Twenty years ago, “housing first” was all the rage. Its premise is simple: Move homeless people into housing, then provide the services they need to turn their lives around.

The idea got its start in the early 1990s, when it became clear that the then-current model of requiring people to resolve their problems, including drug and alcohol abuse, before moving them into housing, was not working. Too many could make a good start; too few could complete the task.

During the next couple of decades, more and more communities, including Bend, bought into the program and created 10-year plans to end homelessness. Bend’s plan was adopted in 2011, says Colleen Thomas, chairwoman of the Homelessness Leadership Coalition that serves Central Oregon and homeless outreach coordinator at St. Charles Behavioral Health. The coalition updated its plan in 2015.

Unfortunately, homelessness is a pretty complicated problem. Yes, some homeless men and women have mental health and/or substance abuse problems, but not all do. Maybe — though I’m not sure I’d agree — some do want to be homeless.

But in a place like Bend, where about two-thirds of the homeless living among us were housed in our neighborhoods not so long ago, mental health and substance abuse issues are not the only things going on. In fact, there’s no one generic homeless person here, beyond the shared fact that the homeless have no place to live.

Housing is terribly expensive, for one thing, and I have serious doubts about how much, if at all, statewide rent control will help. That’s because a big reason rents are high here is that there are not enough houses and apartments to go around. The problem is exacerbated by the reality that Oregonians have, historically, earned less than their counterparts nationwide.

Meanwhile, time has changed the “housing first” model, and not just in Central Oregon.

It’s clear that for some people, a relatively brief spell with such things as mental health services available isn’t enough. Thus “housing first” has morphed into the continuum of care model, which aims to tailor services to the needs of individuals. That may mean help in a sudden financial crisis and no more than that.

It may also mean permanent supported housing, with mental health and other necessary services, including case management, available for the foreseeable future. As you can imagine, long-term care might be expensive. But money’s not the real problem in Central Oregon, says the HLC’s Thomas. Rather, she believes, the region doesn’t have enough of the kinds of services to do an adequate job for all who need them.

There’s also what may be an unsurprising Not In My Back Yard attitude among too many of us about the homeless. We see the shabby, perhaps downright dirty, woman pushing a cart down the street and wish she would go someplace else.

We do not stop to think that she may be dirty and disheveled because she has no place to clean up, that her cart may contain all her worldly possessions, and she fears that if she leaves them, she’ll lose even those meager belongings. We may also fail to recognize that the biggest difference between her and ourselves is that she lacks the supportive friends and family that help keep us on an even keel.

I worry that this region won’t make serious inroads on its homelessness problems unless the communities in the area get seriously involved in solving those problems. Moreover, unless citizens want that to happen, and let city officials know they do, it may not ever happen.

Meanwhile, there are things cities can to do at least alleviate the problem. They can encourage churches and others to open day shelters, perhaps with money, perhaps with other assistance. They can provide secure storage, out of the weather, for homeless people’s possessions. And, most important, I think, they can remember that it may be nothing more than luck that separates them from the homeless men and women they see every day.

— Janet Stevens is deputy editor of The Bulletin. Contact: 541-617-7821, jstevens@bendbulletin.com