Beyond Four Walls: The Relational Foundation of Housing Success

By Carol Roberts, Ph.D.

President/CEO

As leaders in the movement to end homelessness, we have a moral and practical responsibility to follow approaches that are backed by research while honoring human dignity and delivering real results. The genesis for this article stems from two events that happened last week: A conversation about why programs use the Housing First model, and the publication of an excellent article by Simon Dwight (2024) in the Stanford Social Innovation Review. The data is clear: Housing First works, and relationships make it last.

After decades of using Housing First approaches, the evidence is overwhelming: this model works. Housing First means giving people a home first, then providing support—rather than making them prove they’re “ready” for housing. A major review by the Australian Housing and Urban Research Institute found that Housing First programs consistently help people keep their housing (typically 66% to 90% stay housed), which is much higher compared to traditional approaches (Roggenbuck, 2022). Permanent supportive housing—which provides both a home and ongoing support services—achieves up to 98 percent one-year success rates, according to the National Alliance to End Homelessness.

The research shows us something equally important: the size of someone’s social network directly affects how well they can keep their housing stable (Kirst et al., 2020). This isn’t just about giving people keys to apartments—it’s about helping rebuild the connections and community that help people thrive.

As one experienced practitioner puts it: “If housing is the foundation, relationships are the thing that keeps people in homes” (Dwight, 2024). This matches our deepest values: every person deserves not just shelter, but the chance to rebuild their life with dignity and support.

Our Strong Commitment to What Works

In times when policies may change, we stay focused on what research tells us actually works. Housing First isn’t just a program—it’s a value system that recognizes housing as a human right and believes that people are more likely to address other challenges when they have the stability and dignity that comes with having a home.

The Challenge of Starting Over

When someone moves from the streets or shelter into their own apartment, they often face an unexpected challenge: feeling very alone and having to rebuild their sense of who they are and who they can trust. Research from a major Canadian study that followed 2,141 people across five cities gives us insight into the loneliness that Housing First participants often experience (Adair et al., 2021). The study found that people who had the hardest time staying housed—those who spent very little time in stable housing during the study—often avoided relationships with others and had much less contact with family and friends.

This isn’t a failure of the Housing First approach—it’s a reminder that we need to do it more completely. The research shows us that housing alone, while absolutely necessary, isn’t enough. People need both the dignity of their own home and the healing power of real relationships. Our job is to help with both needs.

What Relationships Matter Most

Research shows we need to understand different types of connections: some connect people to others who have similar experiences—like other people who have been homeless—while others open doors to new groups, networks, and opportunities in the broader community (Putnam, 2000). Both matter, but connections to new networks help people build a life beyond just using services.

Our work should focus on these important relationships:

Professional Relationships: Researchers from the major Canadian study found that people who had stronger, more trusting relationships with their case managers were more likely to do better with getting involved in their community and improving their quality of life (Stergiopoulos et al., 2014). Case managers are the staff members who help people access services, navigate systems, and work toward their goals. But these relationships should act as bridges to the broader community, not become the only connection someone has. When services become someone’s whole world, it can make it harder to connect beyond that space.

Peer Connections: Long-term studies show how important relationships with other people who have similar experiences are for keeping housing and moving toward recovery (Kirst et al., 2020). People with lived experience understand the journey in ways that professionals cannot, offering both practical guidance and emotional support.

Community Integration: Research analysis from the major Canadian study found something remarkable: even small improvements in someone’s social connections led to dramatically better quality of life (Friesdorf et al., 2022.) Being socially connected at 12 months was a strong predictor of quality of life and recovery at 24 months. True housing stability happens when people feel they belong in their neighborhoods and have meaningful roles to play—like the organization discussed by Dwight (2024), Change Please, training people as baristas who serve customers in public spaces, rebuilding community connections through everyday interactions.

Building Support for Relationships

Homelessness doesn’t just take away a home—it damages someone’s sense of who they are. After months or years of just trying to survive, people often experience what researchers call “senseblocking”: a kind of emotional and mental fog where imagining a different future feels impossible (Dwight, 2024). Our approach needs to address both practical problems and relationship challenges.

Creating Pathways Back to Community: People need safe spaces where they can try things, make mistakes, try again, and start to feel like themselves. Sometimes what happens in programs matters less than just having the experience of showing up—having structure, having someone to talk to, feeling normal. Activities like cooking classes or art groups aren’t just nice extras; they help people reconnect with time, routine, and ordinary life.

Building Confidence Through Contributing: Small roles—supporting other residents, participating in peer support—offer more than just small payments. They provide trust, purpose, and the experience of being part of something. This rebuilds what researchers call “social efficacy”: the belief that you can successfully connect with others.

The Economic Case for Relationships

The relationship-focused approach reflects both our values and smart use of money. The National Alliance to End Homelessness reports that providing access to housing creates significant cost savings for communities because people with homes are much less likely to use expensive emergency services, including hospitals, jails, and emergency shelter. One study found an average cost savings on emergency services of $31,545 per person housed in a Housing First program over two years. Another study showed that a Housing First program could cost up to $23,000 less per consumer per year than a shelter program.

