How Utah Reduced Chronic Homelessness (2015)
npr.org
npr.org
A big focus was on re-employment and having a fixed postal address. Those who lost their jobs and then their homes with no fixed address were unable to obtain another job and hence fell into a spiral of chronic homelessness.
One of the big takeaways from Italian policy was to firstly provide temporary housing. The second was to create a 'virtual' postal address for anyone affected by homelessness. This apparently helped a lot in enabling people to climb out of homelessness and back onto the career ladder.
Verification could be supplied by the county.
They (basically) already are. USPS provides free mailing service for people who don't have a fixed address, and you can use that as your street address (unlike PO boxes, which are invalid for use in circumstances that require a street address). They'll hold onto any mail addressed to you for 30 days.
If you, heaven forbid, ever become homeless:
If anybody ever insists that you provide a 'real address', lie. List your PO address as "123 Street Name, Apt #PONUMBER".
Nobody will ever be assed enough to check that it's not a real apartment. Nobody.
There are private PO boxes you can rent out, instead.
"According to the Substance Abuse and Mental Health Services Administration, 20 to 25% of the homeless population in the United States suffers from some form of severe mental illness. In comparison, only 6% of Americans are severely mentally ill"
A HUD Report has 26% of people in shelters having a serious mental illness [2] (Search "serious mental illness").
When I researched this a few years ago I regularly saw 200,000 people as the number with serious mental illness who were homeless and about an equal amount in prison (with people regularly cycling in and out of prison because of their mental illness).
[1] http://www.nationalhomeless.org/factsheets/Mental_Illness.pd... [2] https://www.hudexchange.info/resources/documents/2010Homeles...
"Researchers at St. Michael’s Hospital in Toronto surveyed 111 homeless men and found that 45 percent of them had suffered at least one traumatic brain injury (or TBI) in their life, and 87 percent of those injuries occurred before they were homeless. Among the general population, TBI rates are estimated to be 12 percent, according to a 2013 meta-analysis of studies from developed countries."
I am curious about what you are mentioning: any way for you to retrieve more info so I can look it up?
EDIT: A sad/curious anecdote - at one time she was placed in an apartment. I don't know the details but it was probably using the programs outlined in the article. She lit the apartment on fire and ended up in the hospital. As I understand she believed that she owned the apartment complex and could not understand why the managers would not let her make decisions, so she lit it on fire.
Counter-productive is an empirical question, but why is forcing treatment always unethical?
> ...She lit the apartment on fire and ended up in the hospital.
...for example. Do we need to wait for manslaughter charges before the government is responsible?
Often people on the street are at least committing fraud (lying for food, bus fare, cash, etc.). I understand that people do what they need to for survival (at least on their terms), but there is an actual cost to that. For instance, if someone actually lost their wallet and needed fare home, they have to compete with people who say they haven't eaten in days but actually don't want professional help (and may even be unfit to make that decision in the first place). The information asymmetry is enormous in this sort of interaction. To reiterate, the people getting conned aren't the biggest victims here; it's the people who have to deal with a jaded audience and fraudulent sob stories when $20, bus fare, or a prepaid phone is legitimately their biggest need.
Anyway, I'm willing to listen to counterpoints about this, but it just doesn't make sense to me that the government isn't responsible for people who can't (or won't) take care of themselves. I'm talking haven't showered in weeks; open sores on their feet, faces, and bodies; etc. Literally no other group has (or should have!) the power to require someone to get care. If we say it's not the government's job, we're saying it's nobody's job.
I'm willing to hear other thoughts on this. My current conclusion is that the status quo is ethically unconscionable but politically impossible to do anything about, but maybe I'm missing something.
In my Aunt's case, apparently they decided not to press charges about the fire. Maybe they thought they were doing her a favor, and insurance probably covered the damage anyway.
I have dealt with a similar situation involving a family member. I later regretted not being proactive in intervening before it was too late. Years went by, and plenty of situations arose that could have lead to a serious intervention. Instead, nothing happened. In one instance, criminal charges were pending, but somehow they were dropped.
