tl;dr: Homelessness is a big, multi-faceted problem in America today. Many people have very strong emotional reactions to “the homeless problem” while knowing very little about it. I cannot claim to be an authority on the topic, but I’ve done some research and some thinking and have reached some conclusions.
Definitions
“Homeless” is a term that means different things to different people. And there is general agreement by most people that there are four different categories of homelessness / homeless people. I’m going to borrow definitions from JOIN and then add my own comments below:
- “Chronically Homeless”: either “an unaccompanied homeless individual with a disabling condition” who has been continuously homeless for a year or more, or has had a minimum of four episodes of homelessness in the previous three years. ... Typically, these individuals are older, have complex, long-term health issues and often live on the street, in a car, park, or other location that is not suitable for human habitation.
- ”Episodic Homeless”: refers to individuals who are currently homeless and have experienced at least three periods of homelessness in the previous year. These individuals are often younger and suffer from some type of disabling condition, such as substance abuse, mental illness, and/or medical problems.
- ”Transitional Homeless”: the most common type of homelessness. These individuals are also likely to be younger and generally enter a shelter or temporary housing system for only one brief stay. This situation could be the result of a catastrophic event or sudden life change.
- ”Hidden Homeless”: often goes unreported and undocumented. These individuals are known as ‘provisionally occupied’ and are experiencing what is known as ‘hidden homelessness.’ This specifically refers to individuals temporarily living with others (or ‘couch-surfing’) without a guarantee that they will be able to stay long-term and without immediate prospects for acquiring permanent housing. This often describes people staying with friends or relatives because they lack other housing opportunities. This population is considered ‘hidden’ because they do not access homeless supports and services, despite their need for them. For this reason, they do not appear in standard homelessness statistics.
(Again, that is all courtesy of JOIN).
Analysis:
- These categories of homelessness are essentially a classification system not unlike a staging system used for cancer. And so, intentionally or not, homelessness is treated as a disease. And as in medicine, the key to successful treatment is early detection and treatment. At least, many people seem to believe this. I have no idea if it is true in any real sense. But the currently accepted categories of homelessness imply that successful treatment involves getting in early to head it off before it becomes worse.
- In keeping with the metaphor of "medicine", the four categories are reminiscent of a triage classification system. More on this below.
- ”Hidden” homelessness is, I think, a bogus but well-intentioned category. Bogus because, coming from an organization that seeks funding, it comes off as a vague excuse for “homelessness is a bigger problem than any of us realizes, so give us money.” Well-intentioned because - like “Episodic” homelessness - it’s an attempt at "early detection and treatment", ie, to target very early-stage homelessness in an attempt to stop it before it gets worse.
- ”Transitional” homeless people are indeed homeless, but can be easily helped. There is typically a lot of grass-roots community support for these people, and you’d have to search damn hard to find anyone opposed to assisting a family who lost their house in a fire, etc. Note that “Transitional” homeless persons do not wear the stigma of drug / alcohol addiction or mental illness.
- ”Episodic” homelessness appears to be the slippery slope which often leads to “Chronic” homelessness. “Episodic” homeless are characterized as younger than “Chronic” homeless. Again, I'll suggest that these categories are essentially a triage mechanism: applying effort and resources to younger “Episodic” homeless persons is considered key to saving them from becoming “Chronic” homeless. I think this is where things begin to get controversial: how much resource, and what kind? And: are we truly able to save people from “Chronic” homelessness? And, sadly, this is the point where substance use and mental illness come into play. Whether they want to admit it or not, many Americans don't really care about helping these people. They simply want them to go away.
- "Chronic” homelessness is - and I know this is cold - the ‘end of the road’. The document I referenced above states that this is 24%-27% of the US homeless population. In terms of triage these are the poor bastards who simply aren’t going to make it. But unlike triage in an actual medical unit, they can’t be sorted off into a corner until they go away. I do not know all of the assistance that is available to the “Chronic” homeless, but my sense is that they are considered ‘incurable’ and that minimal effort goes into truly attempting to help them rejoin society. "Permanent Supportive Housing" (PSH) seems to be the most popular current 'solution': buy cheap hotels and let people live in the rooms and pay support people to keep the place looking nice. This doesn't really seem like a solution to me, but more of a really expensive way to sort them all off into corner until they go away. Note that despite my use of a triage metaphor, these people are not terminal. But they are older and have more issues with mental illness and substance use, and it is unclear whether or not even massive amounts of time or resource could “cure” them.
