Opinion: How Houston's homelessness breakthrough could be a national game-changer

Marc Eichenbaum, the Special Assistant to Houston Mayor Sylvester Turner in charge of homeless initiatives. He is a member of the Leadership Council for the National Alliance to End Homelessness, and has provided advice to over 70 cities about how to create systems to help reduce homelessness. Michael Nichols is the President and CEO of the Coalition for the Homeless of Houston/Harris County. He has been active in Houston's business and civic life for over three decades. These views are the authors' own. CNN has more opinions.

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Curtis had lived on the street for almost 20 years when our outreach teams met him. He was sleeping under a freeway in downtown Houston. He had been in a deep state of depression after the sudden death of his mom. Lack of mental health support led to him self-medicating, then drug-related imprisonment, and then homelessness.

Curtis could not stop smiling one day in November. He moved into permanent supportive housing, his own apartment complete with a brightly colored door. Curtis now enjoys reading and watching movies in his new home with Bella, a kitten.

Houston's most challenging issues, such as homelessness, can be solved. We know people like Curtis can be helped, as long as we collaborate and work strategically. Our approach in tackling this seemingly unsolvable problem can be used as a model by other American cities looking to combat the growing number of homeless people.

Homelessness in Houston got worse before it improved. In 2011, Houston had the nation's largest homeless population. Our community took action after a decade of dismay at the lack of results from substantial investments and the growing threat of homelessness.

More than 28,000 homeless people in Houston have been housed since 2012. In just over a ten-year period, the number of homeless people has decreased by more than 60%.

What changed? In 2012, the Coalition for the Homeless of Houston/Harris County was chosen as the lead agency for our regional homeless response system, The Way Home.

We then made three important decisions. We decided first to work as a system of collaboration, aligned with a standard set of goals and processes, and to develop strategies and tactics, instead working as separate organizations and government agencies, each trying to chip at the problem. More than 100 organizations in Houston are working together to reduce homelessness. We are using a central database to track service needs and capture information about people who are homeless. A standardized assessment is also used to determine the best housing or service intervention for each household.

We also adopted the best practices proven by data of Housing First. This is a strategy that focuses on helping individuals and families get out of homelessness, and into permanent housing, before addressing any other issues. This is done through voluntary wraparound services such as mental health counseling or substance abuse treatment, health care and job training. The services keep the person in their home, and housing is the key to the effectiveness of the services.

We housed those who were most vulnerable first. Most people assume that a person who is homeless and suffering from mental illness needs to be hospitalized or treated. Most of these people are able to stabilize in housing when they receive the right level of support.

We have also found that the majority of people become homeless because they suffer sudden and unexpected financial losses - those losses that could not be catastrophic if we only had the right policies - and that homelessness can exacerbate mental illness and the need for self-medication. Homelessness is rarely caused by mental illness.

Housing is one of three components in our system to help the homeless. We provide a real home, most often an apartment, with a key and a lease on the person's behalf, as well as everything else needed to live in the unit long-term. We then give them rent subsidies. Residents may contribute up to 30% of their income, depending on the program. Finally, we provide support services that help the individual move forward emotionally, psychologically and financially.

Our success is closely linked to our collaborative approach, which brings together the city and county of Houston, public housing authorities as well as major philanthropic organizations, faith groups, private sector, and more than 100 non-profit agencies.

This was especially important during Covid-19 when homelessness began to be a real danger for many people, who were already on the edge of poverty. We reframed the crisis, despite its challenges, as an opportunity to help them more. Houston and Harris County invested federal pandemic funds strategically, along with contributions from private donors, to allow our system to provide housing or homelessness diversion to more than 12,000 individuals during the pandemic.

Housing with supportive services has also been found to be the best solution for encampments - sites where people who are not housed set up tents in groups. By putting close to 400 people onto the housing path, we have decommissioned dozens encampments.

This difficult work is not only morally right, but it's also fiscally sound. We estimate that it costs less to house and provide services for an individual (about $18,000 per year), than to put them in jail, or to let them suffer on the street and be forced to use our emergency rooms regularly (which is estimated to cost anywhere from $30,000-$50,000).

Our experience shows that as communities work to reduce homelessness, the people who are left on our streets often have severe behavioral issues and require a higher level care. Many organizations, including the local mental-health authority, local Veterans Affairs offices, law enforcement, and public health, have tried to help, but with limited success.

We have observed that too often each organization involved in this work exhausts the tools available to them and either gives up and accepts defeat or absolves itself of responsibility by pointing out another system which should be held accountable. Our neighbors suffer and languish in our streets.

Houston Mayor Sylvester Turner, along with county leaders, have stated that we cannot be complacent. We must not accept the streets to be the final destination for those who are most vulnerable. Our collective responsibility is to act. Now, a diverse group of leaders from across the system meets regularly to develop, coordinate, and implement client-based tailored interventions in order to stabilize and accommodate our most challenging individuals with chronic and acute behavioral issues.

Houston's homelessness is not completely solved. By investing in housing, a proven and effective intervention, we can make homelessness uncommon, brief, and non-recurring. In our most recent performance evaluation period, 90% of the people we housed did not return to homelessness within two years.

Curtis explained that he was not on the streets because he didn't try to find a better home. He believes that he wouldn't have found housing without our outreach team. He said, "They never gave me up."

We have many challenges to overcome, but our commitment remains strong. Houston, when creating The Way Home for homelessness, learned from Denver and Salt Lake City effective strategies to address the issue. Other cities can also learn from Houston. When cities and counties in the United States work together to address the urgent challenges, we are stronger.