Of course, there must be a very high bar against forced institutionalization; we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons.
> we don't want to return to the bad old days when people were locked up for all sorts of unjustifiable reasons.
What makes you think this would no longer be the case?
Ask most people who were diagnosed as mentally ill by east-german authorities before 1990.
Trust me, however nice they are today, you don't want an authority, a committee, or even "community standards" enforce any medical treatment on someone.
> ...for example. Do we need to wait for manslaughter charges before the government is responsible?
You need offenses to put charges forward. That's how justice works. You just don't jail people for things you suspect they will do.
https://www.reference.com/government-politics/302-commitment...
"A 302 commitment in Pennsylvania is an involuntary commitment into a mental health institute for emergency psychiatric evaluation. The person who signs or calls for the 302 must have direct first hand knowledge of the person and the danger they pose to themselves or others."
1) Inflows: higher housing costs increase the inflow into homelessness. Whether it is job loss, drug addiction, mental illness, or whatever...if you have higher housing costs, you are more likely to end up homeless.
2) Outflows: higher housing costs become a higher bar to leaving homelessness. Let's say someone can address, over time, their underlying cause to homelessness. That person will take longer to overcome the bar of housing costs in a high cost area than an equivalent person with lower housing cost bars to overcome.
Both of these arguments seem obvious, almost tautological, but combined what you have is a higher rate of inflows, and a lower rate of outflows. This means two things: ceteris paribus, you have more homeless people, and the homeless people that you do have take longer to leave homelessness.
Now take into account the fact that in high housing cost areas, housing costs more to build because land prices and construction prices are higher (even taking into account Eminent Domain), and you have: 1) More demand (in terms of quantity of people) for relief housing 2) Higher expected time of use of housing. 3) Higher cost of building housing.
These factors are multiplicative, not additive. Combined, I wouldn't be surprised if the cost of attaining the same success rate is two orders of magnitude higher in San Francisco than it is in Salt Lake City. Construction costs alone take care of your first order of magnitude...now multiply those by the higher inflow rates and outflow rates.
This solution is obvious, but you can't put the cart before the horse. Salt Lake City never had to worry about it...San Francisco does.
Seems like every city would have to try the SLC model instead of putting their homeless on a bus with a one way ticket.
I'm interested in the topic, and actively worked with an encampment in Seattle (Nickelsville) that intended to build permanent dwellings. They were inspired by Dignity Village in Portland. But like you say, their efforts were demolished. But surprisingly to me, the cops involved were openly apologetic and gave everyone involved an opportunity to leave rather than risk arrest or property confiscation.
Do you have direct experience with homeless communities that have built dwellings for themselves? If so, can you talk about that experience?
Am I off here? Does it not seem naive to say: "they're homeless, so let's just give them an apartment and say our 'homeless' rate dropped"? As if that was the essential problem? What about the mental health and drug (etc) issues that created the environment for unsustainable work...
I'm not saying it sounds like a bad solution, but it seems like a bandaid on a gaping wound.
I wish people wouldn't latch onto drug addiction as the first thing that must be solved, you're really picking the hardest problem to tackle first and trying to do it in the hardest possible environment to recover. Remember there are plenty of functioning drug addicts in the world wearing suits to their day jobs on Wall Street and the like.
You could just put them in high quality apartments and give them a stipend. The current proposal for a "projects" style homeless shelter where I am would have each unit cost $4,500 per month, with 90% of the units not having a private bathroom (and most not having a full kitchen).
For that price you could easily afford a high end apartment and give the people a large stipend. And if you spread the units out across the city so that each apartment building only had 1-2 homeless families, you'd avoid the problems of concentrating poverty.
We have to find a way to house people who have mental health problems and drug addictions. If you look in any rich neighborhood you'll find lots of people who meet this description living in relative comfort.
That's why you don't house everyone together. This is something that America's War on Poverty got very wrong. You have to decentralize extreme poverty.
These programs typically assign a caseworker who gets to know the homeless people and forms a relationship with them. The early period involves a lot of hand-holding and helping the homeless figure out (or re-discover) how to live a productive adult life.
