The Importance of Change
People often become homeless when different systems have "gaps" that fail to support them - this can be in medical and behavioral healthcare systems, the criminal justice system, employment services, family services, affordable housing, education, and more. Each of these systems has its own challenges and limitations. Additionally, navigating and connecting to services in these systems is often difficult, and when someone falls into homelessness they must navigate through the complexity of many separate systems.
This struggle in the state of survival makes it extremely difficult to take steps that can get people closer to resolving their homelessness. Once a person to falls into homelessness, they are constantly having to make tradeoffs where each choice comes with the loss of a different opportunity (such as going to a doctor’s appointments for a deteriorating health condition or going to a job that pays hourly with no benefits to pay for medication). A person with lived experience commented that “being homeless is a full time job.” Whether intentional or not, the way we have designed - or neglected to design - services, keeps people stuck in their day to day survival.
We are keeping people trapped in their state of homelessness. This leads to suffering, the violation of human rights, and the shortening of people’s lifespans.
Pathways Through Homelessness
Through our research, we discovered three different pathways that people can take during their experiences of homelessness. A person experiencing homelessness can experience one or all three of these pathways during their journey. The most prevalent pathways we observe are the Deteriorating and Relapsing Paths, in which people get sicker and are not supported in making change.
People get sicker when services are not grounded in their realities and not designed to meet their needs. People deteriorate to the point where they need intensive services, costing the system more money.
Services struggle to support long term behavior change, often resulting in relapse. People fall back into the cycle of services again.
When people’s self-determination increases, they become more resilient and more likely to avoid deterioration and maintain their new behaviors.
The system of care treats housing as the ultimate goal for people experiencing homelessness and values goals that are directly aligned with getting housed. With Austin’s current affordable housing shortage, people are often not able to achieve housing— the one goal that the system pushes them to accomplish. Individuals are forced to endure years-long waitlists for housing or never receive housing and as a result spiral into hopelessness. Hopelessness can cause people to disengage with services and lose motivation. Given the current level of resources and capacity, we are setting up people for failure when we treat housing as the primary goal. People experiencing homelessness have other goals, but these are not deemed relevant if the provider working with client do not perceive the goals to be housing focused. However, these other goals can actually increase their likelihood of achieving and maintaining housing.
Goals not directly focused on housing are often aspirations to increase quality of life. People we talked to wanted to create meaningful relationships, reconnect with family, go back to school, or start their own business. Some individual providers do recognize the value in honoring and supporting people to work towards their ambitions even if they program is housing focused. When one case manager discussed how she prioritizes goals with her clients, she said, "I'm the helper; they're the expert. This is their life." Our research found that supporting people in their personal goals can help make them more stable, motivated, and resilient— and increase their likelihood of achieving a permanent housing solution.
When one case manager discussed how she prioritizes goals with her clients, she said, "I'm the helper; they're the expert. This is their life." Supporting people in their personal goals can help make them more stable, motivated, and resilient, which can increase their likelihood of achieving a permanent housing solution.
• Expore housing options
• Self care issues (basic needs, medical/mental health)
• Gain or maintain stable income
"Sometimes the Clients have divergent goals. Our main goal is housing."
- Service Provider
3 Main Goals For Case Management
But what if it's not a hierarchy?
Humans have many other needs that aren't being met. Here is how the prioritization could change:
The Resilient Path: Self-Determination
The Deteriorating Path and the Relapsing Path strip people of their self-determination—from both people experiencing homelessness and the service providers. The people who are able to take the Resilient Path are supported or enabled to cultivate their self-determination—the intersection of autonomy, connection, and competence in their lives.
Autonomy: Feeling a sense of agency and being in control; power to make your own decisions.
Connection: The need to interact, be connected to something or someone, and experience caring for others.
Competence: Seeking to experience mastery and confidence in your knowledge and skills; ability to control the outcome.
During our research, we talked to people that built their self-determination organically through their relationships and connections to the community. There were few examples of services in the homelessness system that focused on self-determination. The examples that we did see increase self-determination while meeting other needs- such as health, income, and shelter. Therefore, there is opportunity to increase self-determination in the way that we deliver all kinds of services in our community.
Listen to how Larry resolved his homelessness through his participation with Arts From The Streets.
When people deteriorate to the point where they need intensive and emergency interventions, they are using the most expensive resources that the community has to offer. When people are not supported in change, they relapse and cycle through services again and again. This service re-do also drains the system.
We have created a high-cost system. However, there is hope.
If we provide people opportunities to exercise choice, skills-building, social connection, and meaningful activity, we increase their resiliency. When we build self-determination into the way we deliver services, we increase a person's ability to resolve their homelessness and/or maintain housing.
We can solve for the bottom-line when we support people's journey to self-determination. And ultimately we create a more efficient system when we create a more dignified one.