Housing Policy and the Homeless Crisis: Why Housing Must Come First

Homelessness Is a Housing Problem

Can we talk about homelessness without beginning with everything we think homeless people are doing wrong? Because that is often where the conversation begins. We talk about addiction. Mental illness. Bad decisions. Criminal records. People who refuse help. People who have damaged relationships or exhausted the patience of everyone around them. Those things are real. I encounter them regularly.

But homelessness is not merely a collection of personal failures. It is also the result of decades of housing policy that has left too many people competing for too few homes they can afford.  In January 2024, approximately 771,480 people were experiencing homelessness in the United States on a single night—the highest number recorded since the federal government began using its current method of counting. HUD pointed to the continuing shortage of affordable housing, rising costs, inflation, and the expiration of pandemic-era assistance as major contributors. This should force us to ask a difficult question:

Are nearly three-quarters of a million people suddenly more irresponsible than previous generations—or have we created a housing system in which one illness, job loss, eviction, or family crisis can push someone over the edge?

The answer matters because it determines what kind of solutions we support.

I believe homelessness is a housing problem. That statement can sound overly simple. Homelessness is connected to addiction, mental illness, trauma, disability, incarceration, domestic violence, and family breakdown. But those conditions do not automatically cause homelessness.

Millions of housed Americans struggle with addiction. Millions live with serious mental illness. Many have criminal records, damaged relationships, or unpaid debts. What separates them from people sleeping outdoors is usually not superior character. It is access to housing.  Some have family who will take them in. Some receive disability income, veterans benefits, or rental assistance. Some own homes. Some live in communities where modest apartments still exist. Some simply had enough money or support to survive a crisis.  Others had nowhere left to go.

Housing policy determines whether affordable apartments are built, whether low-income housing is preserved, whether rental vouchers are available, and whether people with disabilities can receive permanent supportive housing.

For a very long time, the United States has failed to create enough deeply affordable housing for people at the lowest income levels. Housing Choice Vouchers help many families, but they are not available to everyone who qualifies. Waiting lists may be closed for years. Even a person who receives a voucher may struggle to find a landlord willing to accept it. In Murfreesboro, where I live, the waiting list has been closed because it is already so long. It has been closed since I began working with people experiencing homelessness. Even some places that accept vouchers still require proof of income equal to three times the rent—an impossible standard for many people living on disability benefits or very low wages.

Meanwhile, inexpensive apartments disappear, rents increase, and wages and disability benefits fail to keep pace. When housing becomes unaffordable, shelters fill. When shelters fill, encampments grow. When encampments grow, the public is told that homelessness is primarily the result of addiction, laziness, or a lack of enforcement.  We keep treating the visible consequences while avoiding the underlying shortage.

What Housing First Actually Means

Housing First is based on a simple principle: A person does not have to prove that he or she is sober, employed, medically stable, or deserving before receiving a safe place to live. Under Housing First, people are offered permanent housing without first being required to complete treatment, maintain sobriety, secure employment, or move successfully through a series of temporary programs.

That does not mean there are no expectations. Tenants must generally follow their leases, respect their neighbors, and comply with the same basic requirements expected of other renters.  It also does not mean services are abandoned.

A genuine Housing First program connects people with services such as:

• Mental-health care

• Addiction treatment

• Medication and medical care

• Peer recovery support

• Case management

• Benefits assistance

• Employment help

• Transportation

• Daily-living support

The important distinction is that receiving housing is not conditioned upon successfully completing those services. Treatment is offered, encouraged, and made accessible. It is not used as a gate that people must pass through before they are allowed indoors.

The United States Interagency Council on Homelessness has described Housing First as immediate access to permanent affordable or supportive housing without clinical prerequisites such as completing treatment or proving sobriety. The agency has reported that Housing First produces better housing retention, fewer returns to homelessness, and reduced use of crisis services and institutions. Housing First is sometimes criticized as though it means handing someone a key and walking away.  Ummm, no.  That is not Housing First. That is housing only, and the two should not be confused.  Housing First means the housing comes first so that treatment, recovery, and stability have a place to begin.

Why Not Require Sobriety First?

Many people ask, “Why wouldn’t we require sobriety first?” At first, “sobriety first” can sound like common sense.  Why place someone in housing if that person is still using drugs? Why not require treatment first? Why should taxpayers support someone who has not demonstrated a willingness to change? I understand those questions. But they overlook what addiction and street homelessness actually do to the human brain and body. I am going to write that again: They overlook what addiction and street homelessness actually do to the human brain and body.

Imagine trying to recover while sleeping behind a building. You do not know where you will sleep tomorrow. Your belongings may be stolen. You are exposed to heat, cold, assault, and arrest. You may have no place to store medication. You may be unable to keep appointments because you lack transportation, a working phone, or even a safe place to shower. You may be surrounded by drug use every day.You may use substances partly to remain awake because falling asleep outside makes you vulnerable. You may use them to numb trauma, hunger, pain, or fear.

Then we tell that person:  Become stable, and afterward we will give you stability.That is the central contradiction in sobriety-first housing. It asks people to accomplish one of the hardest forms of personal change while they remain in the least stable conditions imaginable. Housing First reverses that sequence:Let us get you somewhere safe. Then we can begin working on what comes next.