Most people who end up homeless turn to drugs, prostitution, and have any existing mental problems hugely exacerbated AFTER they become homeless. In other cases it is some other underlying situation (abusive childhood, etc) that triggers drug use that leads to homelessness.
There's also a strong selection effect: many people who become homeless quickly attempt to find employment and a new place to live. Those who don't get out of being homeless quickly become unemployable and thus are locked into the cycle.
As a society we seem to be stuck in this Victorian-era meme that moral failure brings calamity upon people (aka the Just World fallacy).
That applies to success the same as failure... being ambitious and smart is a necessary but not sufficient condition to become successful.
If Mark Zuckerberg got hit by a drunk driver (through no fault of his own) and became a paraplegic while at Harvard he wouldn't be a billionaire today. If he hadn't gotten into Harvard would he have had the connections to get funding and start Facebook? A million things entirely outside his control had to go right for him to be successful. It was a combination of his character, circumstances, and pure luck. If you don't have all three you won't be successful.
Similarly it doesn't take much weakness or bad luck to completely ruin someone's life.
See Harvard Economist Edward Glaeser, Build Big, Bill an article which explains the high cost of housing is caused for the reasons I stated. http://www.nydailynews.com/opinion/build-big-bill-article-1....
I've held for a while that a homeless person getting into housing solves one of the biggest time sinks they have. Once the time is freed up, they are more comfortable, safer and can therefore sleep better, and they can think and make a plan to get re-integrated into mainstream society.
Commenters note that 'housing first' does not work in larger cities like San Francisco and New York because of the cost of housing. Were a basic income in place, homeless persons would be more mobile and could afford basic accommodations in many more places. Therefore, they'd not be so attracted to more hospitable climates or cities with more homeless services. That would increase the options they'd have to move to less expensive housing.
Why do we have to do it without raising taxes? What's wrong with paying taxes? (A shocking thing to say these days, I know!)
The U.S. could now house, feed, cloth, educate, and provide healthcare to its entire population. Is that a worthy goal? U.S. citizens pooled their money to put a person on the moon; they do it for medical research, aircraft carriers, rural telecommunication, and plenty of education and healthcare already. Why not this?
(In fairness, I say the U.S. could do it. I have no data or research, but the U.S. is pretty close to doing it, it's the wealthiest country in the history of the world, other countries do it - I'm confident it's doable.)
What Powered Utah's Success...And finally, most of the advocates and agencies in Utah know each other and work well with each other. They also know most of the homeless people by name...One person recommends a name from the list...Ed Snoddy, who does medical outreach for Volunteers of America, a faith-based nonprofit, speaks up...."He is notoriously dealing (drugs) right now,"...The group agrees that this individual does not play nice with others, and isn't right for this particular apartment. For now, his name stays on the list.
They assess need/sociability and provide specific rooms to specific people they think will be well suited to them. Each person has a caseworker who helps them manage their life, since evidently these people can't do it themselves.
And these are mostly "supportive housing". I.e. paternalistic organized homes, rather than just handing out money and expecting the homeless to successfully manage their own lives. This housing isn't just regular flats, it's patrolled by off-duty cops, has lots of rules, and you get kicked out if you don't obey them.
This program is run by the guy who organizes paternalistic social programs for LDS - the state literally asked the church if they could borrow him. This is story about how awesome Mormon social technology is, and is completely the opposite of BI.
http://www.motherjones.com/politics/2015/02/housing-first-so...
It's not the sort of discussion we're looking for; and people respond in kind, which produces flamewars.
But why would you even build homes in the first place. Do you think Salt Lake City in 2005 with 2000+ chronically homeless people didn't have at least 2000 homes on the market?
Do you have any evidence that this would be the outcome? What makes you say that much of the money would go towards housing in the first place?
The program has ended up being quite expensive to run, and it's not actually cost effective, to the point where homeless advocates actually criticize the program's in effectiveness.
It's also caused negative impact for other residents in the buildings or nearby areas. Depending on what the stipend provided by the government is and whether it's above or below market rate, landlords will either intentionally neglect and blight buildings in order to run them down, or they will refuse to rent to market tenants, with the knowledge that they can make more money from the stipends for homeless housing. This, of course, makes it more difficult to find housing and has the effect of driving prices upwards.
