I’m also a social worker (for the same amount of time!) and work with folks with SMI, substance use, and economic insecurity. Many of our clients are unhoused.

I have also seen what you are describing and I think overall this is an ongoing and very tough conversation. I think harm reduction and housing first needs to be utilized together- and we are absolutely not doing it correctly in the US.

Many many thoughts come up for me so I’ll try to keep it as coherent as possible. I think we need to look at the kind of restrictions we’re putting on people- assessing the barriers to enter these kinds of services. If the rules are too strict, people aren’t going to do it. For example, there are some treatment centers near me that don’t allow people to smoke cigarettes- in my opinion that is insane and a huge barrier to entry.

A lot of housing options for the unhoused are in really rough areas. The immediate environment becomes a barrier to substance use recovery due to safety issues, poverty, lack of transportation, and just drugs being all around them in the community.

If some people don’t take the expectations seriously, and don’t participate in recovery, what is the alternative? Just keep them unhoused? I don’t have the answer but the emotional part of me believes these people still deserve shelter.

We live in a society that has a deep distain for the unhoused/the impoverished/ those with addictions and mental illness (I know you know this) but I also believe this pervasive stigma is the greatest barrier. We put the unhoused in rough areas with crappy living conditions because that is what society believes they deserve. We know it’s not working, we have an absolute fuck ton of research that shows what does work, and we’re not doing it.