These savings grow when programs successfully build social connections that prevent people from falling back into the situations that caused their homelessness. Investment in relationship-building isn’t just compassionate—it’s cost-effective and strengthens communities.

The Systems Opportunity

Here’s our fundamental opportunity: We can transform systems that were built to count things into systems that connect people. Most homelessness interventions are designed around measurable outputs—bed nights, housing placements, clinical assessments—because they’re easier to fund, track, and report than the long, nonlinear work of relationship-building (Dwight, 2024).

’Recovery doesn’t follow structured performance metrics — it happens through human connection.

This gap between what matters and what’s measured doesn’t have to defeat us—it can inspire us to design better approaches. Staff consistency builds trust. Experimental, client-driven programming creates hope. Outcome measures that include relationship quality and community connection help us provide what actually works. Partnerships across service sectors create natural integration into everyday life.

The question isn’t whether relationships matter—the research settles that. The question is whether we have the courage to design our funding, staffing, and culture around what we know creates lasting change. We’ve created specialized “homeless services,” but what people actually need is what everyone needs: safety, purpose, friends, community. Our opportunity is to remove the barriers that pushed them out of the mainstream in the first place.

Our Path Forward: Principle Over Politics

Relationship-first approaches aren’t just evidence-based—they’re values-driven. The evidence demonstrates that ensuring linkages to health and social service consultations for clients, supporting clients’ engagement with family and community, and enabling clients to improve or maintain good health will drive better long-term client outcomes within Housing First.

As leaders committed to ending homelessness, we will:

• Embed relational support as core program components, recognizing that healing happens in community
• Design services as bridges into the broader community, not isolated systems
• Create confidence-building opportunities that help people rediscover their inherent worth and capabilities
• Address both visible barriers and the invisible wounds that keep people isolated
• Choose solidarity and dignity over charity and pity in every interaction

When we succeed in addressing both the structural need for housing and the human need for connection, we honor our deepest values while achieving our practical goals. We don’t just end homelessness—we restore lives, strengthen communities, and demonstrate that compassion and effectiveness are not opposing forces, but partners in creating lasting change.

The solution isn’t complex: People need homes, and they need community. Our commitment to centering both reflects not just what research tells us works, but who we are as people of conscience. This is our foundation. This is our calling. This is how we build something better.

Our commitment to relationship-centered housing support reflects our understanding that every person deserves not just shelter, but the opportunity to rebuild their life with dignity, support, and hope.

Want to Learn More?

We’re excited to share this research with you! If you’d like to dive deeper into the studies and reports that inform our approach, we encourage you to explore the sources listed below. These researchers and organizations are doing incredible work to understand what truly helps people not just find housing, but build stable, fulfilling lives. Feel free to reach out if you have questions about any of these findings—we love talking about what the evidence shows works best for the people we serve.

We encourage you to read the research for yourself. The links below will take you directly to the original studies and reports. There’s something powerful about reading researchers’ own words and seeing their data firsthand. These studies represent years of careful work following real people through real experiences, and they offer insights that can only come from rigorous, peer-reviewed research. Whether you’re a practitioner, policy maker, donor, or community member, these sources provide the foundation for evidence-based approaches to ending homelessness.

References

Adair, C. E., Kopp, B., Distasio, J., Hwang, S. W., Lavoie, J., Veldhuizen, S., ... & Streiner, D. L. (2021). Housing first, connection second: the impact of professional helping relationships on the trajectories of housing stability for people facing severe and multiple disadvantage. BMC Public Health, 21(1), 1-14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7847021/

Dwight, S. (2024). Community beyond resources. Stanford Social Innovation Review. https://ssir.org/articles/entry/homelessness-solutions-beyond-housing

Friesdorf, R., Ta, M., Amiri, A., Hwang, S. W., Stergiopoulos, V., & O’Campo, P. (2022). Health and social outcomes in the Housing First model: Testing the theory of change. Social Science & Medicine, 299, 114881. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9046122/

Kirst, M., Friesdorf, R., Ta, M., Amiri, A., Hwang, S. W., Stergiopoulos, V., & O’Campo, P. (2020). Patterns and effects of social integration on housing stability, mental health and substance use outcomes among participants in a randomized controlled Housing First trial. Social Science & Medicine, 265, 113481. https://www.sciencedirect.com/science/article/abs/pii/S0277953620307000

National Alliance to End Homelessness. (2025). Housing First. https://endhomelessness.org/resource/housing-first/

Putnam, R. D. (2000). Bowling alone: The collapse and revival of American community. New York: Simon & Schuster. https://archive.org/details/bowlingalone00robe

Roggenbuck, C. (2022). Housing First: An evidence review of implementation, effectiveness and outcomes. Australian Housing and Urban Research Institute Limited, Melbourne. https://www.ahuri.edu.au/research/research-papers/housing-first-an-evidence-review-of-implementation-effectiveness-and-outcomes

Stergiopoulos, V., Hwang, S. W., Gozdzik, A., Nisenbaum, R., Latimer, E., Rabouin, D., ... & Goering, P. N. (2014). Housing First: exploring participants’ early support needs. BMC Health Services Research, 14(1), 1-11. https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-14-167