After decades of attempts to address homelessness—and unknown, but large, amounts of money spent—the crisis seems to have worsened in many places, especially in Portland, Oregon. Since the mid-1980s the region has launched long-range plans to “end” homelessness. All of the plans failed to reach their goals, for many reasons: insufficient funding, political headwinds, legal barriers, and the seeming intractability of solving the problem.

For more than two decades, the “Housing First” approach has been heralded as the best solution. The approach focuses first on providing housing to individuals and families, then addressing issues that led participants to homelessness and are keeping them from being housed. These “wrap around” services are expensive and require individuals to have the ability and will to fully use them.

While the approach has improved outcomes regarding the transmission of HIV and the survival of those with HIV/AIDS and has had some success in reducing alcohol abuse, the National Academies of Sciences, Engineering, and Medicine concluded that there is no substantial published evidence to demonstrate improved health outcomes or reduced health care costs. Moreover, there is no evidence that Housing First approaches have had any effect on reducing overall homelessness or the number of unsheltered homeless.

the state's involuntary commitment law, which has a very high threshold. To be involuntarily committed, one must be an imminent danger to themselves or others or be unable to care for their basic needs. Efforts to change the law failed under Mayor [Bud] Clark and have failed in recent legislative sessions.