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Blog posted by: Jo Prestidge, Tuesday, 31 May 2016.

Jo Prestidge looks at the high financial and human cost of inaction when working with someone who sleeps rough – and the case it makes for a Housing First approach.

“Murray Barr was a bear of a man, an ex-marine, six feet tall and heavyset, and when he fell down - which he did nearly every day - it could take two or three grown men to pick him up. He had straight black hair and olive skin. On the street they called him Smokey. He was missing most of his teeth. He had a wonderful smile. People loved Murray.”

This is the opener to Malcolm Gladwell’s article, Million Dollar Murray, which tells the story of one of downtown Reno's most prolific homeless people.

With all Murray’s years of heavy alcohol use, police contact several times a day, numerous A&E visits, ambulance trips, failed treatment and custodial sentences, the cost of patching Murray up, without changing his situation, was great.

The cost of inaction

“It cost us one million dollars not to do something about Murray,” said a local police officer who started to total exactly how much he was costing public services. At one of the two hospitals Murray was often admitted to, he had run up a bill of $100,000 in six months. That’s one hospital. In just six months.

There are people across England just like Murray. Whatever your perspective on whether they deserve Housing First – an approach which gives people a home without any other conditions or expectations – the evidence suggests that it works for them. Stability, safety and intensive support not only helps people stay in housing but also reduces their contact with acute and costly public services.

More than a roof

In Gladwell’s article we learn that Murray successfully completed a period of alcohol detox and rehabilitation. He moved back into the community but was left to fend for himself. Unsurprisingly, as for many people with multiple and complex needs, it didn't work.

With support from a Housing First scheme, he might have been met from rehab by his worker, contacted daily and visited regularly. His sobriety could have been maintained.

It costs more than just money

But it isn’t just about the financial cost to services.

There is an ethical and moral debate to be had about how much someone's life is worth too.  Whatever people like Murray should be doing to help themselves, this is not always possible without intensive intervention which supports and enables them to do so.

Nobody wakes up one day and decides to live like Murray Barr. Things happen throughout someone’s life that impact how that life pans out. Circumstances impact behaviour and self-belief. They restrict the extent to which that individual can lead a happier, safer and healthier life.

Murray Barr died of intestinal bleeding.  There was nowhere for him in Reno that could offer him the stability and structure, the intensive monitoring or support, that people knew was needed to enable him to prolong his life and contribute to society. The article concludes that perhaps in Reno that solution was thought to be too costly.

Housing First

Whatever your motivation, whether financial or ethical, we believe Housing First is ultimately an effective solution.

Over the course of the next three years we will investigate the full benefits of the approach. In the meantime, why not come along to the Housing First workshop at our annual conference? We'll showcase two Housing First projects: one done on a shoestring budget; one commissioned by the local council at an estimated saving of £10,000 per person per year.

These and other Housing First schemes are trying a different approach to get it right for people with multiple and complex needs. Rightly or wrongly, giving someone their own home can and does save money and save lives.