But we also have some "service resistant" homeless populations that do not want to live in your rule-based housing, they want to live without those rules even if it means living on the street.
SF gets described as 'housing first', but it certainly does not act like it. In SF, we actually have unspent funds from our 2018 "Prop C" ballot initiative which dedicated funding to specific categories, the largest of which was for permanent housing. I.e. there has been money available for 5 years for permanent housing, but the city is not willing to buy available units -- it will only consider developing new projects, which get stuck in planning hell, and have extremely high per-unit costs. The city is not willing to rent vacant market-rate units, even when large numbers are available, including in rent-stabilized buildings, where it could have long-term predictable rents. When rents dropped sharply during the pandemic, we did not put people into empty, cheap apartments. Instead, we payed $5k/month per tent in parking lot safe sleeping sites.
Mayor Breed is also trying to take funds which are set aside for permanent housing and use them for shelter beds and prevention services.
Funding exists to put more people into actual housing basically immediately, but the city instead pursues more shelter beds and ever larger contracts with Urban Alchemy.
Santa Clara County tried a random assignment housing first experiment in 2021 where homeless people given apartments died at roughly the same rates from drug overdose, etc. than homeless people who didn't receive housing.
For these reasons and more, it makes a lot of sense to not acquire one-off units in existing buildings for PSH, and Prop C set asides for PSH instead of shelter or whatever the city deemed most useful for homeless people is kind of downstream of nonprofit politics and not a statement about voter mandates or what's best for homeless people.
I think conflating the two is not productive.
We know little about this problem, and most of our information depends on unreliable self reporting.
In addition, people who are not legible to PIT methodology are certainly not rolled up into state level statistics upon which this claim of failure and the article rest, so in many ways their existence is not relevant to my point or this discussion.
Here you go from my region: https://snohomishcountywa.gov/2857/Point-In-Time
https://www.bloomberg.com/news/articles/2019-03-04/the-probl...
> In addition, people who are not legible to PIT methodology are certainly not rolled up into state level statistics upon which this claim of failure and the article rest, so in many ways their existence is not relevant to my point or this discussion.
OK, I agree that PIT just counts what it counts. But then that means any homeless that aren’t counted by PIT aren’t relevant. It’s just bad data that we can’t really work with.
I suspect we need something like actual government-owned and managed slums - basically jails you can leave at any time. It would be much worse than "normal housing" but it has to be better than a tent under a bridge.
It would cost, but you can externally monitor and correct institutions if you have entirely separate people doing it.
Or - livestream everything and let the public monitor it. (Obviously this can't be done for various reasons, but we now have the technology to literally record it all.)
Shuffling mumblers are not dangerous.
Maybe there's a way to house them in some kind of voluntary mental facility only for non-dangerous mentally ill people. They can come and go during the day. But at least they have a roof over their heads, someone to look after them, provide clean clothes, etc.
Feels like someone must have already tried this and none of the mentally ill homeless were interested.
My position is: if you're a danger to yourself and society you should be coerced into receiving treatment (either in a prison or mental institution) if you are not you should receive housing and non-coercive treatment options through a publicly funded healthcare system.
This seems weirdly controversial though. Seems like people vehemently opposed one or the other half of the solution and we get the terrible situation we have now.
The liability alone would prevent any non-government agency from doing it, and even the government is scared.
It won’t be cheap (likely with security and other support staff you’re looking at one or to staff per “homeless”) but at some point something has to be done, or the status quo continues forever.
Opioid substitution therapy has a long track record of effectiveness, but when treating homeless addicts we all too often insist they go through withdrawal, to nobody's benefit. Not all homeless are addicts, but an individual suffering opioid addiction has very different behavior from someone who isn't, and that requires particular attention. Opioids have the worst relapse rate of all addictive drugs.
Stimulant withdrawal on the other hand is generally less severe, and acute stimulant intoxication is more likely to cause serious behavioral problems than with opioids (or methadone). Cocaine has a surprisingly low relapse rate, once sobriety is maintained for a few months.
Alcohol is a little more difficult, because it not only has a dangerous withdrawal syndrome but it also causes aggressive or impulsive behavior. Treating withdrawal is imperative; substitution is difficult, since other anxiolytics can produce the same impulse control problems. Access to alcohol is pervasive, as well, and we would like to avoid constant monitoring.
When we see only the possibilities of permissiveness or restriction and not active and detailed intervention, we are not playing with a full deck. As another commenter mentioned, simply allowing shelter residents to use drugs creates risks to other residents and staff. But we should be as accommodating as reasonably achievable.
Maybe we should try treating people better than sardines.
Plenty of peoples in the WSJ story were not "service resistant"
The services are inadequate