SnortingCoffee

SnortingCoffee OP t1_j9h5nx1 wrote

>If it’s not so easy for them to post up somewhere else, they will be more likely to accept help.

Is there any evidence of this approach actually working anywhere? I've seen it suggested a lot--just make being homeless even more awful then no one will choose to do it--but I have yet to see any study show that it's an effective approach.

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SnortingCoffee OP t1_j9h4267 wrote

Oh I absolutely don't think it should be housing + no rehab. It's just housing first. Having people in a stable location makes it much easier to connect them with services like substance abuse treatment, mental health treatment, job training & placement, etc.

Here's one study that looked into it:
https://pubmed.ncbi.nlm.nih.gov/10737824/
Conclusion: "The program's housing retention rate over a five-year period challenges many widely held clinical assumptions about the relationship between the symptoms and the functional ability of an individual. Clients with severe psychiatric disabilities and addictions are capable of obtaining and maintaining independent housing when provided with the opportunity and necessary supports."

Here's another, this time with more mixed results:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448313/

"Participants in the Housing First program were able to obtain and maintain independent housing without compromising psychiatric or substance abuse symptoms."

People were more likely to remain stably housed with a housing first approach.

The most interesting highlight for me is that the housing first group had lower levels of engagement in substance abuse treatment, but basically the same levels of actual substance use. This shows that forcing people into substance abuse treatment in order to receive housing is ineffective.

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SnortingCoffee OP t1_j9h28zk wrote

I'm not a landlord, and I never said anything about private landlords, not sure where you're getting that idea from.

And I would have no problem living next to a formerly homeless person. If they were causing problems with noise, damage to the building, etc., I would deal with that the same way I deal with any neighbor causing those problems.

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SnortingCoffee OP t1_j9h1knx wrote

Yes, one of those consequences is that they're more likely to get sober than if they were on the street. Another is that it's likely to save the city money on emergency services. Yes, it has its own problems, it's not a silver bullet. But it's far more effective than what we're doing with that same money now.

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SnortingCoffee OP t1_j9h0km9 wrote

If your goal is to get people sober, housing is the most effective first step. That's not an opinion, that's a repeatedly demonstrated fact. It's not the only step, but it's the first step. This is a classic case of "would you rather solve the problem, or would you rather be right"?

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SnortingCoffee OP t1_j9gtr25 wrote

What we're doing now is not working. Housing first has worked many times in many different places. Sure, when you phrase it as "hey come on in and slam heroin in front of a bunch of people trying to get sober" it doesn't sound like the right thing to do, but just because it sounds bad in the most cynical possible framing doesn't mean it's not a huge step up from the patchwork nonsense we're trying now.

Does anyone think our current strategy is working well?

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SnortingCoffee OP t1_j9gt1rh wrote

>Plenty of people want to remain homeless so they can keep doing drugs and drinking as they please.

Give them shelter without preconditions and they're more likely to get sober. In other words, the whole "no help until you're sober" rule actually makes it less likely for people to get there.

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SnortingCoffee t1_ixzuvdl wrote

I think you replied to the wrong comment here, but the short version is that vehicles over a certain size were considered work vehicles, not road vehicles, and thus exempted from the normal regulations. This size, at the time, seemed so massive that it was a clear difference, and there's no way manufacturers would start making every single small to mid-sized truck absolutely huge, would they? Oops, that's exactly what happened.

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SnortingCoffee t1_iubompq wrote

First off, there's no such thing as an "objective organization". All organizations have profit motives and/or missions that preclude objectivity. But WPATH exists to facilitate an interdisciplinary understanding of gender dysphoria and transgender health issues.

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