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A-plan-to-make-homelessness-history

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19 pointsraghav133114 comments

Housing first is a wonderful program. My stepmother has been running a similar pilot program in Greensboro, NC [1]. The thesis, which is holding up, is that the total cost to taxpayers is lower if the city pays the rent vs. emergency room visits, court system, police, etc. that result from homelessness.

Its also hard to implement. Its hard to find willing landlords with safe housing, and you want to spread folks out instead of ghettoizing them and creating a larger problem. The whole thing only works because of the ridiculously hard work the case managers and other social workers are putting in.

[1] http://greensborohousingcoalition.com/

I love how they preempt the economy issue by saying that it is cheaper to house them than it is to treat them. Wouldn't it be even cheaper to put a limit on how much you can owe the public before you are turned away at the er? After all, this is the money that comes from the insurance premiums that have exploded recently.

It would be cheaper, but not acceptable to the vast majority of the public.

I believe that it was Mahatma Ghandi who said "A nation's greatness is measured by how it treats its weakest members."

He said a lot of things, including suggesting that jews went to the ovens voluntary (as some sort of protest against the Nazies). He may have his hearth in the right place, but I wouldn't take advice from him.

The fundamental problem with this is that figuring out how much you owe the public takes time. If I'm found passed out on the street (say, due to a stroke, or even just from slipping and hitting my head), I'd prefer to be treated immediately, and we'll work out payment after.

There's also the problem that a significant portion of these costs (though likely not the majority) are incurred on law enforcement, not on medical care. Simply denying law enforcement is only going to make the problem worse.

Another worthwhile blog post sullied by an over-sensationalized headline, from the author of How to Change the World.

Let's be honest, this is triage to save the life of people dying on the streets. And frankly, I find that to be a far more galvanizing rallying cry than making homelessness history.

I will boldly predict that this won't work.

There are two types of homeless. The temporary homeless who have been caught out by circumstance and work mightily to avoid remaining homeless. These people tend to be homeless only for very short periods of time (days).

Then there are the chronically homeless, who are generally unable to live within societal norms. Many of these people are mentally ill. And for many of these people giving them a home and money will not solve their problems.

"Many of these people are mentally ill. And for many of these people giving them a home and money will not solve their problems."

This thinking is based on the fallacy that mental illness is a purely biological condition, which anthropology, epidemiology, and clinical data all soundly disprove. Even for mental illnesses that are mostly biological, like schizophrenia, the quality of outcomes varies enormously depending on the person's social environment as well as the course of treatment.

Regardless there are people who choose to remain homeless. When I lived in Finland there were homeless, even though there were plenty of opportunities not to be.

Of course there will always be people who choose to remain homeless, but their goal is only to reduce homelessness by ~83%.

Do you know any LPCs or LPSWs?

First thing they'd tell you is that while mental illness isn't biological, that doesn't mean there's a cure. Some people could go 20+ years in therapy and still end up only a slightly less sick person than they were going in.

Also, many mental illnesses become biological in the sense that brain chemistry actually changes.

Excellent points. Are there any good books on the LPC/LPSW perspective?

I'm not sure. My best friend is an almost an LPC, I can ask her. She's worked with kids aged 4-18, and it's always the older kids she's most worried about. She's working with 13-18 year olds right now, but really wants to go back to 6-12 year olds because she feels like there's a bit more hope for them.

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