Providing low-barrier housing and voluntary treatment is cost-effective, leads to increased rates of recovery, and is effective in ending homelessness
A client working on original artwork at DESC’s 1811 Eastlake location.
Homelessness in the U.S. has grown to record-breaking numbers in the last decade, due to rising housing costs and public systems that fail those at the margins of society. One of the only proven ways to effectively and sustainably end homelessness for people with the most profound challenges is to provide low-barrier, supportive housing without prerequisites — sometimes called Housing First.
A pioneer in the Housing First movement, DESC knows from decades of research that providing housing paired with behavioral health supports and other voluntary treatment options works best and often costs less. It keeps people out of jails and emergency services, helping them stay housed, stable, and supported in their recovery.
Let’s look at what the evidence shows about some key supportive housing outcomes:
Housing First Saves Taxpayer Dollars on Other Less Effective and More Expensive Activities
This approach is not only a better option for people — it’s also more cost-effective, as it reduces strain on public systems. Supportive housing is also sometimes the only option for people who can’t or don’t want to engage in other options.
Living on the streets is chaotic at best, resulting in elevated levels of injuries, medical emergencies, and law violations by people acting out of desperation. Significant portions of people experiencing homelessness and living with behavioral health disorders obtain criminal conviction records, predominantly for minor offenses, which can exclude them from community housing opportunities.
Not only does this place a burden on institutions unequipped to solve homelessness, but it also costs taxpayers more. Police time, jail costs, ambulance rides, emergency room visits, and detoxification centers are all expensive interventions.
When supportive housing is an option for people with criminal records, it lessens their involvement with costly legal system and mental health interventions. In fact, studies show supportive housing reduces jail time and bookings as well as psychiatric hospitalizations for people living in Housing First programs.
Avoidance of these kinds of public costs adds up. In a Denver study, participants in housing had an annual cost of emergency public services that was $6,876 less than the unhoused control group. A study at DESC documented a $4 million reduction in public systems utilization costs in one year for just 95 people.
Housing Leads to Voluntary Recovery
Research also shows that voluntary programming and low-barrier housing result in higher rates of stability and recovery for chronically homeless individuals dealing with substance use disorder.
Tenants at DESC with serious alcohol use disorder who moved into supportive housing without requirements to change their drinking nevertheless reduced their alcohol consumption by 7 percent for every three months they lived in the building over a two-year period.
A New York City study comparing Housing First vs. ‘treatment first’ found people who were provided housing without treatment requirements were 3.4 times less likely to use substances and drink alcohol than those whose access to permanent housing requires entering treatment first.
Another study showed that people in supportive housing were had fewer substance use disorder-related hospitalizations than those who were not.
In contrast, research shows scant evidence that mandatory treatment programs are effective in resolving substance use disorders for people experiencing homelessness. In one study in Massachusetts, 70% of people in treatment were still homeless once discharged from a treatment-first program. Additionally, people in involuntary treatment were found to be twice as likely to die from any cause as those who participated voluntarily.
We know that programs that offer individuals the choice to seek treatment after gaining stability through housing are more effective and allow people the dignity to find their own path to recovery, whatever that path may look like.
Once Housed, People Stay Housed
Many folks with histories of chronic homelessness and substance use disorder remain in supportive housing upon gaining a safe place to rest. Once housed, they can start to work on other goals, such as finding employment, working towards recovery, or reconnecting with family.
At DESC, 95% of tenants in 2024 remained in their permanent supportive housing programs after one year.
Another study showed that those in Housing First spent significantly less time homeless and psychiatrically hospitalized compared to usual care. Ninety percent of the Housing First residents in this study remained housed after one year, compared to 35% of the comparison group.
In Santa Clara County, 86% of participants in permanent supportive housing programs remained housed for several years, compared to only a third in the comparison group. Many participants dealt with chronic physical and mental health conditions.
Another study in New York City showed that 91% of supportive housing tenants participating — all of whom had significant histories of homelessness and substance use — were still housed after one year.
Federal Funding is Under Attack
The points above are a small part of the mountain of evidence, produced at DESC and numerous other places around the country, establishing permanent supportive housing as the most effective solution to chronic homelessness — yet funding is still at risk.
In the U.S., approximately 170,000 beds of permanent supportive housing rely on funding from the Continuum of Care (CoC) program administered by the U.S. Department of Housing and Urban Development (HUD). That’s 170,000 people at risk if CoC funding is cut for supportive housing, which is what the current federal Administration is pursuing.
Act Today:
- Donate to organizations like DESC that provide housing and healthcare to thousands of individuals annually.
- Educate yourself and others on funding updates by following national leaders like the National Alliance to End Homelessness and the Corporation for Supportive Housing
- Stay updated on advocacy efforts and ways to show up for key housing priorities in the 2026 Washington State legislative session.