Beyond Homeless

Highlights

• Before we confront the issue of homelessness, we must acknowledge its profound complexity. The “why” behind homelessness varies widely from person to person. Some causes, of course, are systemic and predictable: housing policies that restrict supply and drive up costs, or economic policies that make it harder to earn a living wage. Others are sudden and unpredictable: the loss of a job, a debilitating illness or disability, or the death of a household provider. Still others stem from untreated trauma that leads to substance abuse or mental illness. A small subset of people may even choose homelessness, preferring a disconnected, vagabond life on the streets. Any serious effort to address homelessness must begin by acknowledging this complexity, rather than assuming there is a single policy fix.
• The Housing First model has been inappropriately expanded by federal, state, and local policy, and should be more narrowly targeted to those most likely to benefit from it. Housing First began as a program aimed at a specific segment of those experiencing homelessness. It has since been expanded to serve as a one-size-fits-all solution despite a dearth of evidence that it is effective for everyone. It is extremely expensive, especially in California, to provide permanent housing, with services supposed to follow. Although Housing First may serve some subpopulations well, other subpopulations will be better served by alternative approaches, including those that better address the underlying causes that resulted in a person becoming homeless. By treating every case as the same, Housing First strips away the individuality, potential, and dignity of those it is meant to help. This has fostered what the editors of this book call the “homelessness-industrial complex,” where billions are spent without meaningful improvement in people’s lives.
• We don’t have to live this way. Real solutions exist, but they have a much different philosophy: The housing readiness model recognizes that people experiencing homelessness have greater potential than Housing First assumes. Instead of providing permanent housing as the first and final step, housing readiness emphasizes transitional and transformational housing—preparing individuals to address trauma, overcome addiction, rebuild skills, and restore dignity. This approach has already shown remarkable success in programs such as Haven for Hope in San Antonio and Union Rescue Mission in Los Angeles, where people receive not just shelter but the necessary tools for long-term independence. These models prove that when programs set higher expectations and offer real support, individuals can—and do—rebuild their lives.
• It’s time to get clear about what “success” actually looks like. Success cannot simply mean surrounding someone with four walls and declaring victory. This book offers a robust and clear definition of a truly stable outcome: First, an individual has legal housing (or lives peaceably without trespass or nuisance); avoids crime and violence; is free from substance dependence that prevents employment; and is able to keep employment (if physically capable). For those who cannot be entirely self-sufficient, support should come primarily through private organizations, with government aid limited to basic safety-net programs such as Social Security, Medicare, and unemployment. The authors of this book stress that funding must be directed to organizations that demonstrate real results—not those that merely satisfy government mandates or chase popular policy fads, as has been precedent. By tying resources to effectiveness and accountability, we can create systems that genuinely help people achieve independence rather than perpetuate dependency and dysfunction. Let’s do so.

Synopsis

Entire neighborhoods in cities across the United States have become open-air asylums, drug markets, and impoverished wastelands—where death, misery, crime, addiction, encampments, fires, disease, and even human waste aren’t just tolerated but normalized. How is this possible when billions of taxpayer dollars have been funneled into homelessness initiatives such as “Housing First”?
The truth is that the money poured into this issue from taxpayers, nonprofits, and private charities alike has mostly made homelessness worse overall. And governments’ failures haven’t just wasted taxpayer dollars—they have cost lives and undermined human dignity.

This isn’t just incompetence.

It’s immoral and unjust.

And it must end.

In Beyond Homeless: Good Intentions, Bad Outcomes, Transformative Solutions, Mary L. G. Theroux, Lawrence J. McQuillan, Adam B. Summers, and other scholars present a better approach rooted in proven solutions. This groundbreaking new book, based on years of research, is exactly what’s needed to address the crisis.

With forewords from acclaimed addiction medicine specialist and TV host Dr. Drew Pinsky and licensed master social worker Scott Ackerson, the book gathers experts on every aspect of homelessness to present a stirring condemnation of the status quo—and an inspiring vision for the future. Drawing on real-life stories, cutting-edge research, and alternative programs with metric-driven successes, they make the case for individualized, holistic interventions that actually work.

Readers will learn how “Housing First” initiatives became governments’ default response to homelessness—and why they fail. They’ll see why permanent supportive housing (PSH) isn’t just ineffective but dangerous. They’ll be shocked at how political interests fuel the homelessness-industrial complex, resulting in ever-increasing spending while falling further behind. They’ll be inspired by the success of real alternatives such as Haven for Hope in Texas and Union Rescue Mission in Los Angeles. They’ll learn the difference between responsible and irresponsible forms of harm reduction. And they’ll understand what policy changes would truly ease the crisis for the unhoused and housed alike—without breaking the bank.

It’s crucially important to remember that at the heart of this crisis are real people—those experiencing homelessness and the residents watching their neighborhoods crumble. Both have paid a high price for failed policies. Both deserve better.

The good news? We can do better. Beyond Homeless shows us how.

A Clear and Compassionate Analysis of the Causes of Homelessness

Homelessness is complicated because people are complicated. It’s a deeply human tragedy, one that evokes all kinds of powerful emotions: fear, frustration, pity, resignation. These reactions are understandable, of course. But too often, well-intentioned pity becomes destructive. A cycle of dependency and defeatism results, convincing both the public and individuals experiencing homelessness that homelessness is something to be endured rather than something that can be overcome. So how do we have a productive emotional response to homelessness? By facing its true causes without surrendering to hopelessness or moral fatigue.

