The voices of Urban Institute's researchers and staff
December 16, 2011

Services For Vulnerable Families Aren’t Luxuries

December 16, 2011

Last month, I wrote about how residents of isolated, high-crime public housing projects pay a price in trauma, substance abuse, physical debility, mental illness, chaotic family lives, and lives lost to violence. These families often need on-going services and supports so they can manage multiple challenges and create the stability children need to thrive.  But services such as case management, mental health and substance abuse counseling, job readiness, child care, and after school programs don’t come cheap, and, as budget pressures mount, supportive services for the most vulnerable families can seem like luxuries that strapped government agencies can’t afford to provide.

Given fiscal constraints, policymakers are demanding evidence that the programs they do fund to help the most vulnerable demonstrably improve such specific outcomes as employment or school performance—a standard that is very difficult to meet. Yet, the benefits of providing high-quality services may be modest and often come from a range of systems, whether, schools, housing agencies, criminal justice, and healthcare. For example, our study found that intensive case management for public housing residents stabilized their physical and mental health. But any cost savings from these gains would benefit Medicaid, not the housing authority that paid for the case management and, since these residents still suffered high rates of chronic disease, the cost savings were likely to be small.

If less than spectacular results trouble you, though, consider the costs of doing nothing — vulnerable children ending up in emergency rooms, homeless shelters, and jails, failing in schools, and disrupting their communities with their antisocial behavior.  Also don’t forget that the families who lived in distressed public housing in many cities until a decade ago bore the brunt of misguided federal and local policies that isolated poor, minority households in neighborhoods with inadequate services and high crime rates. That didn’t happen to the middle class, which has its own problems but seems to be getting all the policy attention as the next presidential campaign year nears.

Beyond that, communities need new and innovative approaches for reaching children and youth and preventing another generation from falling into the type of deep poverty that is so hard to overcome. Promising directions include comprehensive community initiatives like the Obama administration’s Promise and Choice Neighborhoods Initiatives, models that emphasize home visiting and support for families with young children, and new models like the new HOST Demonstration that is using housing as a platform for services for children, youth, and adults.

Meanwhile, even staunch budget hawks should think twice before characterizing the absence of violence, sickness, crime, and instability in children’s lives as “luxuries.”

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