Shelter for good?: examining the ethical issues of housing first for homeless substance abusers

Abstract

In the past fifteen years, the guiding philosophies used in addressing chronic homelessness have undergone a radical shift in approach. Whereas nearly all shelters once stipulated substance addicted or mentally ill residents must undergo treatment for chemical dependency and mental illness prior to admittance, in recent years many cities across the United States and abroad have adopted a "housing first" model. This approach treats housing as a basic human right and allows homeless individuals immediate and indefinite access to shelter and related resources without requirements of treatment, sobriety, or abstinence. This paper examines the establishment, proliferation, and evolution of housing first programs, their efficacy and the empirical research that has been collected in recent years, and the persisting ethical dilemmas and considerations that need to be addressed.