Study finds success in Charlotte-Mecklenburg's efforts to end homelessness

A new comprehensive study from UNC Charlotte's Urban Institute, College of Health and Human Services and School of Social Work shows an effective approach to ending chronic homelessness that helps those in need and benefits communities.

The Housing First Charlotte-Mecklenburg initiative, an innovative multi-sector collaboration that's been working to end chronic homelessness in Charlotte for five years, has placed more than 1,000 people in the Charlotte community in stable housing. This is the largest and most comprehensive local effort to address chronic homelessness. Nationwide, on any given night, more than 550,000 Americans are experiencing homelessness, and this research could offer guidance to cities around the U.S. struggling with this issue.

"The Housing First Charlotte-Mecklenburg effort led to major housing wins during a time of increasing housing scarcity, and the vast majority of those who were able to access housing through the effort did not return to emergency shelters," said Lori Thomas, associate professor at UNC Charlotte's School of Social Work and Director of Research and Faculty Engagement at the UNC Charlotte Urban Institute.

Thomas has completed an evaluation of the first phase of the program, the most rigorous and in-depth study to date in Charlotte and one of the few reports in the country that examines a community's overall response to chronic homelessness. Findings highlighted in Thomas' research may have a significant impact throughout the country in other cities working to expand Housing First programs such as Atlanta, Denver, San Francisco and Washington, D.C.

Key findings from the first phase of the Housing First program include:

• Housing First works. Almost three-quarters of study participants housed through the Housing First program either retained their housing or moved into other housing during the study period. That means a large majority of people who get housed, stay housed.
• Housing First impacts participants. Clients who gained housing showed reductions in trauma, mental illness and substance use. Additionally, housed participants scored significantly higher on standardized overall quality of life indicators.
• Housing First impacts the community. People who were housed were less likely to be arrested or visit the emergency department. Additionally, the average number of visits to the Mecklenburg County Health Departments and the average number of nights spent in emergency shelters all decreased.
• Costs of housing are partially offset through other community services. Based on the changes in service utilization, there is a $2.54 reduction in community services for every $10 invested in housing first permanent supportive housing. This savings reduces the average annual cost of housing first permanent supportive housing from $17,256 to $12,688.

There were also lessons learned that can improve the initiative. Among those:

• Housing First participants experienced persistent and worsening food insecurity. Rates of food insecurity remained high for clients who gained housing. Research suggests people might have more difficulty accessing food once they gain housing, perhaps because they do not have transportation to free resources where they previously got food, or because they now live in a "food desert."
• Housing First participants continued to report poor perceptions of physical health. The impact of years without housing and access to preventative care, as well as the fact that the majority of study participants have two or more disabilities, may account for this finding.
• Housing First and the focus on homelessness highlighted the need for better coordination, representation and communication among stakeholders across various sectors (government, nonprofit, academic and business). Additionally, the initiative drove home the need to connect homelessness to the community-wide affordable housing challenges facing Charlotte and Mecklenburg.

"With the release of the Housing First Evaluation report, we are able to share information with the community about the results and impact of a public-private, community initiative to end chronic homelessness," said Stacy Lowry, director of community support services for Mecklenburg County. "In addition to outcomes, this report also provides an in-depth analysis of the initiative, itself. By looking at the relationship between outcomes and process, Charlotte-Mecklenburg can use this report to expand and strengthen existing efforts to prevent and end homelessness as well as inform new, systemic solutions to address complex problems comprehensively and effectively."