Recent criticism overlooks the proven effectiveness of strategies like Housing First and harm reduction in ending homelessness.
Since 1979, DESC has been a recognized national leader in implementing innovative and cost-effective strategies that end chronic homelessness. One proven strategy is Housing First — the approach that offers immediate, low-barrier, and long-term stable housing paired with comprehensive behavioral health, medical, and support services to help people achieve lasting stability.
On July 24, 2025, President Trump issued an Executive Order addressing homelessness in the United States. This order could undermine evidence-based strategies like Housing First and harm reduction that are essential to recovery and survival.
The executive order is causing nonprofits working to end homelessness to question whether the Trump administration is targeting ineffective homelessness service providers, or dismissing proven solutions like Housing First, permanent supportive housing, and harm reduction as failures. If it signals a true interest in supporting best practices in doing this often difficult work, there may be an opportunity to continue our work with federal support.
Specifically, the order details:
- Potentially freezing support for housing and homelessness assistance if programming violates terms laid out by the order
- Ending support for Housing First policies that “deprioritize accountability and fail to promote treatment”
- Halting grants issued by the Substance Abuse and Mental Health Services Administration for programs that “fail to achieve adequate outcomes” including harm reduction and safe consumption
Whether this move targets underperforming providers or threatens to undo proven solutions, one thing is certain — real Housing First and harm reduction work, and the evidence backs it.
What is Housing First, really?
Housing First acknowledges that once the chaos of living on the streets is eliminated from people’s lives, they can better connect with services and work toward stability. An effective intervention for reducing chronic homelessness among vulnerable adults, DESC first started pioneering this method in the 1990s.
Housing First rests on the principle that housing is a human right, and that providing it with robust services is far more effective than withholding it to force change. In fact, the so-called “tough love” of treatment-first models fails most people experiencing chronic homelessness and can cause additional trauma.
The good news is that decades of research show low-barrier entry and no prerequisites lead to greater stability, better health, fewer emergency room visits, and less conflict for people who’ve experienced chronic homelessness.
What Housing First Is NOT
Housing First is NOT Housing Only.
Housing First is NOT giving someone experiencing homelessness keys to an apartment and saying, “goodbye.” Comprehensive wraparound services — from substance use treatment and medication management to onsite behavioral health care — are essential for helping tenants succeed on their own terms.
Housing First does NOT require clinical prerequisites like courses of treatment or evidence of sobriety. It does, however, include continuous assertive engagement with tenants to offer services and treatment options that meet their specific needs — and to help them sustain those supports. Additionally, people in low-barrier housing are more likely to stay housed, avoid falling back into homelessness, and require fewer emergency services.
It’s important to note that some housing providers have adopted the “Housing First” label to qualify for federal funding, without offering the comprehensive medical and behavioral health services that are essential to the model. This misuse has caused public confusion about what Housing First truly is and how it works.
DESC believes that housing is a human right, not a reward for clinical success. Only once the chaos of living on the streets is removed can a person begin to work on overall stability in their health and daily life.
Why it works
Housing First is recognized as an effective practice by national researchers and policymakers. In fact, the United States Interagency Council on Homelessness (USICH) defines Housing First as: “a proven method of ending all types of homelessness and is the most effective approach to ending chronic homelessness.”
In DESC’s 45-plus years of experience, we have found that Housing First is the most helpful and cost-effective tool for people experiencing homelessness, especially those living with substance use disorders, severe mental health challenges, and other disabling conditions.
One study showed, when comparing two groups of homeless individuals, that those in the Housing First program spent significantly less time homeless and in hospitalized care. Ninety percent of the residents in that program were housed after one year compared to only 35 percent in the comparison group.
Another study in King County found that once housed and surrounded with resources and support, residents visited the emergency room 17 percent less in their first year inside compared with the year before.
DESC will never stop working to support our most vulnerable neighbors. We stand with those pushed to the edges of society and reject the idea that anyone is beyond help.
No one is beyond help.
When individuals can sign a lease, move in without first completing treatment, and access comprehensive care, they have a real chance to build a better life — for themselves and the community.
Join our fight today by donating, volunteering, or just spreading the word — Housing First works.