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Comment by sovnade | Hacker News Reader

Homelessness isn't just caused by someone not having a home. There is a massive overlap of mental illness and substance abuse/addiction.

Just giving a homeless person a house will not solve the underlying problems that caused them to be homeless in the first place. There needs to be movement on multiple fronts - mental health, physical health, rehab, job training, personal finance, etc.

If the solution was easy, someone would have done it. The uncomfortable truth is when you have someone who is addicted to heroin or fentanyl or meth who isn't really participating in society like everyone else..sometimes there's not much you can do for them. Overcoming addiction is incredibly challenging even for people with means and support systems. Without those, sadly the numbers are abysmal.

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There's a compelling argument [0] that the biggest driver of homelessness is a shortage of housing. Mental illness and addiction can lead to homelessness, but homelessness can also lead to mental illness and addition. There are lots of places suffering severely from the fentanyl crisis, but where homelessness is less of a problem.

The solution may be simple, but it's not easy. (And it's not the entire solution either) Building large quantities of housing is a difficult problem, especially in California.

[0] https://www.theatlantic.com/magazine/archive/2023/01/homeles...

15% of the homeless in SF have a traumatic brain injury. That statistic means almost 1 in 5 right off the top need long term medical care. "Mere housing" won't do jack for those people.

Even more have mental health issues. Some have physical health issues. The number of homeless who are perfectly healthy and just need housing is vanishingly small--those homeless are generally hiding from someone and won't want to be part of a tracked program.

We know what needs to be done: long term healthcare that needs lots of money.

We know what happened in the past: those facilities were horror shows because of underfunding.

We know what the "solutions" were in the past: shut the facility down and throw those people out onto the streets and let the prision system deal with them.

The starting point for solving homelessness is universal healthcare. Nothing less. Without universal healthcare, everything else to "solve" homelessness is just rearranging the deck chairs.

If it was just a matter of house prices, why isn't California's homelessness solved by cheaper homes in Fresno or other parts of the state? I can't help but feel there's more to it than cheaper housing.

Strangely that's not what Finland[0] has found to be the case. By using a housing first approach they've been able to severely decrease the number of homeless people.

You are absolutely correct that other interdictions are needed as well.

[0]https://world-habitat.org/news/our-blog/helsinki-is-still-le...

Finland already has universal healthcare, no? Don't remove that from your calculations.

You can't really be homeless in Finland during winter for very long though.

I think if you give someone a house they are definitionally no longer homeless, even if they remain mentally ill or addicted to drugs.

I think the fallacy you're making is assuming all homeless have the same problems. There are definitely some homeless or near-homeless people where having a safe place to sleep, shower, and store their belongings will allow them to hold a job long enough to get back on their feet. There are others that need serious rehab. There are others that need mental health counseling. There are others that will never be able to care for themselves and need to be put in a care home.

So really there is no one-size-fits all solution. Individual treatment is needed, and early intervention always has the best outcomes.

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