The document discusses harm reduction housing models presented by DESC (Downtown Emergency Service Center) at a conference on homelessness. DESC provides various housing and treatment services in Seattle for over 2,000 vulnerable individuals each day with disabilities like mental illness, drug/alcohol addiction, and histories of homelessness, abuse, and trauma. DESC follows a housing first model placing people directly into housing from the streets without treatment preconditions and using a harm reduction approach rather than mandated abstinence.

1. www.desc.org Harm Reduction Housing Models presented by Bill Hobson Annual Conference National Alliance to End Homelessness July 12-14, 2010 – Washington D.C.

2. A Substance Abuse and Mental Health Services Administration (SAMHSA) initiative Funded by SAMHSA’s Center for Mental Health Services and Center for Substance Abuse Treatment Mission is to promote the adoption of evidence-based and promising practices in co-occurring mental health and substance use disorders

3. www.desc.org Overview of DESC Large 24-hour emergency shelter Two smaller overnight emergency shelters Licensed mental health and chemical dependency treatment services 9 supportive housing projects (750 units) 630 people in 8 project based setting 120 people in scattered site setting Focus on vulnerable adults with disabilities: Severe and persistent mental illness Chronic drug/alcohol problems Serve over 2,000 each day & over 7,000 each year High level of integration across programs

4. www.desc.org Population Characteristics Severe and persistent mental illness Chronic alcohol and other drug problems Long-term homelessness Multiple concurrent disorders Aversion to or ambivalence about addressing problems History of abuse, neglect, and trauma

5. www.desc.org Harm Reduction Foundation “ Come as you are” ethic in place since 1979 Change and conformity cannot be forced Success comes in increments

6. www.desc.org Housing First Principles Targeted to the most vulnerable. People moved into housing directly from the streets without preconditions of treatment acceptance or compliance. Provider is obligated to bring robust services into the housing. Continued housing is not dependent on participation in services. Harm reduction approach rather than mandating abstinence. Residents have leases and tenant protection under the law. Can be implemented in either a project-based or scattered site model.

7. www.desc.org Elements of Vulnerability Subject to victimization by others Poor self-care abilities Less likely to seek out mainstream services Physically at risk for injuries/illnesses History of poor decision making