All of Pathways clients are diagnosed as mentally ill, and 90 percent are considered addicted to either alcohol or drugs, which makes the program's success rate even more unusual.
Nationally, for every 100 individuals or families seeking affordable housing, there are only 37.84 available units. So programs that offer housing once clients are "clean" sometimes find they have no housing to give when clients are finally ready.
"There's no absolute promise that if you move through [the programs' requirements], you'll get housing," says Philip Mangano, executive director of the Interagency Homeless Council on the White House Domestic Policy Council. "You can do all the right things, make the right promises, perform well in the program. The promise of that is housing, and the difficulty is, there's a shortage."
The housing-first strategy, he continues, "puts the emphasis on the appropriate antidote to homelessness housing. And that housing becomes the nexus point for the delivery of social services."
At Pathways, those social services include jobs at the five Pathways offices, adult education, alcohol and drug-abuse support, psychiatric and nutrition counseling, and soon, careers at a Pathways-run thrift store in Queens and a bakeshop in Harlem. Twenty percent of clients are working or in school, and 70 percent participate in some form of treatment for alcohol or drug abuse.
Those social services represent about 40 percent of the program's annual cost; apartment-rental fees soak up the rest.
Mr. Tsemberis grew up in tiny Srouka, a Greek village on the Peloponnesian peninsula where, he says, "mentally ill relatives are part of the family, live with you, have dinner with you, and are contributing to the family's well-being.