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Further, many programs husband their resources--and rig their results--by
"creaming." That is, they target families deemed most likely to succeed: typically
households who have sustained sudden losses of income, who can prove they will
be able to maintain their residence after receiving help, or who can demonstrate
that they are likely to be self-sufficient in the future. The households most likely to
become homeless in the absence of the intervention are effectively ineligible (see
also Lindblom, 1991). More broadly based housing subsidies to households with
worst-case housing situations would reach a far larger group of those at risk, albeit
at both greater cost and less specificity of effect.
Finally, programs to prevent eviction and foreclosure, even if unrestrictive,
widespread, and successful, would reach only a minority of families--those whose
homelessness stems from eviction--and would rarely reach single individuals.
This limited reach is not a reason to avoid such programs but suggests that broader
action is necessary.
Supportive Services for Impaired or Disabled Individuals
For individuals with severe mental illness or other impairments, services other
than subsidized housing are likely to be necessary. As there are no studies designed
to include assignment to a no-services group, this must be considered a common-
sensical assertion rather than a demonstrated fact. In any case, whether services
should be linked to housing or whether homeless individuals should make use of
services in the community remain much contested issues.
Popular treatments of homelessness usually emphasize the contributions of
one or several major impairments, but the analysts often ignore the biases of
cross-sectional samples (rather than samples of new entrants) and lifetime, rather
than current, diagnostic measurements (Baumohl, 1993). Once these and other
methodological problems are controlled for, it is clear that only a minority of single
individuals who become homeless have suffered recently from a major mental dis-
order, a substance use disorder, or a physical impairment that rises to the level of a
work disability, and rates among homeless families are even lower (Koegel et al.,
1996; Lehman & Cordray, 1993). More important, although those with serious
impairments are overrepresented among homeless people, only a tiny fraction of
all people with major physical impairments, mental disorders and/or substance use
disorders ever become homeless (Federal Task Force on Homelessness and Severe
Mental Illness, 1992; Institute of Medicine, 1990). The same complaints made
Shinn, Baumohl, and Hopper
Culhane (1992, p. 438), for one, notes that providing specialized social services, like providing
housing for homeless people only, creates incentives for both policymakers and homeless people to
use shelters "as a secondary welfare and housing system." The Interagency Council on the Homeless
(1994, p. 91) argued against "institutionalizing a separate support system for the homeless population"
and for improving access to mainstream services.