Seems to me housing first doesn't work in New York because the politics around telling real estate are more corrupt.
http://abc7ny.com/news/the-investigators-homeless-struggling...
> The city’s Department of Homeless Services pays many times the amount the rooms would usually rent for — spending over $3,000 a month for each threadbare room without a bathroom or kitchen — because of an acute shortage in shelters for homeless men and women. Indeed, the amount the city pays.. has encouraged Mr. Lapes to switch business models and become a major private operator of homeless shelters. He is by most measures the city’s largest and owns or leases about 20 of the 231 shelters citywide. Most of the other shelters and residences are run by the city or by nonprofit agencies, but his operation is profit-making, prompting criticism from advocates for the homeless and elected officials.
For the record, a privatized shelter system isn't inherently a bad thing. Private shelters are an integral part of addressing homelessness in many cities.
The problem is that this particular program is an unbelievably inefficient route to that end result, and it also does so in a way that eats away at existing inventory for long-term tenants.
It sounds like the problem isn't Housing First, but a lack of resources for it.
If that is indeed the case, I really can't blame them. Who would want a likely mentally unstable homeless person living on their property? I'm sure the expected property damage is substantially higher than from a standard tenant. Forcing landlords to take "vouchers" for high-risk tenants is essentially forcing much of the cost of homelessness away from the city and onto the landlords.
"Although overall homelessness has actually increased slightly over the past decade in Utah, such a large reduction in chronic homelessness is still an impressive achievement. But is it real?
Unfortunately, no. I spent some time studying Utah’s data and found that the miraculous 91 percent reduction in chronic homelessness appears to be driven by changes in how people were counted, rather than by how many there were."
Think of all of the stuff most folks take for granted that are pretty much mandatory in most US cities in order to get and keep a job:
1. ID. So many of the homeless folks I know have had significant trouble obtaining ID after losing it or having it stolen, or having never had one because they left home at a very young age, etc. I can't count the number of conversations I've had trying to assist folks get an ID. Our governments don't make it easy (you need at least birth certificate and Social Security card, and some sort of mail showing where you live in some cases). For people without cooperative family or with no living parents, this step is very tough. It's stupid to think that lack of a tiny thing like ID is why so many people are without work and without homes, but, it's a reality.
2. Transportation. If you have no car in most US cities, it's hard to have a job. This one reason metropolitan areas are so much more densely populated by homeless folks; mass transit tends to be most accessible in the city center.
3. Staying clean. Would you hire someone who smells bad or looks dirty for any job? Homeless folks feel invisible because people don't want to be near dirty/smelly people of indeterminate mental health. Even if someone is perfectly able to do a job, being dirty is a guarantee they won't get the job.
4. No reliable way to reach them, if someone does decide to hire them. When I hear/see someone being hostile to a homeless or poor person because they are lucky enough to have a smart phone (I guess because a phone is an expensive thing), I'm just aghast. How the hell do they expect a homeless person to get out of homelessness without a phone, email, and a way to get online? So many low-level jobs have online application processes and require interaction via email and web in order to get the job.
5. Not getting a decent night's sleep, ever. Without a home, sleeping is a challenge every single day. If there are enough beds in the shelters (never the case in any city I've lived in), they have to be in the shelter by a certain time and have to be out very early (6AM is the "checkout time" at many shelters). This does double harm. The inflexible schedule prevents folks from holding jobs that conflict with that strict schedule, like second shift and night shift work, which often pays reasonably well, and has low barriers to entry. And, it also means they probably are running on an hour or two less sleep than a human actually needs to thrive. I hung out in downtown Eugene recently, and I was told that there was at least one fight, every single night. One broke out across the street within an hour of that conversation. I don't know that poor sleep is the cause of the frequent violence, but I'm confident it's a major contributing factor (and the science on sleep deprivation backs that theory up). Now, these were street kids, who don't go to shelters because the rules are too strict for them, and they sleep in sleeping bags and tents, but they, too, aren't getting enough sleep.
