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Their place to call home:
Shelter places women in house to boost morale, perhaps save money |
Author(s):
Carolyn Y. Johnson, Globe Staff
Source(s):
Boston Globe
Date: May 26, 2005
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Lois Spencer hit rock bottom last July. The 58-year-old Connecticut native couldn't find a job or pay the
rent after moving to Quincy, so she moved into the Father Bill's Place homeless shelter to get back on
her feet.
Months later, she was still struggling. Lining up with a hundred men and a dozen women to fight for a bed
each night was scary and humiliating. Toting around all her belongings during the day was difficult,
especially with her breathing hampered by what would turn out to be a lung disease. But it was her mind
that suffered most.
"You get yourself into a rut," living in the shelter, she says. "You get sort of depressed. You lose your
momentum, motivation... I thought, 'I'm going to die here.'"
A few weeks ago, all that changed -- thanks to an experiment that challenges conventional wisdom about
the best and most economical way to help the homeless.
Spencer and 11 other longtime homeless women moved into a house in Quincy big enough so that each could
have a room of her own. The three-story house -- part dorm, part rooming house, with two kitchens and
four baths -- is the centerpiece of the new "Housing First" pilot program run by Father Bill's.
Within a week, the difference was visible. Spencer and her roommates padded around their new house
looking happier, more energetic, even hopeful.
"I've started to look at housing as a medical intervention -- and I wish I could write a prescription for
it," said Dr. Jessie McCary, who is affiliated with the Boston Medical Center. McCary and Tatjana
Meschede, a researcher at the Center for Social Policy at the University of Massachusetts at Boston,
will monitor the women over the next two years, documenting changes in health and quality of life. They
will also monitor the cost of permanent housing as compared with the shelter services. If past models
elsewhere are any indication, the outcome may surprise some.
In New York City, a housing initiative placed 4,679 homeless people with severe mental illness into
permanent housing and monitored their health for four years. Before the intervention, supporting each
participant costs society about $40,000 a year, mostly in emergency medical care expenses. Once in
permanent housing, the cost was roughly the same, despite the high price of Manhattan housing. The
difference was that they needed less medical treatment once they were in a better living arrangement.
Repeating that experiment in Quincy -- which has far less expensive housing -- is likely to show a
net savings, researchers believe.
"What we're really trying to show is this is an overall decrease in the cost to the state," Meschede
said. As the women have the time and privacy to deal with their medical issues, including serious
mental illnesses, diabetes, or other chronic diseases, the researchers say, they will feel better,
need less medical care, and be able to go out and look for work -- things that lingered on many women's
"to do" lists for months while they spent their energy coping with the stresses of life in the shelter.
The most important outcome in the New York experiment, McCary said, is that the participants were
mentally and physically healthier than those who stayed in shelters, and were living more stable
lives. That seems to be happening here, too, she said.
"The most successful intervention I've
seen is an apartment, a place with a kitchen," she said.
The program reverses the nationwide norm for taking care of homeless people -- the so-called "continuum
of care," in which the homeless are given a place to sleep at night, and then receive intensive
healthcare services or job training as they inch toward a final goal of permanent housing. The new
group home gives the women the stability of permanent housing from the very beginning, with the hope
that it will be the path back into an independent life.
New York is not the only big city to have tried this. So has San Francisco, also with positive
results.
"Let's put the homeless women in housing first, and then provide healthcare and case management and
anything else they need to gain independence, instead of this warehouse concept of throwing men and
women into these shelters," said John Yazwinski, executive director of Father Bill's Place.
The women in Housing First said they had been constantly on guard at the shelter, protecting their
belongings from being stolen, worrying about where they would spend the day when they left each
morning. Also, they said, they were allowed only a few moments of privacy each day, in a bathroom
shared with 15 others. Even then, there was always someone banging on the door.
Just days after the women moved, the difference was palpable; the scent of fresh carpet and a clean
load of laundry welcomed visitors to the new house. The women were scheduling appointments to look
for jobs and to see their doctors. They were able to have friends and family visit them.
"There's nothing we miss," said Nancy Carroll, 58, of Hingham, who said she became homeless for the
first time in October, when her money ran out. Carroll has a plant in her room now, a simple touch
of normalcy that she could never even dream of in the shelter.
"It's green. It's got leaves. I just water it when it needs it."
Carolyn Y. Johnson can be reached at
cjohnson@globe.com.
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