This is one of three supporting documents connected to Vital City’s recommendations on serious mental illness and homelessness, “What To Do (and Not To Do) About People in Crisis on Streets and Subways.” Find "How the System Works (or Doesn't)" here and "What the Data Show" here.
A primary recommendation of the Vital City report relating to people living on the street with serious mental illness and other afflictions is rooted in a housing-led approach. The evidence that such an approach can work is strong.
But this kind of proposal has met strong skepticism, focused on the city’s extreme housing shortage, the severity of needs and government’s limited agility in executing complex operations. We looked at three global cities that have more successfully addressed homelessness to understand whether the conditions that enabled progress there could be replicated in New York City. Each of these cities has starkly different cultures, programs, laws and governance structures. Yet they all arrived at successful solutions toward ending street homelessness. There are some important lessons that can be applied to New York City.
Helsinki
Finland is a strong social welfare state with a broad commitment to a high standard of living for all its residents. That includes benefits that support families with children, universal health care, education and basic income security. In fact, the Finnish Constitution includes the duty of the government to support each person’s right to attain housing of their own choice.
Despite these offerings, Finland experienced a significant surge in homelessness toward the end of the 20th century, driven by an urban housing squeeze that failed single adults, an economic crash and the rapid downsizing of psychiatric institutions without enough community housing and support to absorb people. Helsinki, the capital, with a population of 650,000, initially addressed the need through opening significant new shelter capacity and a progressive staircase approach to moving people from the streets to shelter, then working on housing from there. This initially cut street and shelter homelessness in half (from roughly 4,000 to under 2,000), but saw far less progress in reducing the number of people staying in shelter. Fifteen years in, even the decline in street homelessness stalled.
In 2008, the national government abandoned the shelter-centric approach and pivoted to a housing-led solution, including a commitment to bypass shelter and convert those resources and facilities to housing.
Many people experiencing long-term homelessness have co-occurring serious mental illness and substance use disorders. Helsinki paired a normal lease with on-site or mobile mental health and substance use disorder interventions, tenancy sustainment and harm reduction practices. Research shows that the stability of housing improves the likelihood that these kinds of services would help a person succeed. Finland’s Y-Foundation found that the basics of stable housing — a fixed address, privacy and “domestic peace” — reduce crisis and make it more feasible to manage medications, keep appointments and build routines, making health and social problems easier to address. A frequently cited Finnish estimate finds up to about €15,000 saved per person per year in reduced emergency health, social services and justice costs.
Civic health improved as neighbor-relations teams mediated conflicts and prevented disturbances with landlords by applying casework services that were available on call, around-the-clock before crises spilled into the streets. This further contributes to reducing visible street homelessness and helps make public spaces feel calmer.
As shelters and hostels in Helsinki were phased out or converted into permanent housing, the city went from roughly 600 shelter beds in 2008 to one permanent emergency center with just 52 beds by 2019. Between 2008 and 2022, there was a 68% reduction in the total number of people experiencing homelessness in the capital, with street homelessness becoming a rare occurrence.
Tokyo
Japan’s welfare culture is rooted in moral obligation rather than in individual rights or entitlement. It reflects traditions that emphasize family and community responsibility over state dependency. Social-service programs are generally rooted in work requirements, and the stigma of receiving public benefits remains an enduring challenge to connecting to people in need. Japan’s welfare state is often described as “productivist” — designed to support economic participation rather than to provide universal coverage.
Within this context, Tokyo also experienced a rapid increase in street homelessness in the late 1990s, primarily driven by unemployed single men brought about by Japan’s economic collapse. The number of people living rough in Tokyo (a city of 14 million) peaked at 5,798 in 1999. Since then, street homelessness has declined dramatically. Official counts (conducted by visual daytime surveys) found 565 people living on the street in January 2025.
In 2002, Japan passed its first Homelessness Act, defining homelessness simultaneously as a human rights concern and a public-space challenge, with a high degree of expectation on those who are unhoused to take actions to overcome their own homelessness. In the years that followed the release of the Act, authorities cleared encampments from parks and riverbanks, motivated by a wide public demand for public access to shared spaces. These actions, however, were paired with a strong sense that public welfare should be deployed to support people through housing and services as essential to solving street homelessness.
Like New York City, Tokyo government policy focuses on shelter for street homeless individuals. However, once a person has completed intake, there is great urgency to ensure national benefits and housing assistance are achieved quickly. This is enabled by a broad definition of eligibility. A person identified as unhoused is deemed automatically eligible for a comprehensive package of rental support, cash assistance and case management. Decisions about public assistance are generally made within 14 days; under the law, they must be completed within 30 days.
