Samantha Batko contributed to this post.

What is it like to sleep squeezed in the backseat of a car? What is it like for a 4-year-old?

Darlene, a mom who has spent many months homeless, told me about her experience living in a car with her 4-year-old son. Each night, they would drive around San Francisco looking for places to park—places where they would go unnoticed but that weren’t so isolated that they would be at risk of harm. Sometimes, when they could afford to, they stayed in cheap motels. But most nights, they had to sleep in the car.  

One night, Darlene’s son, Max, reached his breaking point. She told me, “We were driving by the motel, and he says, ‘I wanna sleep in a bed. I wanna sleep in a bed,’ and he was just screaming it on the top of his lungs. ‘I wanna sleep in the bed!’ And he kinda just screamed himself to sleep.” 

Darlene had reached her breaking point, too. She looked at her young son, who hadn’t taken a bath or shower in a month and had been living on Goldfish crackers. Desperate, she decided to end his homelessness by calling child protective services on herself in the hopes of getting help. She promised Max he would sleep in a bed, even if it meant she couldn’t be there with him. “I was just stuck,” she told me, as her voice cracked.

I could see how the stress had taken a toll on Darlene. Homelessness is a punishing and traumatic experience for parents. And new research tells us that for children, particularly young children, it’s the type of toxic stress that lingers, affecting development and health outcomes later in life. 

Children younger than 4 who experience homelessness, either prenatally or after birth, are at increased risk for adverse health outcomes and higher health care utilization. This research, conducted by Dr. Megan Sandel and colleagues, found that at this critical moment in children’s development, “there is no safe time” to experience homelessness, and longer durations of homelessness can make outcomes worse.   

This evidence on how homelessness affects children suggests policymakers should be doing everything possible to prevent homelessness and, when families who do lose their housing, to help them exit homelessness and stabilize in housing quickly. Rapid re-housing (RRH) can help homeless families in crisis.

How rapid re-housing helps people exit homelessness

RRH provides housing search services, short-term housing assistance, and case management services to help people exit homelessness. Our recent review of the evidence concludes that RRH helps families exit shelter faster than they would exit on their own.

A US Department of Housing and Urban Development study completed by Abt Associates found that homeless families assigned to RRH exited shelter two weeks quicker than those who left on their own. Shelter exit was even quicker for families who were assigned to and accessed RRH assistance. 

Providing RRH costs about $4,000 less than leaving families to exit homelessness on their own. Emergency shelter is expensive, and there isn’t a clear way to exit without assistance paying rent. While many families remain stuck in emergency shelter, they use a lot of costly services.

Research shows that most families who receive RRH assistance do not return to shelter and are more likely, compared with families receiving usual care, to be living independently in an apartment with a lease. Like many low-income families after their assistance ends, they may struggle to afford the rent.

But RRH disrupts homelessness so that children like Max don’t have to sleep in cars and parents like Darlene don’t have to separate from their children to get the help they need. It’s possible that RRH assistance could have helped Darlene and Max avoid separation and foster care. 

The importance of helping families exit homelessness as quickly as possible

Darlene and Max’s story took a positive turn. With the help of child protective services, Darlene connected with a supportive housing program (which provides ongoing assistance for housing and supportive services for families involved in the child welfare system), earned her GED, and got Max back. It took five months, and during that time, she visited Max frequently in foster care.

When I talked with her, they were living in a one-bedroom apartment with a cat and a view of the hills of San Francisco. But they were still struggling. Max was bullied at school and was being treated for attention-deficit and hyperactivity disorder, and Darlene wasn’t sure how safe the neighborhood was for them. But she was in a better place. When I asked her about her outlook for the future, she said, “You can’t fall off the ground. I’m already on the ground.”

We still have a lot to learn about RRH: how to make the program work best in tight rental markets, how it affects the number of people the homeless crisis system can serve, and how it affects a community’s homelessness rates. As researchers tackle these questions, the evidence we do have shows that policymakers should expand RRH. The program model served 90,000 people in January 2017, but there isn’t enough RRH to respond to all homeless families in crisis.

Expanding RRH assistance should also coincide with efforts to increase overall supply of affordable housing, which would help prevent homelessness from occurring in the first place.

RRH can disrupt homelessness for children, and as Darlene and Max’s story demonstrates, rapidly re-housing children to help them exit homelessness as soon as possible is an important step toward finding stability and avoiding long-lasting consequences.