Sobriety first, housing plus

Chris Megison has worked with the homeless for nearly three decades. He and his wife, Tammy, helped thousands of men get off the streets, find employment, and earn their way back into society. But it was a volunteer stint at a winter emergency shelter for families where they saw mothers and babies sleeping on the floor that gave them the vision for their organization Solutions for Change. The plan was far from traditional: Shelter beds, feeding programs, and conventional human services were replaced with a hybrid model where parents worked, paid rent, and attended onsite workshops and classes in what became known as Solutions University. The model blends sobriety, counseling, housing, educational opportunities, employment training, and health care.

“If you go back to the tenements of the 1950s and 1960s, that was a failed social experiment — people got in but they couldn’t get out,” Megison said in a phone interview. “The ‘housing first’ model builds on this same system. They’re behind doors, but they’re still suffering. We call it ‘The Churn.’ About 80 percent return to the streets because they’re dependent on drugs.”

Megison says sobriety is the key to success. “Homelessness is a symptom of an underlying set of root issues — past trauma and addiction. In my 27 years working with the homeless, it’s the biggest issue. If we don’t treat the symptom, it won’t work. We are ‘sobriety first, housing plus.’ We don’t like shelters either; we help 500 people a day and the majority spend less than 90 days in a shelter. We have built 200 units of housing in Northern San Diego so far — most are three to a unit, moms with kids.”

Solutions University, the Megisons’ award-winning concept for helping families in crisis, utilizes a comprehensive, holistic approach. “The people we help have lots of traumas,” Megison says. “Family of origin, abuse, mental health issues. . . . Once they get sober, we work with them on those traumas. Then they can get jobs and keep jobs.”

One of the other keys to success is the length of the program. “It’s a three-year commitment,” Megison explains, “and they’re employed within six months. We have moms in medical assisting making $25 an hour; we do a lot to help them get higher wages. That’s the only way they can survive and take care of their families.” The success rate is astonishing: 74 percent who make it to the 500-day mark and 93 percent who get to the 1,000-day mark transition to off-campus housing. “Once you do a thousand days . . . I know that sounds like a lot to politicians, but you usually don’t become homeless again. Something happens at a thousand days,” Megison says.

Asked what he thinks about San Francisco’s homeless crisis, Megison says even he couldn’t solve it unless the city’s leaders had a dramatic change in thinking. “It’s so entrenched in the societal system. . . . Not only have I watched from San Diego over 20-plus years how it’s devolved; my kid lives there and gives me a play-by-play. Friends who live there are begging me to come help but the leadership is all in [on the current system], so there’s not much we could do.”

RIGHT INTENT, WRONG DESIGN

Besides the fact homelessness is deeply entrenched in San Francisco’s culture, the path taken by city leaders like Jeff Kositsky (director of the Department of Homelessness and Supportive Housing) will never produce a successful result, according to Megison. “Even if he has the right intent, it’s the wrong design. San Francisco is the leader in executing on the wrong design. At some point he has to think, Look, we are losing this war and we are spending over $300 million, and he should start to question that. Add private donations and state and federal funding, and you’re probably pushing a billion dollars spent on homelessness in San Francisco. There shouldn’t be a single person left in that city who says it’s about more money.”

As for the dozens of nonprofits paid millions of dollars to help solve homelessness in San Francisco, Megison says bluntly, “It’s obviously not working. We refer to it as the ‘homelessness industrial complex’ — so who’s making the money here? These nonprofits are incentivized to not solve it; this has grown into a monster with a lot of dependents. Many nonprofit CEOs, when off the record, will say they’re just managing the system and trying to contain homelessness. And they can’t even contain it any longer. San Francisco wants the homeless behind doors, but it’s so bad up there even that can’t be done. The drugs are so linked up there; they try to uncouple it, but that’s absolutely the wrong design. One of the biggest mistakes is thinking these folks can survive 30 years of addiction, trauma, and abuse and you can solve their problems in 30 days, or by putting them in housing where counseling and sobriety and job training are optional. San Francisco has fallen into the trap where instead of doing the work they’re just putting them behind doors. At Solutions, we grab that other bootstrap and say, ‘Let’s do this thing called life.’ But if you let them keep doing drugs and don’t deal with past traumas and don’t get them employed, then you’ve got The Churn.”

HAVE NOT, CAN NOT, WILL NOT

While mental illness is a problem on the streets, Megison believes city leaders pump up the numbers, based on what he calls the three parts of homelessness: Have not, can not, and will not. “After three decades in the trenches, I see about 10 to 12 percent who are truly severely mentally ill — they are the ‘can nots’ who need the most services. Politicians will try to tell you it’s more like 40 percent, and that’s because they want to convince people there are more ‘can nots’ so therefore ‘we must’ give them more. Then there are the ‘have nots’ — they’ve had some really bad luck and just need help getting back on their feet. So the ‘will nots’ are about 80 percent of the population — the ones with substance problems, committing crimes, who will not change unless you do the intervention. We create an old-fashioned sense of community where there is accountability. In San Francisco sobriety and working are optional — accountability is a dirty word. Now you’ve lost.