Synthesis
What we know about housing-first and supportive housing
Pathways to Housing, At Home / Chez Soi, Denver supportive housing — what experimental and quasi-experimental evidence says about ending chronic homelessness.
5 experiments synthesized · 4 positive, 1 mixed, 0 null, 0 negative
The housing-first approach — providing permanent housing without preconditions like sobriety or treatment compliance, then offering services as desired — has been tested in dozens of cities since the late 1990s. The Canadian At Home / Chez Soi trial, which randomly assigned more than 2,000 chronically homeless individuals across five cities, remains the most rigorous test of the model.
The pattern is unusually consistent across studies: housing-first programs durably house roughly 75–85% of participants two years on, compared to 30–50% in treatment-as-usual; they reduce shelter use, emergency room visits, and incarceration; and they break even or save money once those offsetting service costs are counted. They do not, in most studies, produce significant reductions in substance use itself.
The harder open question is what fraction of the homeless population is well-served by housing-first versus by rapid rehousing for shorter-term episodes — different interventions for different durations of homelessness.
Takeaway
For chronic homelessness, the experimental evidence is among the strongest in any social-policy domain: house first, offer services second.
The underlying experiments
Positive findings
4 experiments- Positive
Right to Counsel — NYC Eviction Court Legal Representation
NYC Office of Civil Justice / Furman Center for Real Estate and Urban Policy · New York City, USA · 2017
Effect: Eviction warrants: fell 40% citywide from 2017 to 2019 as program expanded. Represented tenant outcomes: 84% of represented tenants avoided eviction (compared to historical ~50% eviction rate for unrepresented tenants). Representation rates: rose from under 1% to 38% of tenants citywide by 2019. Cost-benefit: city estimated savings of $320M in shelter costs vs. program cost of $166M, a ratio of nearly 2:1.
- Positive
Denver Social Impact Bond — Supportive Housing for Chronic Homelessness
City of Denver / Colorado Coalition for the Homeless · Denver, CO, USA · 2016
Effect: Jail days: −40%; ED visits: −34%; housed nights: 83% vs. 37% at 24 months; net public cost reduction offset SIB payments
- Positive
Rapid Re-Housing vs. Transitional Housing
Columbus Metropolitan Housing Authority · Columbus, OH, United States · 2016
Effect: Rapid re-housing: 77% stably housed at 24 months vs. 64% for transitional; no significant difference in substance use or employment
- Positive
At Home / Chez Soi — Housing First
Mental Health Commission of Canada · Vancouver, Winnipeg, Toronto, Montréal, Moncton, Canada · 2009
Effect: Housing stability: 73% of time housed (HF) vs. 32% (control) at 24 months; quality of life significantly improved; community functioning improved; mental health symptoms not significantly different; cost per additional day housed much lower than shelter system
Related policy areas