The real cost of supported housing for the mentally ill and homeless has been a hotly debated topic for some time. At the University of Pennsylvania, Dr. Dennis P. Culhane studies homelessness and assisted housing policy. His research has contributed to a shift in public policies to address homelessness, including expansions of supported housing for people who are chronically homeless and housing stabilization programs.

Formerly, the goal of homeless programs was to treat people for issues like substance abuse and metal illness, with the goal that this would lead them out of homelessness. Presently the attention has shifted to getting people back into housing quickly with the treatment and support they need to start living independently for the long term.

Dr. Culhane’s study “Service Use and Costs for Persons Experiencing Chronic Homelessness in Philadelphia” examines the service utilization and costs within the chronically homelessness populations in sheltered and unsheltered locations. Using shelter and street outreach records over a 3 year period, the study found that 20% percent of the persons who incurred the highest costs for services accounted for 60% of the total service costs of approximately $20 million a year. Most of the costs were for psychiatric care and jail stays. A small population was incurring the most cost because they were using expensive services like hospital emergency room instead of regular doctor visits.

Supportive housing programs for people with serious mental illness who experience chronic homelessness were found to substantially offset their cost because the use of acute care services diminishes in that environment of housing stability and access to ongoing support services.