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Prison Policy Initiative on 09/11/2023 by Brian Nam-Sonenstein
Housing is one of our best tools for ending mass incarceration. It does more than put a roof over people’s heads; housing gives people the space and stability necessary to receive care, escape crises, and improve their quality of life. For this reason, giving people housing can help interrupt a major pathway to prison created by the criminalization of mental illness, substance use disorder, and homelessness.
For this briefing, we examined over 50 studies and reports, covering decades of research on housing, health, and incarceration, to pull together the best evidence that ending housing insecurity is foundational to reducing jail and prison populations. Building on our work detailing how jails are (mis)used to manage medical and economic problems and homelessness among formerly incarcerated people, we show that taking care of this most basic need can have significant positive downstream effects for public health and safety.
Using housing to interrupt cycles of incarceration
Homelessness, substance use disorder, mental illness, and incarceration are deeply intertwined experiences. Around 45% of adults in the United States who have been diagnosed with serious mental illness also have a co-occurring substance use disorder. People with such dual diagnoses are 12 times more likely to be arrested than people with neither diagnosis. This is borne out in prison populations. A study of Iowa’s state prisons, for example, found nearly 54% of people with serious mental illness also had a substance use disorder.
Drug and alcohol disorders can be both a cause and a consequence of being unhoused. Many people use drugs to self-medicate and cope with mental illness and the constant stressors of homelessness. One point-in-time count of homelessness across the United States in 2022 found that roughly 21% of unhoused people had a “severe” mental illness, and 16% engaged in “chronic substance abuse.” As frequent targets of aggressive policing, unhoused people face constant threats of criminalization. A recent survey of 441 unhoused people in Colorado found 36% had been arrested for a crime of homelessness, 70% had been ticketed, and 90% had been harassed by police, while recent research shows that 1 in 8 city jail bookings in Atlanta involved a person experiencing homelessness. In the end, policing homelessness creates a vicious cycle of poverty and confinement, where basic needs are never met: Formerly incarcerated people are almost ten times more likely to be unhoused than the general population, and 52,000 people who left correctional facilities in 2017 directly entered shelters.
For many years, housing policy was dominated by moralistic views of homelessness, which held that people just needed to take matters into their own hands and pull themselves up by their bootstraps. Drug use and mental illness were deemed character flaws and personal weaknesses, incompatible with housing or employment, and total sobriety and participation in treatment were required to receive what few services were available. Thankfully, decades of advocacy have begun to supplant these ideas with more effective supportive housing models like Housing First.
Housing First programs provide low-barrier permanent supportive housing with wraparound voluntary mental health services and case management. These programs have demonstrated success in ending chronic homelessness and improving quality of life, especially among people experiencing both substance use disorder and mental illness. Though advocates and scholars have for years urged Housing First facilitators to better target services toward the needs of people with criminal legal system involvement, research has shown these programs are effective in reducing arrests and incarceration even when they aren’t tailored specifically to criminalized populations.
Take, for example, this report which examined results from a 10-year follow-up with participants in the New York City Frequent Users System Engagement program (NYC FUSE) – a supportive housing program working with housing providers in the city, including Housing First practitioners. Compared to a closely matched comparison group, the researchers found that participants spent an average of 95 fewer days in jail, and 256 fewer days in shelters, over the 10-year period.
Other programs focused specifically on arrest, incarceration, and reentry have shown equally impressive results: