Tsemberis and homeless consumers first developed a consumer-run drop–in center for people experiencing homelessness and mental illness. They then created the Pathways to Housing program, which came to be known as Housing First. They initially showed that the program was more effective in getting people off the streets and keeping them housed than the citywide average for programs funded under the same city-state agreement to provide housing for people with serious mental illnesses and chronic homelessness, then conducted a randomized controlled trial of the Pathways to Housing model in comparison to the dominant model which attempted to provide “appropriate” housing for individuals in treatment programs, and allow them to earn their way toward more autonomous settings via cooperation with service providers and success in treatment. The Pathways model was substantially more successful, and the greater success lasted for the full four years of the study. The model also proved more cost effective, in large part due to reductions in psychiatric hospital stays. By 2010, the Federal Interagency Council on Homelessness advocated Housing First in its strategic plan asserted: “Housing First is a proven method of ending all types of homelessness and is the most effective approach to ending chronic homelessness.” The Mental Health Commission of Canada put the Housing First model to rigorousrandomized trial in five Canadian cities and found that in the first year it more than doubled the time participants spent in stable housing relative to a control group and the model has spread to Europe. According to the Pathways to Housing website, the model has been included in over 300 cities’ 10-year plans to end homelessness, and the model is credited with helping to reduce rates of homelessness among adults with serious mental illnesses. Indeed, a current problem is that everyone is jumping on the housing first bandwagon, whether they actually adhere to the core principles of consumer choice or not. Tsemberis is re-branding the model “Pathway Housing First” and has published a manual to try to help people who want to implement the model. In 2018, Tsemberis visited Dublin to support the roll out of the Housing First initiative in Ireland. He was listed as one of the speakers at the 2019 Housing First Scotland Conference and the Mayor’s Summit on Homelessness in Amarillo, which took place in July 2019.
