Trump Administration Threatens Effective Housing First Approach to Homelessness, Sparks Concern Among Experts and Advocates

Washington, D.C. resident Rachelle Ellison spent 17 years living on the streets, cycling between jails, hospitals, and homeless shelters before securing permanent housing in 2008. This transition occurred through a non-profit organization that provided her with rental assistance, mental health treatment, and support services via the Housing First policy.

Ellison emphasized the importance of having stable housing to work on personal issues: “Once I got the housing stabilization and the foundation underneath my feet, I was able to focus on myself.”

Housing First is a long-standing bipartisan initiative that prioritizes providing permanent housing for chronically homeless individuals without requiring sobriety or treatment upfront. Following this approach, services are then offered to address substance abuse, mental health issues, education, and employment needs.

However, the Trump administration is advocating for reducing funding for Housing First programs, citing their perceived ineffectiveness and contribution to “crime and disorder,” as well as a record number of people living on the streets. In contrast, the Trump administration seeks to fund programs with stricter sobriety or work requirements and increase involuntary commitments for homeless individuals with mental health issues.

This week, federal troops were ordered to forcibly remove homeless people from Washington, D.C., a significant shift in federal policy. Since the George W. Bush administration, giving people homes along with social services has been the primary government approach to combat homelessness.

Leading researchers and advocates warn that shifting away from Housing First will have dire consequences for those struggling with homelessness. After securing an apartment through Housing First, Ellison began addressing her drug use and mental health disorders stemming from childhood abuse. For years, she worked alongside a team of mental health and drug treatment counselors to maintain sobriety.

“Housing First actually saved my life,” Ellison stated, now advocating for homelessness solutions at a national level.

The Housing First model emerged in the early 2000s, replacing the previous treatment-first approach to addressing homelessness. This older model required individuals to become sober or participate in programs before receiving housing, often emergency shelters or transitional housing.

Several studies have found that Housing First programs offer greater long-term housing stability than treatment-first models and may even lower overall costs by reducing hospital and ER visits, according to a 2023 review by the Department of Housing and Urban Development (HUD). The Department of Veterans Affairs has used Housing First to decrease veterans’ homelessness by 55% since 2009, while cities like Houston and Denver have also seen success with this approach.

Last month, a White House executive order sought to reintroduce the treatment-first model, directing federal agencies to end funding for organizations that offer housing without requiring substance abuse or serious mental illness treatment first. This move is met with concern by experts like Dennis Culhane, a University of Pennsylvania professor whose research on chronic homelessness formed the basis for Housing First programs: “What the administration will find out is exactly what happened before: The people who need the most extensive supports get evicted from transitional housing.”

Trump’s executive order also calls for local jurisdictions to use civil commitment laws to remove individuals living on the streets who “cannot care for themselves” or “pose risks to themselves or the public,” aiming to shift them into long-term institutional settings. However, there may be a shortage of mental health hospital beds in America due to underfunding and recent cuts to Medicaid and grants for drug addiction and mental health programs, making it harder for people to access treatment.

Lara Pukatch, the chief advocacy officer at Miriam’s Kitchen, a housing and social services nonprofit in Washington, D.C., expressed concern that the executive order does not address homelessness issues or make access to healthcare easier: “We’re seeing a total lack of investment in solutions we do know work.”

Mass street homelessness is a relatively recent phenomenon in America, with factors such as de-institutionalization without provisions for housing or social services starting in the 1950s, government cuts to housing, and an underfunded mental health care system contributing to this issue. The results of the treatment-first approach during the 1980s and 1990s “were not very positive,” according to Dennis Culhane. People who entered were often discharged for failing to comply with sobriety requirements, leading them back onto the streets.

George W. Bush’s administration recognized the value of addressing chronic homelessness and adopted Housing First as their primary approach in 2003. Obama continued this approach, launching a goal of ending veteran homelessness in 2009, which was achieved through Housing First programs. Congress also accelerated funding to Housing First programs that year.

However, the first Trump administration initially continued the Housing First approach but has since shifted its position as unsheltered homelessness became more visible, especially in Democratic-run cities on the West Coast. Housing First has also become a target of conservatives, who argue that housing without treatment requirements has not worked effectively.

Stephen Eide, a senior fellow at the Manhattan Institute who studies homelessness, stated: “Housing First was oversold, it became far more dominant than it deserved, and homelessness reached historic levels. What you’re going to see under Trump is simply a rebalancing of priorities.” Republicans in Congress have introduced legislation to redirect funding away from Housing First programs towards providers that require job training, addiction treatment, or other services. Several states, including Florida, Georgia, Missouri, have also passed laws restricting Housing First programs.

Despite these changes, proponents of Housing First maintain that the issue is not the model but rather a lack of funding to accommodate rising homelessness and address a crippling affordable housing shortage. “Housing First has failed because we haven’t fully invested in Housing First,” said Frederick Shack, CEO of Urban Pathways, a housing and social services provider in New York City. “You can’t solve the problem without the resources.”