A lot of folks in medicine have asked me over the past couple years, "Can you explain how housing works?"

A thread for folks in homelessness medicine:

It's always meant well, and I'm always excited when people in medicine want to talk about housing.

What I don't think folks realize is that asking how housing works is a little bit like asking, "Can you explain how medicine works?"

Housing, like medicine, is a complicated field and constantly in flux.

Are there algorithmic cases? Sure. But like medicine, different things work better for different people. Every situation is a bit unique. And the best practices/policies are constantly changing.

I would also argue it is virtually impossible for someone experiencing homelessness to access subsidized housing without a skilled, long-term housing navigator/case manager on their case.

I think medical providers mean really well when they want to create a resource of some kind that helps people access housing, and I absolutely encourage this! Please, please get more involved!

But "resources" aren't enough.

The same way you need a medical provider to quarterback medical care, you need a skilled housing navigator/case manager when it comes to housing.

The other difficult thing to explain is that housing navigation is not something that can happen in a short-term setting. Housing is all about the long game.

Can I get someone a housing opportunity within a year? In most cases, probably.

Can I get someone a housing opportunity in an ER visit, or even an in-patient stay? Heck no.

When thinking about creating a housing program in a medical setting, it's important to keep this in mind. Continuity of care is crucial.

A housing navigator in an ER or hospital is great (and crucial!), but they are only really useful if they have capacity for continuity of care/outreach/consistent follow-up (or have capacity to coordinate closely with those who do).

All this is to say I am so glad more folks in medicine want to understand how housing works. I am always happy to talk about housing and strongly believe hospitals, ERs, and community health centers should hire housing navigators!

I just wanted to share these thoughts, especially when medical providers are often in leadership roles when it comes to program development for people experiencing homelessness.

If you have gotten this far, thank you for reading! I'm interested to hear what others think too!