Housing First or Treatment First? Evidence from the VA's Homelessness Programs

• In Event: Mental Health Care and Its Impacts

Abstract

Debates in homelessness policy often pit “housing first” and “treatment first” style interventions against one another. In the former model, permanent, highly subsidized housing is given unconditionally and immediately. In the latter model, unhoused individuals are offered short-term combined housing and treatment programs, known as transitional housing, where issues like substance use are addressed. I use data from the Department of Veterans Affairs’ Homelessness Registry to study a national sample of nearly 300,000 unhoused, mentally ill Veterans. Using a multiple instrumental variable design, I find that “housing first” reduces three-year mortality by 4.6 percentage points. In contrast, “treatment first” has no long-term effects on health.

Author

• Sydney Costantini, University of California, Berkeley
  Presenting Author