IMHO, “Chronic” homelessness is the most overwhelming aspect of the “homeless problem” in the United States. Frankly, when mainstream America becomes unhappy about homeless people, these are the people they’re unhappy with: most of the stereotypes about drugs, alcohol, mental illness, petty criminality, and lack of personal hygiene come from this group. No, I don’t have a miracle fix for “Chronic” homelessness. But perhaps this is a problem thatdeserves more attention and resources than it currently receivesis not going to be solved by conventional thinking on the matter. I changed this line when I read that the City of Austin was planning to spend $515 million on homelessness over the next three years. That's for 3,000 people.
Perhaps a lack of resources is not the issue.
Conclusions:
- I feel like American attitudes towards drugs, alcohol, and addiction do not help the effort against homelessness. I am personally willing to consider addiction to be a form of mental illness. But many Americans would disagree, especially when treatment funding comes from their tax dollars[2].
- A final comment on applying the disease metaphor to the problem of homelessness: as I stated above, I do not even know if homelessness is effectively a disease - although it’s probably better than (God forbid) a “war on homelessness” - nor if the principles of Early Detection and Treatment truly apply. But if I’m going to run with it, I’d point out that a lot of modern medicine puts a high priority on simple Prevention. While I see occasional discussions of homelessness prevention, they tend to acknowledge that Something Must Be Done and then move on to assisting people who are facing “Transitional” homelessness. My sense is that Prevention - in the solid, long-term sense that truly wipes “Chronic” and “Episodic” homelessness from the map - is not considered practical. In the words of The Center for Evidence-based Solutions to Homelessness: … the more enduring path to ending homelessness … is to fix the systemic problems that cause it: social inequalities of income, wealth, and opportunity, and the failures of the social safety net. To me, this sounds like either Communism or the Return of Jesus Christ. I have no faith in Communism, so perhaps the most pragmatically useful action I can personally take is to start praying a lot.
[1] I do not know if people at large are familiar with the term “triage”. From Wikipedia:
Modern medical triage was invented by Dominique Jean Larrey, a surgeon during the Napoleonic Wars, who "treat[ed] the wounded according to the observed gravity of their injuries and the urgency for medical care, regardless of their rank or nationality", though the general concept of prioritizing by prognosis is foreshadowed in a 17th-century BCE Egyptian document. Triage was used further during World War I by French doctors treating the battlefield wounded at the aid stations behind the front. Those responsible for the removal of the wounded from a battlefield or their care afterwards would divide the victims into three categories:
- Those who are likely to live, regardless of what care they receive;
- Those who are unlikely to live, regardless of what care they receive;
- Those for whom immediate care may make a positive difference in outcome.
[2] We've all seen a man at the liquor store beggin' for your change
The hair on his face is dirty, dread-locked, and full of mange
He asks a man for what he could spare, with shame in his eyes
"Get a job you fucking slob, " is all he replies
God forbid you ever had to walk a mile in his shoes
'Cause then you really might know what it's like to sing the blues
Then you really might know what it's like
- Everlast, “What It’s Like”
[3] The Big Rock Candy Mountain
One evening as the sun went down
And the jungle fire was burning
Down the track came a hobo hiking
And he said, "Boys, I'm not turning"
"I'm headed for a land that's far away
Besides the crystal fountains
So come with me, we'll go and see
The Big Rock Candy Mountains"
In the Big Rock Candy Mountains
There's a land that's fair and bright
Where the handouts grow on bushes
And you sleep out every night
Where the boxcars all are empty
And the sun shines every day
And the birds and the bees
And the cigarette trees
The lemonade springs
Where the bluebird sings
In the Big Rock Candy Mountains
In the Big Rock Candy Mountains
All the cops have wooden legs
And the bulldogs all have rubber teeth
And the hens lay soft-boiled eggs
The farmers' trees are full of fruit
And the barns are full of hay
Oh, I'm bound to go
Where there ain't no snow
Where the rain don't fall
The winds don't blow
In the Big Rock Candy Mountains
In the Big Rock Candy Mountains
You never change your socks
And the little streams of alcohol
Come trickling down the rocks
The brakemen have to tip their hats
And the railway bulls are blind
There's a lake of stew
And of whiskey too
You can paddle all around it
In a big canoe
In the Big Rock Candy Mountains
In the Big Rock Candy Mountains
The jails are made of tin
And you can walk right out again
As soon as you are in
There ain't no short-handled shovels
No axes, saws nor picks
I'm goin' to stay
Where you sleep all day
Where they hung the jerk
That invented work
In the Big Rock Candy Mountains
I'll see you all this coming fall
In the Big Rock Candy Mountains
- Harry McClintock, "The Big Rock Candy Mountain"