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Single-site housing first for chronically homeless people

Daniel K. Malone (Downtown Emergency Service Center, Seattle, Washington, USA)
Susan E. Collins (Psychiatry and Behavioral Sciences, University of Washington, Harborview Medical Center, Seattle, Washington, USA)
Seema L. Clifasefi (Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA)

Housing, Care and Support

ISSN: 1460-8790

Article publication date: 15 June 2015




Chronic homelessness is a serious public health issue that places a strain on health-care and criminal justice systems. Typical housing models place requirements on chronically homeless individuals that are often experienced as insurmountable barriers to housing. Housing First (HF) models attempt to more effectively reach this population, and an emerging version of this is the single-site HF approach introduced by Seattle’s DESC. Single-site HF entails the provision of immediate, permanent, low-barrier supportive housing to chronically homeless individuals within a single building. The paper aims to discuss these issues.


In this case report, the authors use DESC’s 1811 Eastlake, a well-known and well-researched application of the single-site HF approach, as an example to describe single-site HF, enumerate its underlying principles, and provide a strong evidence base for its replication.


The paper provides information and insight into elements of a successful single-site HF program and what it looks like in practice.

Research limitations/implications

1811 Eastlake is one specific application of the single-site HF approach focused specifically on chronically homeless individuals with severe alcohol problems who are the highest utilizers of publicly funded services. Due to the specific nature of the population, the findings presented may lack generalizability. Therefore, researchers are encouraged to continue evaluating the outcomes of single-site HF programs on alcohol use, mental health and quality of life outcomes for all populations receiving single-site HF.

Practical implications

The accumulating research and clinical evidence have indicated that HF is key to engaging and housing chronically homeless individuals.

Social implications

These ongoing efforts stand to decrease the burden of chronic homelessness for affected individuals, their families, communities and society-at-large.


Many housing providers look to DESC’s 1811 as a model program. This paper fulfills an identified need to describe a successful model of single-site HF for purposes of replication.



Malone, D.K., Collins, S.E. and Clifasefi, S.L. (2015), "Single-site housing first for chronically homeless people", Housing, Care and Support, Vol. 18 No. 2, pp. 62-66.



Emerald Group Publishing Limited

Copyright © 2015, Emerald Group Publishing Limited

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