In short, having a home makes a huge difference in nearly every element of chronic poverty, and that, paired with a consistent income, are the things that most indicate whether someone will be able to become a self-sufficient functioning member of society again. This is a great idea, and it's awesome that Utah has had such great success with it. I hope more cities and states implement these ideas.
All these factors culminate into a hellish experience in which you regularly face defeat and look for an escape, something you can control, like drugs, alcohol, or death.
> It's really difficult to overstate how hard it is to get back out of homelessness, once you reach that point, without significant outside help.
I'd add that when someone becomes homeless, they often are at their weakest point and now have to spend their limited capability on trying to survive (as you describe). On top of that, we're expecting they will overcome incredible challenges and boost themselves out of homelessness. It's just not realistic.
* Homeless rarely have their things with them, suggesting perhaps that housing and storage are provided (at some level) to them.
* Those who panhandle near campus ask strictly for cash, and seem to some extent disappointed when they are given food instead.
* Homeless are never on campus, EVER. This seems strange to me because facilities such as bathrooms, drinking fountains, out-of-sight benches, and rain-cover, are in abundance. Clearly they are kept away, but it surprises me how EFFECTIVELY they are kept away, almost as if they are afraid of it.
* During the various University touring seasons (year round but more coming in Spring/Summer) there appears to be fewer homeless people in the more touristy areas near campus. This is purely anecdotal, but again it appears as if there is some contract with the local homeless to keep them away.
* Every morning recycling bins are spilled with their contents spread out as if someone came during the night and rumaged through them. This is particularly evident in the many alley ways near campus where most garbage/recycling is found. I would think there was some type of reward program geared towards the homeless that incentivized collection of recyclables, but it back fired and led to a large amount of littering in the area.
I have never been even close to homeless but I have always lived around it (San Francisco, Greater Bay Area, Eugene) and am somewhat fascinated by its societal implications. Eugene in particular is unique because it seems like a lot of people are trying really hard to make it better, yet are failing for a lot of reasons.
This one I can explain. Oregon has a deposit/return program; several states have them. The basic premise is that every product in a can or bottle includes a deposit fee, which you only get back when you return the can or bottle for recycling. I think the deposit is .05 on most single serving sized bottles and cans. So, 20 cans collected is $1.00. 100 is enough to buy a pretty good meal. It's kind of a normal part of some homeless folks day to roam around collecting bottles and cans; it's not as profitable as flying a sign at a busy intersection or busking, or even just asking for money downtown, but it is maybe more comfortable for the folks who don't want to beg (I can understand that; I don't know if I could ask someone for money even if I were starving, with this damned American work ethic and foolish pride).
Since there is very little incentive to put the trash back in the bins after they've collected the items that are worth month, they just leave the trash on the ground. I guess there is even a disincentive to pick up the mess; that's time that could have been spent collecting more items worth money. It's annoying, but perfectly rational.
I've never asked any of the folks I know why they don't spend any time on campus; I've never been to the campus, myself, so it's not part of my Eugene experience, thus far. Downtown (and Whiteaker for bus and van dwellers) is clearly the preferred location in Eugene. Springfield's homeless are much more widely disbursed, not sure why, and seem to congregate in a few specific locations near the river. I haven't really made the acquaintance of any of them to ask, but I see them on my walk between the RV park where I'm staying and the co-working space I'm renting in Springfield. They tend to be older, and I suspect they want nothing to do with the kids in downtown Eugene, because of how much drama there is among that crowd.
Eugene is an interesting place, in terms of how visible the homeless population is. There seems to be somewhat less hostility in both directions (i.e. in a lot of places I've lived, homeless folks are treated very poorly, and they tend to be surly in response...that dynamic doesn't seem to play out here; there's maybe less fear in both directions). I dunno. I don't have solutions, really, but I do like to see people treated with basic human decency, no matter what their situation. I judge a city (and its inhabitants), to a significant degree, by how it treats those most at risk and most in need; and homeless folks are certainly among the most at risk and most in need.