. To the extent that programs are able to stabilize a person’s life, they may also encourage and facilitate reconnecting with family and friends. Supportive housing programs may also provide a conducive environment for making new friends. At the same time, research should also be done to determine whether these environments create “artificial” networks that are more reliant on staff than on family and friends, and therefore may not be as stable or reliable a source of support.
In sum, over the last decade or so, much has been learned about reconnecting homeless individuals and families back into the community. Some of these lessons have translated into action; others have not. Continued research and programmatic action is needed to add to our knowledge base and provide additional ammunition for action so that homelessness can become a phenomenon of the past, rather than an enduring plight of society.
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