Substance abuse remains one of the most significant contributors. In San Francisco alone, nearly one in four people experiencing chronic homelessness cite drugs or alcohol as the primary cause of their situation. The problem runs deeper still: 52 percent of unhoused individuals self-report alcohol or drug abuse—up from 42 percent in 2019—and some independent estimates are even higher. In many cases, despair drives addiction, which in turn deepens despair … and on and on it goes.

Mental illness and physical disabilities compound this, too. A staggering number of people on the streets live with untreated mental or physical conditions that prevent stable employment and housing. Decades of underinvestment in effective community-based treatment have left too many people to cycle between emergency rooms, jails, and sidewalks—abandoned by the very systems meant to help them heal.

And yet, while personal crises certainly play a major role in all this, economic forces cannot be ignored. Across California—and, increasingly, across the country—skyrocketing living costs, restrictive zoning and land-use regulations, and housing shortages have priced countless people out of stability. We must critically examine each and every one of these policies, with eyes wide open to their consequences.

Homelessness is the result of human failure—policy failure, community failure, and yes, personal failure. But just as these failures are created by people, they can be solved by people, too. We must replace performative pity with clear-eyed compassion. It’s the best chance we have toward recovery and human dignity.

What Is “Housing First”—and Why Hasn’t It Worked?

“Housing First” has become the dominant approach to addressing homelessness in America. In theory, it sounds compassionate and straightforward: Give people housing first, and the stability of having a roof over their head will allow them to access supportive services and rebuild their lives. In reality, it rarely works that way.

Because the high cost of housing consumes the lion’s share of funding, the services promised to accompany housing—mental health treatment, addiction recovery programs, job counseling—are often unavailable or go unused. Predictably, then, the root causes of homelessness remain unaddressed, and Housing First policies result in a revolving door between housing and homelessness.

“They’re inside, but culturally homeless.” That’s how a Salvation Army officer who works directly with people experiencing homelessness described the effect of Housing First policies. Four walls alone cannot heal addiction, trauma, mental illness, or a flat-out refusal to abandon the vagabond lifestyle. These policies apply a Band-Aid to a severe wound.

To add insult to injury, Housing First policies are extremely expensive as well as inefficient. High costs, lengthy project timelines, and the total inability of Housing First policies to produce much (if any) of a dent in homelessness in San Francisco and Los Angeles after years of effort show the futility of this endeavor. Even at an average rate of $500,000 per unit in California (sounds high, but is probably a conservative estimate as of this writing), providing housing for the estimated 171,531 homeless Californians would cost roughly $86 billion. That’s assuming that every unit could be built right away, which is highly unlikely given California’s hyperaggressive regulatory environment.

But even if it could be done, warehousing people out of sight is not compassion. It transforms human beings into dependents of the state, permanently reliant on the taxpayer. The taxpayers’ dollars deserve better stewardship; individuals experiencing homelessness deserve genuine recovery and community.

The Homelessness-
Industrial Complex

The tragedy of homelessness has spawned a vast network of well-intentioned programs staffed by sincere individuals who genuinely want to help. But while these staffers’ hearts may be in the right place, their organizations and bureaucracies have become entrenched interests—a “homelessness-industrial complex” that too often perpetuates an ineffective status quo.

Chapter 6 of this book untangles how homelessness dollars are spent in one city: San Francisco, long considered to be ground zero for homelessness. The authors trace the flow of funds from city, state, and federal sources. Most importantly, they distinguish between money spent on homelessness programs and money that actually reaches people experiencing homelessness—a gap that reveals how much funding never touches those it’s meant to help.

Worse still, even the spending that does touch those it’s meant to help … doesn’t seem to help much. A staggering chart from Chapter 6 shows that homelessness in San Francisco has increased by a whopping 22 percent since fiscal year 2013–14, despite skyrocketing spending—Department of Homelessness and Supportive Housing spending increased by 278 percent, federal spending increased by 126 percent, and state spending increased by 70 percent.

If the definition of insanity is doing the same thing over and over and expecting different results, then it is nothing short of insane to keep spending taxpayer dollars on failed Housing First policies and ineffective programs. Good intentions are not enough. It’s past time to pursue what actually works.

What Actually Works?

One lesson we should have learned by now is that homelessness, at its core, is not a problem caused by the underfunding of government programs. Despite dramatic increases in funding and billions of dollars spent in recent years, the homelessness problem continues to worsen! Throwing taxpayer dollars at the problem doesn’t work, and Housing First policies certainly don’t work. But what does?

Rigorous research and inspiring personal testimonies found in this book show that housing readiness programs are the way forward. In contrast to Housing First policies, housing readiness policies focus on transitional and transformational housing. Many organizations have implemented this model with great success, including Haven for Hope in San Antonio, Union Rescue Mission in Los Angeles, Step Denver, and the Salvation Army.

Housing readiness programs aim to provide temporary housing and wraparound services to help individuals experiencing homelessness address underlying issues until they reach the point at which they are able to secure permanent housing and achieve full success. Such programs can be very long, with some lasting up to three years. They include wraparound recovery, job training, and other services, and they often require participants to maintain sobriety or fulfill other expectations in order to continue in the program.

Critics complain that housing readiness models impose too many barriers to entry (such as sobriety requirements) and “cherry-pick” people who are already willing to help themselves. But such programs have transformed people’s lives and prevented them from becoming perpetual dependents. We would be wise to learn from and emulate the models that already exist.

In short, housing readiness works because it treats people as capable human beings, not passive recipients of aid. It restores purpose, accountability, and dignity—the very foundations of lasting recovery. This book shines a light on those truths, cutting through decades of bureaucratic mess and failed compassion to show what actually heals communities and transforms lives. In these pages is hope, grounded in proof—and a roadmap for turning that hope into action.