Combating Homelessness with Housing First

Tim* was living in the woods. Fearful of having his footprints tracked, he designed a system – moving from tree to tree – so his feet didn’t touch the ground.

“He was unable to engage with any kind of psychiatric or medical services because of mental health symptoms,” says Katherine, Program Manager for Delancey Street Case Management Services.

Without stable housing — the team knew — it would be difficult, if not impossible, for Tim to get help for his symptoms. “Housing comes before addressing other issues that people might be facing in their lives,” says Katherine.

It’s why Delancey Street takes a Housing First approach; which studies find highly effective. “If someone is homeless, they are much more worried about staying warm and safe and having food and clothing than about attending mental health or medical appointments,” Katherine explains. “Once you get someone inside, their ability to make a plan and follow through drastically improves.”

Connecting people who have experienced long-term homelessness with housing that’s a good fit for them is one of the primary goals of the team. They also work to provide hope, to help people find resources to meet their basic needs, and to get additional services that they need. “We might help with planning appointments, utilizing a food shelf, getting a cell phone,” says Katherine. “We might help them work on getting chemical dependency treatment or help with complex medical conditions like untreated cardiac disease or diabetes.”

Goals are set by each person the team works with, and it’s common for them to center around mental and physical health. Often – because of past experiences and sometimes active symptoms – individuals don’t trust easily, so the team does a lot of relationship-building. “The work can look a lot like conversations at first,” notes Katherine. “We’re learning about each other, so trust can grow.”

For Tim, trust came slowly. Because of the severity of his symptoms, he required both a psychiatric hospitalization and time in a residential treatment facility. Once he started taking medications, though, the team started to notice a difference. Tim did, too. “I feel like I was in haze, and the haze is lifting,” Katherine remembers him saying.

The path hasn’t been easy. Tim struggled with hoarding and had to re-learn what’s acceptable when you live in the community. Loneliness is an ongoing challenge. Yet, he managed to keep a place of his own for 5 years and then move into another place. He got a job with help from employment services. He continues to take his medications.

“It’s mindboggling how far he’s come,” Katherine says, a big smile spreading across her face. “It’s a teeny little bit every day.”

“We’re giving people the dignity of having a home, of having food and their possessions, and a place for their family to be,” she continues. “We’re all a couple of difficult circumstances away from the situation that the folks we work with are in. There’s no one type of person. There aren’t qualities that make homelessness more likely to happen to one person over another. People who are homeless respond really well to a person being warm and supportive and helping them move toward a higher quality of life.”

*The client’s name has been changed to protect their privacy.


More About Guild’s Delancey Street Case Management Services: 

  • Provides: Flexible services and support to help people with histories of long-term homelessness establish and maintain housing and improve their quality of life.
  • Counties served: 7-county metro area
  • Accepts referrals from: Hearth Connection
  • Payment for services:Insurance is billed. Additional funds come from Hearth Connection.



February 22, 2019

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