In 1992 Sam Tsemberis, a professor of psychiatry at New York University, started a programme that turned that sequence on its head. Pathways to Housing gave rough sleepers furnished flats in poor districts. Medical care, treatment for addiction and help in learning to cook, pay bills and so on were offered, but not required. After five years 88% remained housed.
Since then dozens of cities around the world have seen similar success with what has come to be known as “housing first”. The premise is simple: to end homelessness, give out homes—even to people who may have lived on the streets for years. Homeless people are triaged much like arrivals at a hospital emergency room: those deemed most at risk of dying on the street go to the top of the queue. The approach is becoming standard in Denmark and Finland, and is being tried in over a dozen other European countries, as well as Australia and Japan. Over 200 American cities have ten-year plans to end homelessness, following a national plan drawn up four years ago that features the housing-first model. Canadian cities are drawing up similar schemes.
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