Homelessness is a major problem in Winnipeg. In 2014 the Winnipeg Poverty Reduction Council estimated that at any time approximately 350 individuals stayed in one of Winnipeg's homeless shelters, 700-1,000 individuals were in single room occupancy hotels, and 1,400 stayed with friends or family in order to avoid living on the streets or in homeless shelters. These numbers are in line with aggregate estimates for Canada.

Until recently Canada generally relied on reactive emergency services such as shelters, food programs, policing responses and hospital emergency departments to address the needs of the homeless. In this system, homelessness was typically approached with a "continuum of care" model. Individuals are expected to transition towards having a home by moving through a series of steps, for example moving from the streets to shelters, to transitional housing and finally to permanent housing. Transitioning from one step to the next is generally reliant on the individual being perceived as housing ready by being able to demonstrate sobriety or behavioral control.

In recent years organizations around the world have begun to address homelessness in a new way, using a "Housing First" (HF) approach which argues that access to suitable housing is a basic human right and that housing is the first step to recovery for homeless individuals. Often associated with the "Pathways to Housing" program introduced in New York by Sam Tsemberis and his colleagues, the HF approach is to provide housing first, and then combine that housing with supportive treatment services. The New York Pathways to Housing program argues that it "fosters a sense of home and self-determination, and it helps speed the reintegration of Pathways clients."

Following the large, multi-year, federally funded At Home/Chez Soi (AH/CS) project, the federal government transitioned toward HF in its Homelessness Partnering Strategy (HPS). Like other HF research, the AH/CS project showed that an HS approach resulted in a high housing retention rate among participants, dramatically reduced the cost of public services especially for high need clients, and resulted in increased participant well-being.

The evidence that HF is more effective than a continuum of care model in addressing some aspects of homelessness is very strong. However, researchers have raised some caution about challenges in implementation in rural communities and its lower effectiveness for some subgroups, namely youth, high acuity clients and Aboriginal peoples. Here we wish to focus on another challenge, which is the effect of full implementation of an HF approach without addressing the availability of affordable housing. Researchers have argued convincingly that, since the 1980s, Canada has disinvested in social housing and incentivised home ownership over renting. As a result there is a serious shortage of affordable housing across Canada. This fact will challenge efforts to implement HF.

First, the shortage of affordable housing can create challenges in administering the program. This can impede the implementation of an HF approach, as shown by the City of Toronto's 2009 evaluation of the Streets to Homes program, an early HF intervention. In Toronto's tight housing market, 30 percent of clients had no choice in the type of housing they were offered and 29 percent said they had no choice in location (client choice is an important element of an HF approach). The shortage of affordable housing resulted in shared accommodation, which was less desirable to clients and, when compared to individuals housed in private apartments, generally led to worse outcomes. The average client spent 41 per cent of their income on rent, as opposed to the 30 per cent target of the program, leaving 68 per cent of respondents without enough money to live on after rent was paid. Further, the study found that many housing units lacked physical capital. In particular, some clients found food storage and preparation difficult due to their apartments lacking stoves, large fridges or cupboard space.

Second, it's conceivable that, in the context of a severe shortage of affordable housing, a strong HF initiative in the absence of a systematic effort to increase the supply of low-cost housing can have negative effects. A successful HF initiative will greatly increase the demand for housing that is already in short supply. For example, in Winnipeg the AH/CS study followed 513 people of whom approximately half were housed. Even with this small number in the HF program, conversations with participants indicate that individuals who were not housed experienced increased challenges in obtaining housing because much of the available stock was occupied by HF participants. In the absence of the addition of more low-cost housing, the challenges will only be exacerbated when the client population for an HF initiative is increased.

Moreover, a successful HF initiative can disadvantage low-income renters who are not connected to an HF initiative. The HPS HF initiative provides funding primarily to house chronically and episodically homeless individuals. These individuals comprise a small portion of the total low-income population (including the hidden homeless population) who are competing in this housing sector. With increased pressure on low-cost housing, rents may rise or landlords may become more selective, or both. Of course there is a possibility that an HF initiative will increase the number of low-cost units available because of support to landlords. However the small size of this housing sector in the first place suggests that this increase will be small.

This argument is not intended to suggest that an HF approach should be abandoned. It's clear that HF is an innovative and effective approach to housing homeless individuals. However, without a commitment to increasing the availability of low-cost rental housing, it will not be able to fulfill its promise.

Matt Stock is a graduate student in the Queen's School of Policy Studies and Evelyn Peters is a Professor in the Department of Urban and Inner City Studies, University of Winnipeg.

Photo: At Home/Chez Soi residence, Mental Health Commission of Canada