HONOLULU (KHON2) — Whether homeless are from Hawaii, or moved here without a place to live, the help they can get is undergoing significant change. What’s working? Always Investigating followed up on the crisis on the streets.

A change in approach is bringing state, county and nonprofit efforts together to address the root causes of homelessness, but a shortage of shelter and affordable living space remains a roadblock.

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We see it across the state: more people living outside in more places, without shelter, clean clothes or adequate food.

“We don’t need to be homeless to experience the housing crisis,” said Trish La Chica, executive director of the Mayor’s Office of Housing for Honolulu County. “The perception is that there is an increase in homelessness and a rise what is visible encampments.”

Service providers that do an annual point-in-time count found a 7% increase in unsheltered homeless across the neighbor islands since the last pre-pandemic survey in 2020. The Oahu count comes out next month

“We’ve seen a shift over time,” explained Connie Mitchell, director of the Institute for Human Services. “Before when I first started many years ago, there were more people in shelters than unsheltered. But now we see more people unsheltered.”

Part of the reason is a gradual decline in shelter space over the years on Oahu, coupled with a growing affordable housing crisis for all families.

“We do need more shelter space, and that is a priority for the city,” said Dr. James Ireland, director of the Honolulu Emergency Services Department. “We are entertaining various models, including having more nonprofit support for shelter space. We also discussed having a city shelter that is city-run and funded. I think everything’s on the table.”

Short of restoring shelter beds, there are things that are working now, such as Crisis, Outreach, Response and Engagement, the city’s EMT-based effort to handle homeless issues.

“It’s connecting them to medical services, addiction and mental health services,” Ireland said. “And really trying to reduce 911 calls and our pressure on the police and EMS ambulance units.”

Concerned neighbors and businesses — even the homeless themselves — can call CORE (808-768-CORE) along with or instead of the cops or an ambulance. A converted parks building gives CORE a headquarters in the heart of Chinatown, where they say the volume of homeless has come down 50% to 75% in just a few months. A second location is coming to Iwilei.

“We have now teams going to Waikiki. We went to Windward Oahu recently,” Ireland said. “We’re going to be going to Waianae on the west side on Friday of this week, and then probably next month starting to go to the North Shore in Central Oahu.”

Another program that works is HONU, launched by the Honolulu Police Department.

“You don’t see this in the rest of the nation where police officers play a role in housing navigation, and providing that compassionate approach,” La Chica said, “But one individual had been living under the Nimitz bridge for 30 years, went into HONU and finally got into a place he could call home.”

IHS is stepping up efforts to help combat the drug use and mental illness that keeps so many in the cycle of homelessness and contributes to violence.

“We are going to court to get guardianships, and to get assisted community treatment orders,” Mitchell said. “We are applying for more of those and we’re trying to increase the number of people that were actually medicating.”

HIS has gotten more than 40 people onto medications, nine into guardianships and 14 into treatment. CORE plans to a hire a psychiatrist and nurse practitioners with this background, too.

“I think potentially that can prevent people from becoming unstable in the community, and we see in acute psychosis to see these violent acts,” Ireland said.

The multifaceted and symptoms-based approach is a big switch from a “Housing First” effort that dominated policy in recent years.

“Housing First is still important, and we are still doing that,” La Chica said. “But a clear focus for this administration is looking at it from a systems perspective. In terms of systems, we know that providing an apartment alone or a shelter alone is not enough.”

Finding the homeless permanent housing they can afford and hang onto is the ultimate goal, and it’s a requirement in state contracts with service providers.

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“Before we started putting those metrics into place, only a third of people exiting homeless services moved into permanent housing placements,” said Scott Morishige, the governor’s homelessness coordinator. “Now it’s well over 50%.”