When the plight of the desperate men and women who live on America’s streets comes up in conversation, the topic of affordable housing inevitably follows.

But, in reality, the homelessness problem was not created by a crisis in the housing market. If it were, we’d be well on our way to solving it.

In an important Heritage Foundation report headlined “The Housing First Approach Has Failed,” Christopher Rufo explains why, despite the billions of dollars the federal government has spent for shelters, the number of homeless people has gone up 20 percent in the last five years.

The homelessness problem (by and large—there are exceptions) was never about the shelter; it was about something more fundamental: human behavior, and we are not going to make headway until we acknowledge this. Rufo writes:

In order to reduce homelessness, policymakers at all levels must understand that chronic and long-term homelessness is not primarily a housing problem—it is a human problem.

According to a 2019 report from the University of California Los Angeles analyzing data from 64,000 surveys, 75 percent of the unsheltered homeless have substance-abuse disorders, 78 percent have mental health disorders, and 84 percent have physical health conditions. In other words, these are not simply people who lack shelter; the majority are suffering from profound human pathologies.

Progressives may argue that it is judgmental to acknowledge the human factor—as opposed to the housing factor—in the growing number of homeless people. But it is inhumane not to admit what is going on. That’s what well-intended federal programs have done for decades. Rufo writes:

In recent years, the federal policy response to homelessness has centered on a single concept: Housing First, which holds that the public should provide permanent housing for the homeless without requiring abstinence from drugs and alcohol, or even participation in substance abuse treatment or mental health services.

Under the George W. Bush Administration, USICH presented the Housing First approach as the key breakthrough to ending homelessness. Over the course of the following decade, USICH and HUD redirected billions of dollars in funding away from transitional housing programs and toward Housing First programs. Despite concerns from service providers that this policy would reduce resources for emergency shelters, transitional housing, and treatment programs, the Housing First coalition plowed ahead.

By 2009, Housing First had become the de facto policy at the local, state, and federal level, as local service providers oriented their programs toward federal funding priorities in order to maximize their ability to receive HUD grants. During this period, 234 cities officially adopted the philosophy of Housing First and submitted “10-year plans to end homelessness.” Today, the vast majority of federal homelessness funding is spent on Housing First programs.

The problem with the Housing First approach, argues Rufo, is not that it costs so much but that it doesn’t help very much in that it doesn’t reduce homelessness. As noted the number of chronically homeless is growing. Rufo reports that there is another approach gaining momentum: the Treatment First approach. Here is how it works:

While Housing First prioritizes the values of “harm reduction” and low barriers to entry, the Treatment First model prioritizes the values of addiction recovery, personal transformation, and self-sufficiency. In Treatment First programs, the goal is to rehabilitate the individual, then secure permanent housing. It is also called the “linear” model, because it relies on a guided progression through recovery programs, building human capacity and treating addiction and mental illness.

Progressives might flinch that there is a values angle in some Treatment First programs:

Reverend Andy Bales, CEO of Union Rescue Mission in Los Angeles, which offers faith-based treatment programs for the chronically homeless, explains the different objectives between Housing First and comprehensive treatment programs: “Housing First [sometimes leads to] a life of addiction and actually overdosing in that unit…. We want more than that for our graduates. We want them to have a recovered life, a productive life, a life more abundant than it was when they entered our facility.”

Progressives can take heart—we will still be spending money on homelessness, but we’ll actually be moving towards curing the problem by giving people a chance to acquire habits that prepare them for living stable lives before they are placed in housing.