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Comment by DoreenMichele | Hacker News Reader

Lack of affordable housing is a major underlying cause of homelessness in the US, moreso than lack of mental health support.

Early on in the pandemic, I saw some people saying things like "Housing is healthcare." And it's true.

I just don't know how to get anywhere harping overly much on that, so instead I'm making sketches and notes and if I don't end up homeless again and dying on the streets, maybe I can do a pilot project.

Probably not, but we all need an occupation (as was said in The importance of being Earnest).

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Affordable housing alone will not solve this. We have to actually expand use of Kendra's Law. Homeless people in NYC that are mentally ill, using drugs, and engaging in criminal activity will not use any more additional resources provided to them. These are people that refuse help. Affordable housing would not solve for these people.

I never said affordable housing alone would solve it.

I'm quite confident that doubling down on going draconian on people who have no means to fix their own problems absolutely won't make anything better. If you take that far enough, the logical conclusion is something inane like "we should just shoot all homeless people" or something.

People have to be given a path back. Cutting them off will not magically cure what ails them.

No but that is all you mentioned.

I'm all for affordable housing. But when a homeless man commits murder, the answer to that isn't a one liner about the importance of affordable housing which is always the first and only thing that's mentioned when it comes to the homeless. There is nothing draconian about Kendra's Law by the way. It is far more humane to make sure treatment, psych beds are used, especially for people that do not have the capability of knowing when they need help.

When anyone commits murder, the appropriate response is jail time. That's not peculiar to homeless people.

I know a whole lot about homelessness and have left many comments on the subject over the years. If you want to have a meaty discussion about it, I'm capable of doing so, though this approach to engaging me isn't a good way to get that.

I write less about homelessness than I used to. These days, I try to focus on community development.

I think that's the best antidote we have and one that gets too little attention.

There comes a point where we need to stop just pulling people out of the river. We need to go upstream and find out why they're falling in. ― Desmond Tutu.

There were 485 murders in NYC in 2021. What is the difference between those and these ones, other than the murderer being homeless?

Some stats I pulled up: - Minimum wage in NYC is $15/hr, coming out to ~$30k/yr pre-tax @ 40hrs/week and 50 weeks/year, or $22,752 yearly after tax.

- At 30% of income rule for rent, that comes out to $568/month for rent. At 80 hrs/week that's ~$1k

- "The Bronx neighborhood of Bedford Park has the lowest median rent in the city—$1,558 for a one bedroom"

Forgive me if I'm misunderstanding something, but how is this not a problem of lack of affordable housing?

And for people that won't take paths back? And are actively harming the people around them?

Those people exist. Not a huge number of them, but they have an outsized effect.

We used to have sanitariums, or locked folks up in jail if they got that bad. They suck, it's expensive, they are ripe for abuse.

But having random insane people wandering the streets accosting people, or in rare cases even murdering them, isn't working either.

Crisis management is always a necessity during a crisis but you don't crisis manage your way to a solution.

I'm not interested in investing more of my time in crisis management for this problem space. I'm looking to find ways to actually shrink the problem.

I'm not saying we should stop doing any crisis management and I'm baffled that multiple people are reacting as if I had.

I'm saying one key piece is we need to resolve our housing supply issues. It's one piece. It's not a comprehensive solution but I think it's really important and far too many people seem to think lack of housing is somehow wholly unrelated to homelessness, which also baffles me.

I don't see how anyone can assert that but I run into pretty frequently.

The crisis management (in California referred to as 5150) is a revolving door that only 'helps' anyone by temporarily patching them up and letting them go back to whatever bad habits and environment got them there in the first place.

Better housing will help some. Better accessible care will help some. Better other things will help some.

But there is no fall through default option here being exercised if those options don't help those who aren't helped enough by those options they stop being a repeated danger to themselves or others. In theory it's possible to still get committed. It's almost impossible to actually get committed (as in persistently kept away from society in a controlled institution), and those places are so underfunded and terrible, the street might actually produce better outcomes for everyone.

'Crisis management' is about taking a crisis and not making it a crisis anymore.

But it's generally about a short term emergency intervention, not about long term control of a situation that is fundamentally unstable, unsound, and not 'resolvable' due to a persons own actions. There are people who cannot and will not do what is necessary to stay sane. There are not a lot of them. But they do exist.

We can reduce the overall size of the problem through housing reform. But it doesn't remove the need for some kind of not-a-humanitarian-disaster institutionalization in a non trivial number of cases

People don't refuse help that they need and want. If large groups of people are consistently refusing the help then it is not the help they need.

Yes yes people don't always know what they need it can be complex. But the majority of homeless people I know and have known needed and wanted help, but were unable to accept the terms of the help offered by the state, or various charities.

I have been homeless and not some cute "living in my car for six months after college" but open sores untreated addiction rotting teeth in the subway station homeless. People I love are still out there dying those deaths and it hurts so so much to hear the way you talk about them in comments today. Not just this one either.

"These people" need anything but more carceral violence directed at them. I've spent time both in jail and institutionalized. Jail is worse but the difference is more a matter of degree than type.

What you want is to have them removed. You're entitled to your wants of course and even to pursue them. But don't use helping homeless people as part of your justification. It is very hard to read these comments and believe you have ever known or cared about someone who was homeless in your city.

> People don't refuse help that they need and want. If large groups of people are consistently refusing the help then it is not the help they need.

This is a tautology. You are essentially defining the word "help" as whatever homeless people define help to be, yet you give some credence to the fact that homeless people might not actually know what is actually helpful for them. What is good for homeless people that are on drugs, that don't want to go to a homeless shelter, that don't want psychiatric help are very often bad for everyone else around them. So maybe we should stop making decisions that put the liberties of homeless people first.