Tokyo treats housing as the first intervention; rent is paid as an automatic part of assistance to cover time-limited rent and stabilize people in ordinary apartments through local welfare offices. Behavioral and medical health help complement housing, but getting them is not a prerequisite to accessing housing resources.
It is important to note that, simultaneously, Tokyo continues to rely on institutionalization of the mentally ill; Japan has a national capacity of 324,000 beds (a rate of 258 per 100,000 people, compared with 35 per 100,000 in the United States). This likely means the street homeless population there has less acute needs than we experience in New York, and accessing care when a severe level of need arises is comparatively easier.
Houston
The social welfare culture in Houston (population 2.4 million) — and more broadly in Texas — reflects a market-oriented, individualistic and charity-driven ethos, rooted more in local initiative and private responsibility than in strong government provision. In January 2011, Houston’s point-in-time count found 8,538 people homeless with over half unsheltered (4,440). This was a 25% increase from 2010.
In response, the Coalition for the Homeless of Houston, the local entity responsible for receiving and dispersing federal homeless funding, began a coordinated effort to address the crisis. In 2012, they created a community plan that became the backbone of The Way Home, with a focus on ending homelessness through permanent housing with supportive services.
The Way Home was made up of more than 100 partners — including homeless service agencies, local governments, public housing authorities, the local Veterans Affairs office and other nonprofits and community stakeholders. The plan itself is driven by a desire to spend any available funds on housing rather than shelter.
In 2014, then-Mayor Annise Parker publicly backed the effort, committing her political capital to reducing homelessness despite having little role in service delivery, which was provided through an independent nonprofit and the charitable sector. By addressing homelessness as a priority and invoking shared community responsibility, the mayor set the foundation for coordinated business and philanthropy investment in homelessness solutions.
To achieve its coordinated approach, Houston stood up a single point of coordinated access, adopted a common assessment tool, worked from a single by-name list and clarified who was accountable for outcomes across dozens of providers, with the Coalition as lead agency.
Coordination with police and the behavioral health system was also instrumental in its success. Harris County’s Judge Ed Emmett Mental Health Diversion Center steers low-level cases to treatment. Clinicians are embedded in Houston’s 911 call center through the Harris Center’s Crisis Call Diversion. They route these calls to a mix of clinician-only and clinician-with-police-officer teams for on-scene crises, depending on the severity of the conditions reported by the caller. In 2024, the system diverted 5,033 calls from police/EMS, and rapid response teams resolved 84% of these calls without law enforcement. The Harris Center’s Crisis Intervention Response Teams co-respond with the Houston Police Department or Harris County Sheriff’s Office for behavioral health calls, doing assessment, safety planning and transport to treatment, not jail, whenever public safety considerations allow. An independent evaluation found participants were significantly less likely to be rebooked, and the county avoided about $5.54 in jail costs for every $1 invested.
The Houston Recovery Center’s Sobering Center is a standing alternative to address public intoxication. It has saved roughly 37,000 officer hours, letting police focus on priority crime while people sober safely and get connected to treatment.
This same broad coalition of partners was able to quickly step up to meet needs during the COVID-19 pandemic, which further reinforced the strength of the coordinated response. The City of Houston and Harris County, together with the Coalition, launched a two-year, $65 million Community COVID Housing Program that accelerated permanent placements and paired them with encampment “decommissioning through housing,” not enforcement alone. The partners later extended the effort with additional funding and formalized a playbook.
Texas adopted a statewide public-camping ban in 2021. Since then, the city has decommissioned more than 90 encampments, with about 90% of these individuals moving into housing. Fewer encampments have meant less police involvement and fewer criminal citations. The city pointed to a coordinated, housing-first pipeline that reduced visible encampments and delivered durable results.
The results are visible and sustained: More than 32,000 people have been housed since 2012, roughly 9 in 10 still stably housed two years later, and a sustained drop in overall street homelessness (down 75% to 1,100 in 2024) has made Houston a national reference point even through storms and leadership changes. This happened because the region centralized decisions, shared data and stuck to one objective across City Hall, the county, providers and the business community.
Translating these successful models to New York City
Given the policy, legal and cultural differences, this multicity review shows that cities do not need a single set of preconditions to overcome street homelessness. It has been achieved in places with different social welfare philosophies and benefits, and different motivations for their actions. What is common among them is the commitment to collective action through an approach that moves away from shelter-centric strategies and prioritizes, wherever possible, the swift movement of people from the street into stable housing with necessary supports.
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