The current Trump administration is moving federal homelessness policy toward treatment, recovery, and self-sufficiency and away from Housing First. In April 2026, HUD Secretary Scott Turner said the administration intended to abandon what he called failed Housing First policies and promote treatment and recovery instead. The administration’s concern about untreated addiction should not simply be dismissed. Addiction destroys health, relationships, and communities. People deserve access to meaningful treatment—not merely a room in which they can continue dying. But the choice between housing and treatment is a false one. We should provide both.

The danger arises when housing is made dependent upon treatment success.  Addiction is widely recognized as a chronic, treatable disease. The administration itself has acknowledged that relapse rates can resemble those of other chronic illnesses and has called for evidence-based care and continuous support.

Yet a sobriety-first housing model may respond to relapse by removing the very thing that makes recovery more possible: housing.

We would not remove a diabetic patient from housing because that person failed to manage blood sugar correctly. We would not tell someone with depression that shelter depends upon never missing a therapy appointment. But when addiction is involved, we often turn symptoms of an illness into evidence that a person is unworthy of help. People relapse.  They miss appointments. They resist treatment. They become frightened, angry, or distrustful. They may reject help today and accept it later.

None of that means boundaries are unnecessary. Programs must protect residents, staff, and surrounding communities. Dangerous behavior cannot be ignored. Housing First does not require tolerating violence or serious lease violations. But there is an important difference between holding someone accountable for harmful behavior and making perfect recovery a condition of shelter.

In traditional treatment-first or “housing readiness” systems, people may be expected to progress through stages: Street. Shelter. Treatment program. Transitional housing. Then, perhaps, permanent housing.

Who Gets Left Behind?

Each stage may have its own requirements. One relapse, missed meeting, behavioral incident, or rule violation can return someone to the street. The people most capable of following complicated rules move forward. The people with the most serious disabilities often fail. That creates a cruel outcome: the people who need supportive housing most may be the least able to qualify for it.

A person with untreated schizophrenia may not keep appointments consistently. Someone with a traumatic brain injury may struggle with instructions and deadlines. A person living in survival mode may appear uncooperative or disorganized. Sobriety-first programs can interpret these symptoms as a lack of motivation. Housing First recognizes them as evidence of greater need.

Housing changes the possibilities.

A door that locks changes things.

A bed changes things.

A bathroom changes things.

A refrigerator for medication changes things.

An address for benefit applications changes things.

A place where a caseworker can find you changes things.

Sleep alone can change a person’s ability to think, regulate emotions, and make decisions.

Once housed, a person no longer has to spend every hour solving the immediate problems of survival. That does not make trauma, mental illness, or addiction disappear. Housing is not magic. But it gives recovery somewhere to happen. It is difficult to attend treatment when you do not know where you will sleep. It is difficult to take medication correctly when it is repeatedly lost or stolen. It is difficult to maintain sobriety while living in an encampment where substances are constantly available.

Housing does not guarantee recovery. But homelessness makes recovery far less likely.

One of the most persistent misunderstandings is that Housing First asks nothing of people. It does not. A strong Housing First program combines compassion with accountability. It distinguishes between conditions that should not disqualify someone from housing and behaviors that genuinely endanger others.

A person should not lose eligibility merely because he has an addiction. That does not mean he may threaten his neighbors. A person should not be denied housing because she has untreated mental illness. That does not mean every destructive behavior must be accepted.

A person should not have to become employable before receiving housing. That does not mean programs cannot encourage responsibility, participation, and greater independence.

Housing First says that dignity and shelter are not prizes awarded after someone becomes easy to help. That is very different from saying choices do not matter.

The Current Administration’s Approach

The current administration argues that homelessness programs have spent more while homelessness has continued to rise. That criticism does deserve examination.Federal homelessness funding cannot be judged only by how many programs exist or how much money has been allocated. We should ask whether people remain housed, whether services are available, whether communities create affordable units, and whether programs produce meaningful improvements.But rising national homelessness does not prove that Housing First caused the increase.

A housing program cannot overcome an enormous shortage of affordable homes if it reaches only a fraction of those who need it. Nor can supportive housing solve the crisis alone while rents continue rising and people are pushed into homelessness faster than programs can house them. This is important:

The 2024 federal homelessness report connected the increase to the lack of affordable housing, inflation, the end of pandemic assistance, natural disasters, and pressures on local shelter systems. Blaming Housing First because homelessness rose during a housing shortage is a little like blaming emergency rooms because the number of sick people increased.

The real question is not whether Housing First has ended all homelessness.It has not. The question is whether people offered permanent, low-barrier housing are more likely to remain housed than people required to achieve sobriety or treatment compliance first. The evidence and experience behind Housing First say yes.

I believe in recovery.

I believe in treatment. I have been through it.

I believe that people can take responsibility for their decisions and rebuild lives that have become painfully broken.

I have also learned that responsibility and compassion are not opposites.

We can tell the truth about addiction without requiring someone to recover underneath a bridge.

We can encourage treatment without making shelter conditional upon perfection.

We can set boundaries without withholding basic human dignity.

And we can recognize that some people will not accept help immediately. Some will relapse. Some will test every bit of patience we possess.

But people do not become more treatable because they are cold, exhausted, and afraid.

They become more reachable when they are safe.

Housing First does not say housing is the only thing a person needs. It says housing is where the work can finally begin.

In Part Two, we will look more closely at how federal housing choices—from rental assistance and affordable-housing construction to program cuts and changing grant requirements—have affected the number of people entering and leaving homelessness.