What Works with the Homeless

Homelessness is a destroyer of urbanism. If your city's sidewalks are filled with sleeping men, drug abusers, the mumbling mentally ill and aggressive panhandlers, it's in big trouble. Tourists won't come, conventions will steer clear, downtown businesses will decamp, and residents won't put up with the smells, sights and hassles; they'll move to the suburbs. Cities know this and have tried two general approaches: coddling and criminalizing. Neither works.

So, is there anything that does work, that actually moves homeless people into safe, clean environments and eventually to productive society? Yes, and the pioneer for this middle way is Philadelphia. As much as any big city, national experts say, Philly has solved its chronic homelessness problems. In the mid-1990s, it had 4,500 people living on its streets. Today, there are about 130.

How did Philadelphia perform this minor miracle? By doing three hard things: It built enough supportive housing units to take care of its homeless population (supportive housing has services on demand for drug and alcohol abuse, mental illness and other problems), created a central intake authority to assess and place homeless people into appropriate programs (and, importantly, track their progress), and launched an innovative outreach program to persuade — but not compel — the homeless to leave the streets.

The outreach program may be Philadelphia's greatest innovation. The city has 20 workers on the street around the clock, looking for homeless people. Some are welfare workers, others are police officers with special training. If a regular officer sees a homeless person sprawled on the sidewalk, he can call the outreach unit and within 20 minutes, a worker will be there to question the person and talk about life on the inside. What does this cost? Philadelphia spends $60 million a year on homeless services. While that's not cheap, others spend more and get much less. San Francisco, for instance, spends $104 million a year on direct services and has one of the worst homeless problems in the country.

Footnote: There are two additional keys to Philadelphia's success, says Dennis Culhane, a University of Pennsylvania professor who has studied efforts to deal with homelessness around the country: Philly targeted the hardest cases, not just the easy successes, and stayed committed. That's important because it took about four years to see dramatic improvements. "People have to realize a problem like this doesn't go away in 12 months," Culhane said, "and it won't go away at all unless you have a real commitment by the city and the public. You have to keep your eye on the prize." Posted 7/1/2004

Postscript: The Philadelphia way of dealing with homelessness (sometimes called "Housing First") remains the only approach that deals with homelessness effectively and humanely.