www.desc.org

Harm Reduction Housing Models

presented by Bill Hobson

Annual ConferenceNational Alliance to End Homelessness

July 12-14, 2010 – Washington D.C.

www.desc.org

A Substance Abuse and Mental Health Services Administration (SAMHSA) initiativeFunded by SAMHSA’s Center for Mental Health Services and Center for Substance Abuse TreatmentMission is to promote the adoption of evidence-based and promising practices in co-occurring mental health and substance use disorders

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Overview of DESC Large 24-hour emergency shelter Two smaller overnight emergency shelters Licensed mental health and chemical dependency treatment services 9 supportive housing projects (750 units)

630 people in 8 project based setting120 people in scattered site setting

Focus on vulnerable adults with disabilities:Severe and persistent mental illnessChronic drug/alcohol problems

Serve over 2,000 each day & over 7,000 each yearHigh level of integration across programs

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Population Characteristics Severe and persistent mental illness Chronic alcohol and other drug problems Long-term homelessness Multiple concurrent disorders Aversion to or ambivalence about addressing problemsHistory of abuse, neglect, and trauma

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Harm Reduction Foundation “Come as you are” ethic in place since

1979 Change and conformity cannot be forced Success comes in increments

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Housing First Principles Targeted to the most vulnerable. People moved into housing directly from the streets without preconditions of treatment acceptance or compliance. Provider is obligated to bring robust services into the housing. Continued housing is not dependent on participation in services. Harm reduction approach rather than mandating abstinence. Residents have leases and tenant protection under the law. Can be implemented in either a project-based or scattered site model.

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Elements of Vulnerability Subject to victimization by others Poor self-care abilities Less likely to seek out mainstream services Physically at risk for injuries/illnesses History of poor decision making