New PSU-OHSU Study Charts the Complex Paths of Homeless Residents in Multnomah County

A collaborative report released by Portland State University’s Homelessness Research and Action Collaborative and the OHSU-PSU School of Public Health provides the most detailed look yet at how people experiencing homelessness move through the system in Multnomah County.

The study, titled “Without…,” draws on interviews, case records and field observations to trace the day‑to‑day decisions, setbacks and coping strategies of individuals as they seek shelter, services and, ultimately, stable housing. Researchers found that journeys are rarely linear; many participants cycle through multiple shelters, temporary accommodations and informal arrangements before securing permanent residence.

Key findings highlight the role of fragmented service networks, limited affordable housing stock, and the interplay of health challenges—particularly mental health and substance‑use issues—in shaping each person’s trajectory. The report underscores that even when assistance is available, timing, eligibility criteria and bureaucratic hurdles often delay progress, causing people to fall back into street or couch‑surfing situations.

Contextualizing the data, the authors note that Multnomah County, which includes Portland, has long grappled with a housing affordability crisis and a rise in unsheltered populations. The county’s recent policy shifts, such as increased funding for low‑income housing and expanded outreach teams, are examined against the lived experiences documented in the study.

By mapping these pathways, the report aims to inform policymakers, service providers and advocates about where gaps are most acute. Recommendations include streamlining intake processes, creating more coordinated case management, and expanding rapid‑rehousing programs that can respond quickly to individuals’ changing circumstances.

While the findings paint a sobering picture of systemic strain, the authors also point to examples of resilience and community support that helped some participants transition out of homelessness. The report concludes that a more integrated, person‑centered approach—one that accounts for the fluid and often unpredictable nature of homelessness—could improve outcomes and reduce the cycle of repeated shelter use.