This blog is in response to the blog written by Barbara Comito of the Spokane Union Gospel Mission on February 4, 2021:
I will not dispute that the mission is not, at least in many ways, doing God's work - but I know my dad got kicked off 'the program' because he was working a job with off hours, and I got kicked out of the mission because I was trying to work on a freelance project I was told would pay $3,000 which was enough for me to get my own apartment, because 'no electronic devices are allowed in the day room' - which didn't mean cell phones, DVD players, or gaming devices - specifically laptop computers. I guess the rationale at the time (ten years ago as of this writing - 2011) was they didn't want donors or board members walking in there and seeing 'these poor souls' have nice shit - homeless people are supposed to 'look' homeless. I got angry and asked for a real staff instead of just the program dude at the desk (program people, like most people who end up homeless have really poor interpersonal skills and tend to exert authority and perceive a power differential where none actually exists) and even the actual employee, when told that I was working on a software engineering project that literally could get me out of homelessness and was on a deadline, said I had to put my laptop away and check it in a bag.
I chose instead to leave because it was more important to me to perform my work that quite literally would end my homelessness than have somewhere warm to stay that night, plus, I had keys to the shop where I was working on the whole RADIUS/AAA project for Chuck at Wind Wireless. Later that night when I was walking by the Bel Air motel, someone I knew from jail shouted down to me and I was up there smoking meth with him a few minutes later despite being on drug court and facing negative consequences for doing so.
"Housing First" only "doesn't work" because they aren't creating communities of care which address SAMHSA'S "eight dimensions of wellness" and people get kicked out of their housing when failing to maintain abstinence after a certain time-boxed period. I can cite thousands of evidence based studies that correlate better outcomes with longer episodes of care for treatment, but 99% of people end up with a 28 day inpatient stay. No SUD (substance use disorder) treatment modalities I'm aware of here in the US have anywhere near the success level of San Patrignano in Italy:
A holistic approach to wellness and year or years of participating in "therapeutic communities" boasts a 72% success rate in remission of SUD for multiple years. I'm not sure what statistics UGM is utilizing to determine outcomes or the scientific rigor it would stand up to, but they are laypeople using spirituality and attempting to install rigorous discipline via arbitrary rules which often, leave people no better than they were even after completing the program which takes a year or more. I have several friends who have completed this program and maintained long term abstinence, but no more than I can count of a single hand.
When I compare this to the hundreds of people I know in the NA fellowship in Spokane who have achieved long term abstinence from drugs from traditional therapeutic interventions, even though this is through the lens of my anecdotal experience, it seems that with how well connected I am in the recovery community, I should know more examples of not just successful abstinence - but lives that possess some significant improvements in the SAMHSA criterion. San Patrignano could be done for less taxpayer money vis a vis Medicaid reimbursements than traditional inpatient settings, but our 'system of care' is not integrative enough to do this and the agencies that possess or can obtain the capital to do a similar therapeutic community are not willing or able to abandon the current model as reimbursements for episodes of care barely keep the lights on and the staff paid.
I wish I had all the answers, but I'm disappointed that it seems Italy has found the answer that we, with a monstrously enormous GDP in comparison, have not. Housing First is just one facet of a complex system, and just like light is only reflected in a single portion of a cut gem, the entire continuum, system, and direct therapeutic interventions involved in the provision of care/individual episodes of care cannot come close to obtaining these outcomes because nobody is willing to step up and do the work to reimagine the process and try something completely new, even though San Patrignano has been pulling it off for fifty plus years. Johann Hari's "Chasing the Scream" and Gabor Maté's TED talk explains very well that the opposite of addiction is community. UGM tries to create this with hurting people who hurt people lacking the healing people who can heal people. Nobody who can leave the mission and lead a productive life wants to come back around as anything but a guest speaker - and while they make everyone go to chapel and listen to stories from the folks that made it out - they don't have actual therapists and chemical dependency counselors and peer supports... they just have Jesus.
I never would have the life I do today if it wasn't for Jesus and SUD counseling, therapy, random people who don't know me from Adam giving me a room in their home, getting me jobs, and investing in me in ways that the best spiritual and secular programs are not unable, but unwilling to do.
When you contrast this against Compassionate Addiction Treatment or even Peer Spokane or Jewels Helping Hands and compare their outcomes with the fraction of the amount of budget and staff that goes along with UGM, it's pretty easy to say that the answers are there and the outcomes don't lie. Unfortunately, these organizations are relatively unknown and very few people who feel good about tithing or making charitable contributions to UGM "because Jesus" are blatantly unaware that other folks have better outcomes with less resources. Because these organizations are smaller, they don't have the resources to obtain the large matching grants that organizations like the one I work for do, and do they barely hang on and keep doing the work in the trenches that demonstrably has the fruits of recovery blooming in their orchard with higher yields with fractionally smaller acres than the mission.
The mission serves a purpose and keeps people out of the cold and fed three squares - but to deny evidence based outcomes "because Jesus" really, unfortunately, results in a disservice to those who are having greater efficacy when judging outcomes.
Source: Community healthcare worker with a minors in Addiction Studies married to a SUDP/therapist who got kicked out of the mission for having a job and got clean in LA not Spokane because the fellowship of AA there is so much more robust than that in Spokane they were their very own voluntary participatory version of San Patrignano - a true therapeutic community that as laypeople possess more insight than the smartest scientists with the best studies