In NYC where I live, two Asian women were killed by black, homeless men in this past month. I'm frankly not interested in making my language any more flowery for your taste with homeless people. I'm only interested in real policy solutions. Until you actually acknowledge the violence, the degeneration of our subway, streets, and city, then we're not going to be able to talk any further.

They are talking about Chronic Visible Homeless... a very different group than the majority of homeless population who don't; live on the street, talk to themselves, or murder complete strangers.

Shrink the problem generally and your worst case scenario cases get less problematic as well. Follow the 80/20 rule and help those most easily helped so society is more generally functional and our worst cases will be something we are more able to manage.

That makes sense if they are the same problem. In this case I think we've just linguistically bundled them together as "homeless" but they are actually completely distinct problems and groups.

I don't agree with you.

I spent nearly six years homeless. I spent a lot of years suicidal. I have an incurable medical condition.

I'm back in housing. I'm healthier. I'm rarely suicidal these days.

I agree that lack of housing is a tremendous stressor and may cause or exacerbate mental health or substance use issues. Affordable housing has lots of benefits.

But when you look at the path that people took to being chronically visibly homeless on the street the pre-cursor in general isn't affordable housing.

> Roger’s parents wondered why, with so many advances in the science of mental health, their brilliant son was talking to voices and eating out of garbage cans.

One of the known problems is that it's common for schizophrenics to go to a hospital for inpatient treatment, get better, go home to family and get worse again.

Their family members may care about them and still be part of the problem. It's really common for people to want to save face and swear it's not their fault, it's something else. In such cases, they won't change. They won't take responsibility for their role. They will blame something else, anything else.

I think it's a mistake to just take the word of a relative as to what went wrong in a case where they might be part of what went wrong. But I usually don't say that because I know that's likely to get really negative reactions from people.

Suffice it to say I still don't agree with you and there's probably nothing to be gained from discussing this further.

I'd be greatly interested to hear what you think the proper approach and solution in that case is.

I've already told you and you have hand waved it off as not a solution: I think we need to fix our very, very serious and longstanding housing supply issues.

If it were feasible for someone to rent a room for not much money and live decently without a car in a walkable neighborhood such that working part-time with decent wages or full-time minimum wage allowed a person their independence, then people with impairments wouldn't be prisoners of dysfunctional and stressed families who are often doing all the wrong things because their scared to death and don't know how to fix anything.

We've built a world in which only a small number of people can possibly keep up the rat race. We've torn down more than a million SROs which used to be normal housing and we now think of that as only housing for homeless people, not housing for young, single adults or childless couples or seniors or students.

(SRO stands for single room occupancy. Copy-paste isn't working for me at the moment, so I can't provide a link.)

In the US, it's nigh impossible to live without a car. It's nigh impossible to find someplace really cheap in a walkable neighborhood that's suitable for a household of one to three people.

Parents who know their child can't function well enough to work all the damn time and afford an expensive home and expensive car etc know this is a nightmare from which the entire family has no escape route.

The escape route for everyone is to make affordable housing in walkable neighborhoods the norm again so ordinary people who can function some of the time but can't run full throttle all of the time can protect their own agency, establish their independence and not be driven crazy by other people freaking out about the burden of caring for them forever with no hope of a solution.

I can work part-time. I can't work a regular job.

I currently live someplace cheap in a walkable setting. I've grown healthier and more functional because of it.

I would like to replicate that and make it more the norm in this country, like it once was.

That's a thing that works but it's a thing you aren't going to find plausible if your focus is on how to deal with people after everything has gone wrong and it looks unfixable. It's fixable. It's also very much preventable in many cases.

We just refuse to work on that. We are too busy screaming about how the sky is falling.

No I disagreed about prioritizing affordable housing and treating mental healthcare as an after thought.

I was asking specifically about the person that is dealing with schizophrenia in the example that you provided. What are the next steps in resolution.

Housing is healthcare. I've already said that in my very first comment in this particular thread.

To whatever degree a mental illness is treatable with medication, it can be viewed as a physical ailment with somatopsychic symptoms.

I've already said that, elsewhere in this article discussion:

https://news.ycombinator.com/item?id=30334409

If that isn't computing for you, it isn't going to get better to keep telling me I'm wrong and you don't agree.

Your mental models of this problem space and mine clearly aren't jibing. This form of engagement isn't likely to bridge the gap between where you are on this and where I am.

I've spent years talking about this stuff online, including on HN a whole lot. It's not been a waste of time but there's only so far that goes.

At this point, my focus is on trying to flesh out a potential pilot project -- like I said in my first comment.

Sometimes words get in the way. Sometimes the best thing to do is do it and show people.

That's what I hope to do though I may not be able to. I'm not wealthy. I'm not connected. Most of the world does not see what I see.

(Shrug)

I'm not sure why you keep talking at me instead of answering my simple question. I never once disagreed about the importance of affordable housing if you actually read what I said instead of getting so easily offended by what I am saying. I am repeatedly saying that we need to instead reinforce mandatory treatment, provide psych beds, and mitigate dangers of homeless people (that are a danger to themselves and others), especially for those that are committing violent crimes. To you, this is crisis management that is extremely convenient to ignore. That is not convenient for the rest of us that deal with the negative externality from these types of homeless people every single day.

Repeatedly mentioning that you spent years talking about this has absolutely no bearing on me. It's not my mental model that isn't working with yours. It's really your language and how you are approaching basic questions that are asking for a clarification on your insight.

It definitely seems like words are getting in the way for you then if you can't do the simplest of explanations. Have a good day.

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