What is Housing First?

Housing First (HF) is an approach to addressing homelessness that prioritizes providing stable, permanent housing. Instead of requiring people to meet certain conditions before receiving housing, like sobriety, the approach asserts that individuals should have immediate access to a living space.

Housing First is based on the belief that housing secures a foundation for an increased quality of life with regards to mental health, employment, and relationships. The National Alliance to End Homelessness recognizes two common models.

• Permanent supportive housing (PSH), for those with chronic illnesses, disabilities, mental health issues, or substance use disorders who have experienced long-term or repeated homelessness.

• Rapid re-housing, is employed for a wide variety of individuals and families, which provides short-term rental assistance and services.

Housing First stands in stark contrast to the traditional Treatment First (TF) model. The Treatment First model asserts that temporary accommodation with health services, usually substance use. People can receive permanent housing if they follow the terms of their mental health and substance use treatment. Hence, Treatment First.

So which model works?

A meta-analysis from demonstrates that Housing First interventions experienced fewer trips to the emergency department, hospitalizations, and the time spent hospitalized compared to controls.

Ultimately, access to housing is a determinant of health.