Policy, Services, and Quality Standards for the Care of Street Dwellers: An International Review


Until the late 1980’s, the services offered to street dwellers in various countries around the world were primarily ad hoc and designed to provide a short-term response to the problem. In the 1990’s, in view of the growing population of street dwellers worldwide, the focus shifted to comprehensive rehabilitation programs designed to take the street dwellers off the street and provide them with intensive rehabilitative care. In the early 2000’s, programs increasingly focused on housing solutions and prevention. In recent decades, policy makers across the globe as well as researchers and academics have been debating the issue, looking for the most appropriate and effective services in response to the needs of the population of street dwellers. Two distinct approaches have emerged in the discourse – the linear approach, which is in favor of graded rehabilitative care that ultimately leads to independent housing, and the housing first approach, which advocates a permanent housing solution as the first step in dealing with the problem of street dwelling.

In Israel, the phenomenon of dwelling in public places is rather new, first encountered in the early 1990’s. In 2019, the percentage of street dwellers was estimated at around 0.03% of the general population in Israel. The policy adopted by the Israeli authorities is based on the linear approach, offering well-structured, graded rehabilitation care programs for street dwellers that respond to their needs and ultimately, provide them with independent housing. However, in recent years, programs based on the housing first approach have also been raised for discussion.

In August 2020, the Court Assistance and Correctional Administration at the Ministry of Labor, Social Affairs and Social Services asked the Myers-JDC-Brookdale Institute to evaluate the current policy regarding the population of street dwellers, the services provided in response to their needs, and the quality standards of the services provided.


The goal of this review is to examine the current policies and the services in place across the globe for the population of street dwellers. The review aims to shed light on the following questions: (1) What are the characteristics and needs of the population of street dwellers? (2) What are the approaches adopted to address the needs of the street dwellers, and what are the types of services provided in response to their needs? (3) What are the quality standards of the services provided to the street dwellers?


The review is based on various national and international information sources. The international scientific literature has been reviewed to examine how street dwellers are defined and how the phenomenon is explained, and to explore the characteristics and needs of the street dwellers as described in the literature. Policy papers of international organizations have been reviewed as well as governmental policy papers of Canada, Australia, Finland, and Sweden, which reflect various approaches to the care of the street dwellers and policy changes over time. Finally, comparative studies of the issue have been reviewed as well as documents setting forth quality standards for the care of the street dwellers in the following English-speaking countries: Australia, Ireland, and the USA. Data collection for this review was done from September to December 2020.

Findings and Conclusions

The street dwellers form a heterogenous population with various complex needs (health, employment, and personal needs). Studies show that the housing first approach is more effective in securing a long-term housing solution and works best for street dwellers with mental disability while the linear approach is advantageous in preparing street dwellers for the move to independent housing and is especially suitable for those with substance abuse problems who seek rehabilitation and are capable of coping with shared housing arrangements. An integrated course of action is thus recommended where the two approaches are differentially applied to meet the needs of the targeted population.

As for the quality standards for the care of street dwellers, the countries reviewed adhere to commonly accepted standards with regard to both the overall care and the specific services provided. Overall services are guided by generally applied standards: (1) collaborating with service recipients in the process, providing them the opportunity to voice their position, thus enhancing their commitment to the process to the extent that they are willing to take part in the process; (2) offering integrative support services coordinated to encompass the range of services needed by the street dwellers; (3) implementing early intervention and prevention programs designed to reduce chronic street dwelling; (4) hiring high-quality, responsive professionals adept at dealing with the diverse needs of the street dwellers and tailoring customized services that address their unique personal needs.

Dedicated services provided in specific settings are guided by variously focused standards: (1) In emergency facilities, where street dwellers are offered short-term services, e.g., food and shelter, standards are focused on infrastructure and physical conditions as well as on administrative aspects and code of conduct. (2) In long-term, transitional housing facilities offering provisional housing solutions for extended periods of time along with support at varying levels of intensity, standards are focused on the threshold conditions, the payment required, the length of stay, and the support programs in place. (3) In supportive permanent housing facilities, which provide permanent housing solutions along with individual support services, standards are focused on the rental terms and accessibility to community-based