Friday, December 27, 2013

More on homelessness

7 am, Christmas morning 2013, San Francisco
After I put up a post two days ago with photos of some of San Francisco's unhoused residents, a friend raised issues about the way we think about these folks -- especially about our assumptions that "homelessness" is a consequence of pushing people out of mental institutions or results from addictions. She referred me to the National Coalition for the Homeless and particularly to their factsheet "Why are people homeless?"

Mental Illness: Approximately 16% of the single adult homeless population suffers from some form of severe and persistent mental illness (U.S. Conference of Mayors, 2005). Despite the disproportionate number of severely mentally ill people among the homeless population, increases in homelessness are not attributable to the release of severely mentally ill people from institutions. Most patients were released from mental hospitals in the 1950s and 1960s, yet vast increases in homelessness did not occur until the 1980s, when incomes and housing options for those living on the margins began to diminish rapidly. According to the 2003 U.S. Department of Health and Human Services Report, most homeless persons with mental illness do not need to be institutionalized, but can live in the community with the appropriate supportive housing options (U.S. Department of Health and Human Services, 2003). However, many mentally ill homeless people are unable to obtain access to supportive housing and/or other treatment services. The mental health support services most needed include case management, housing, and treatment.

Addiction Disorders: The relationship between addiction and homelessness is complex and controversial. While rates of alcohol and drug abuse are disproportionately high among the homeless population, the increase in homelessness over the past two decades cannot be explained by addiction alone. Many people who are addicted to alcohol and drugs never become homeless, but people who are poor and addicted are clearly at increased risk of homelessness. Addiction does increase the risk of displacement for the precariously housed; in the absence of appropriate treatment, it may doom one's chances of getting housing once on the streets. Homeless people often face insurmountable barriers to obtaining health care, including addictive disorder treatment services and recovery supports.

Or, less formally, people listening and responding to voices that don't exist for the rest of us are terribly visible on the streets, but they are not all or even most of people without housing -- only the most obvious. A fraction of homeless people are addicts, but that is more a condition that makes their poverty harder to overcome than a precipitating cause of their loss of shelter. This certainly fits what I've seen among precariously housed people I've known; several seemed to become drunks as their lives collapsed on the street rather than being on the street because they drank.

No one denies that these folks need a wide variety of forms of help, but none of that is likely to do much good until people have secure housing.


Rain Trueax said...

It will be interesting to see how Phoenix's experiment works in the long run. They had (I think) 1/4 of their homes unoccupied due to foreclosures. If they give them or even rent quite cheaply those homes to homeless people, will they then take care of them and raise themselves up? We have all seen housing that is not cared for (and it's not cheap keeping up a house as anybody who has one knows). I am not convinced at all that getting everybody into free homes will solve the reason they are out there. I am thinking of the guy we saw at the rest area with his sacks, blankets and dog, as he just sat there with people giving him money. I would bet he was a veteran as it would be the right age. Is he someone that if he was handed keys to a home, would be able or want to care for it? SF, if it wants to do such a thing within the city, needs somebody to leave as they don't have that many vacant properties.

The mentally ill can get into group homes but again that takes coordination by some government agency to be sure they are not being taken advantage of or even abused.

I don't think this starts with a house as many had a house and lost it due to unemployment, illness or their own unwillingness to use what money they had wisely.

What kind of costs did you figure it would be to take the homeless today and get them into homes. Habitat for Humanity does some of that with building homes for families but that's generally poor families not those homeless men you photographed or that I saw outside that rest area. It's a good group though to donate to or volunteer with as they do build homes-- one family at a time. I wonder though what their long term results are. I've never looked as often there is a reason the home was originally lost.

I've known several people who were one accident away from homelessness. They often had no skills/ability to earn money in our culture. They were country folk though and that probably is very different for the ability to find a shack they can live in. Cities have codes. Out here nobody looks to see if the property is maintained either with fines if it wasn't. Lucky for us since our front and back yards, just outside the cat yards, are sheep pastures ;)

Hattie said...

All I can say for sure from my own observations is that Sweden has eliminated homelessness as a social problem. They meet people's needs while providing adequate aid and supervision.
Why couldn't we put in localized pilot programs to copy the Swedish model?
Homelessness is just the most obvious manifestation of widespread poverty. Most poor families put together enough resources so members can stay off the streets, but it is a tough struggle.

janinsanfran said...

Sandra passed along this comment: "For some reason, I was not allowed to comment on the blog site itself. The FAQ is wrong. People were not released onto the street in the 50s and 60s. That didn't begin until the 70's. Not to say some people didn't end up on the street in the 50s and 60s, but hoards were released when the laws changed in the 70s."

Rain Trueax said...

Actually according to this site-- -- there are over 17,000 homeless in Sweden and 3 million in Europe. It's a worldwide problem. The issue is what do we do about mental illness which can be the cause? Do we force them into shelters? I've heard some say those shelters are dangerous. Oregon has homeless camps and I haven't recently heard the violence rate but this is NOT a simple problem because there is this sense of fairness, liberty and unwillingness to force people. Years ago vagrants got arrested (I know this from my father-in-law in Douglas Arizona lol) That was the Depression when people rode the rails and he came from a family that was forced into migrant labor and then his own kind of vagabonding years. (When I knew him he was like Fred Astaire for the total gentleman but I've seen the early pics and believe the stories).

I think a lot of us want to find answers but the question is what helps with such a diverse society and we have magnified it by the wars that left so many damaged mentally. I thought we learned after Vietnam but we haven't and Dem or Repub, it's the same for ongoing wars and then the damage it leaves behind.

Rebecca said...

Hattie -
You are so right about Scandinavia. I teach Ethics in San Francisco, and one of the issues we look at is housing and homelessness. A couple of years ago I had a student from Norway. Knowing what the answer would be, I asked him in front of the class, "How does Norway deal with the problem of homelessness?"

My student looked puzzled. He paused, then answered, "We don't really have any homeless people in Norway." My U.S. students were shocked.

They have grown up assuming that some part of our population always have been and always will be living with homelessness. In fact, widespread homelessness is a relatively recent phenomenon in this country, beginning with changes in funding for Housing and Urban Development under the Reagan administration in the 1980's.

BTW, certain groups of people are greatly over-represented among people living with homelessness, including African Americans, and especially shamefully, combat veterans.