In the hallway of Pathways to Housing, a loud, chaotic office in East Harlem, Hughes Smith can't stop talking about his furniture: "It's unbelievable," he says.
It's not often that someone brags about 10-year-old futons. But for Mr. Smith, shuffling down the hall wearing a tan baseball cap and yellow headphones, permanence is something to celebrate. "After being homeless so long," he explains, "you just don't believe it." His L-shaped studio, blocks from the East River and boasting three big closets, still dumbfounds him.
Since 1993 "nine years, March 31st," he announces Smith has been a client of Pathways to Housing, which offers apartments to mentally ill homeless New Yorkers.
Pathways doesn't require medication, abstinence from drugs or alcohol, or use of social services a leniency that flies in the face of conventional demands that the homeless demonstrate "housing readiness" through sobriety, psychiatric visits, even cooking skills before they're provided with a place to live.
Instead, Pathways runs on a "housing first" model, with the philosophy that before someone can work toward recovery or employment, a safe, comfortable home is necessary.
Such programs as Pathways, which offer permanent housing with optional support, gained a foothold in the 1990s bursting from almost none in the 1980s to 114,000 beds nationally in 1996.
Sam Tsemberis launched his program in 1992 with 50 apartments, a PhD in clinical community psychology, and a $500,000 grant from the New York State Office of Mental Health.
Today, the grants total $7.2 million and the program has an 85 percent success rate, he says.
Each night, about 800,000 Americans are homeless, and 31 percent of homeless adults report both mental-health and substance-abuse problems; an additional 32 percent struggle with one or the other. Those with addictions generally go through detoxification programs an average of 11 times. These are, typically, the hardest to house: Turned away by programs that demand sobriety or a clean bill of health, many people with these problems have spent years on the streets or in psychiatric hospitals.
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