Homeless street outreach

Volunteers and government workers who work to provide housing through street outreach oftentimes operate under the Housing First Model, which became prominent in the United States after 2010. This model prioritizes getting individuals their basic needs before all else, alleviating their critical needs for things like food and shelter first before attending to secondary needs such as finding a source of income or attending to substance abuse issues.[7] Although this model has been criticized as a "housing only" model, meaning that in some cases individuals are not provided with enough support or resources once they are housed, it is generally regarded as an effective solution to homelessness. Going hand in hand with street outreach is the Housing First Model. It is often the state provision towards homeless street outreach because it gives tangible results, gets people off the streets, and is overall beneficial for a cities economy. Government officials that perform street outreach with the Housing First Model in mind can sometimes be faced with backlash because these outreach services can be seen as a way for the government to expand control over a previously hard to govern group, or a method by which unhoused community members are pushed out of sight for the benefit of their housed counterparts.[8][9]

Barriers to effective outreach in regards to providing housing for unhoused individuals come from limited housing options, local pushback from housed individuals, or mistrust between unhoused individuals and outreach workers. The Housing First model only works when outreach workers are able to redirect homeless individuals to adequate housing resources. When shelters are at capacity and supportive housing units are full, outreach workers cannot move individuals experiencing homelessness into housing. When creating new housing developments that cater towards the unhoused community, these developments are oftentimes met with pushback from local authorities or housed neighborhoods that harbor NIMBY sentiments.[10] Another potential barrier is created by a sense of mistrust between unhoused individuals and governmental agencies and partners like outreach workers. Some unhoused individuals reject services and resources provided by outreach workers and are labeled as care avoidant or shelter resistant as a result. Typically this demographic of people reject help because they either view these services as ineffective or no longer trust a system that has failed them in the past.[11]

Social services are an essential part of outreach work in any city. Outreach workers in this sector are responsible for connecting individuals to physical and mental health resources as well as drug and alcohol counseling. Typically, these services are provided by trained professionals such as clinicians, case managers, and social work specialists. This kind of outreach involves an element of physical and moral danger for the outreach worker, as the traditional boundaries between clinician and patient do not exist in this domain. There is potential for outreach workers in this domain put their own wellbeing at risk in order to help those who in some cases may not adhere to the help they are given.[12] The role of the outreach worker can become uncertain in this practice—although outreach workers are supposed to be advocates, in this situation there is an inherent power dynamic that positions the outreach worker as the role of the gatekeeper, which allows them to wield the power over the unhoused individual to provide them with certain services.

Several homeless street outreach programs focus on providing specialized mental health services, harm reduction, or health services in response to the lack of public services that effectively address these needs. Due to the intersectionality of issues that contribute to homelessness, some organizations have developed outreach that allows services to be offered concurrently for individuals who belong to more than one category.[13]

Issues surrounding territory, respect, and understanding regarding the homes of the unsheltered when engaging in homeless service outreach is often a factor that is considered by outreach workers, especially for those concerned with providing social services. Volunteers aim to affirm the territories of those that are unsheltered by acts of respect for privacy (including asking for permission to enter a person's space, knocking on the frame of the tent to notify residents about potentially entering the homes of the unsheltered).[14] The right approach in terms of the location and timing of street outreach, the people included on the team, and verbal and nonverbal first impressions can make the difference for individuals hesitant to access social services.[15] Instead of coming from a place of governance and regulation that often results of Housing First centered street outreach, community outreach by volunteers are often focused on giving dignity and respect to the unhoused.[16]

When conducting service-based outreach, it is important to be aware of individuals who do not wish to seek services or may be distrustful of offers of help. For example, in harm reduction outreach, the opioid epidemic and alarming increase in accidental overdoses from substances laced with fentanyl has led to a strong negative outlook on the "fentanyl problem" and may stigmatize individuals who use fentanyl recreationally.[17]