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State of California

Housing, the Homeless, and the Clueless

“For every complex human problem, there is a solution that is neat, plausible, and wrong.” ~ H.L. Mencken

In a recent “Weekly Update,” California Attorney General Rob Bonta started his summary by saying,

“An estimated 170,000 Californians sleep in shelters or on the street each night, and housing scarcity is driving prices higher and higher. We’re in an existential housing crisis. One that our state is committed to solving. In 2021, I created a DOJ unit focused on protecting housing laws, and we're ready to take action if local communities don’t do their part and instead choose to violate them.” [Emphasis added]

Despite Mr. Bonta’s tough talk and beaming, self-confident smile, there is nothing about this statement that is true and within it lie all of the reasons California is unable to do anything about its homeless crisis.

First off, to set the record straight, according to the Public Policy Institute of California, as of the last official count, the number of homeless individuals in California is 115,491, not 170,000. That doesn’t mean homelessness is not a critical issue and for reasons that remain unexplained by anyone in government, California has 1/3 of all the homeless people in the entire nation. But Mr. Bonta is exaggerating the number by 46%. Exaggeration is a chronic condition in Sacramento these days.

But that’s not the worst of it. Worse is that there is simply no credible evidence to support conflating homelessness with housing affordability. By and large, in the majority of cases, they are completely separate issues.

The first is the result of a gross failure of our social system to provide the help and treatment that the vast majority of homeless people desperately need. The second is a gross failure of our economic system to pay people a living wage. However, the combination of both is certainly toxic.

Karen Bass, the newly elected Mayor of Los Angeles recently announced that she will house 4,000 homeless people in her first 100 days in office. This goal, if achieved, is taken as de facto evidence of success in combating homelessness. End of story. Mission accomplished. Let’s toast to the mayor’s success.

But what would this really accomplish?

The operating theory about homelessness at the moment is a policy called “Housing First.” It posits that housing is a human right and that homelessness is, itself, a disease, so providing a home is the cure. It’s a nice idea. It sounds compassionate. But what if it’s not true? What if it’s just another one-dimensional, ignorant, and even inhumane way to view homeless people, because reducing the causes of homelessness to having a home allows politicians to turn their backs on the real causes and what we really need to do?

What if homelessness has little to do with not having a roof over one’s head and is actually just a symptom of a more pervasive disease(s) and that ‘Housing First’ is no better than putting a Band-Aid on an infected wound without providing antibiotics? Because, in the majority of instances of homelessness, “Housing First” is a theory akin to believing that we can give brand new computers to people who can’t read or write or do math, and expect things to change.

What is true is that the failure of our economic system to pay a living wage for most jobs increases the need for assistance from our under-funded social support system, creating a self-perpetuating dynamic that is certainly contributing to homelessness, misery, and social anxiety in general.

Of course, I'm not saying that providing housing for the homeless is a bad thing. I'm just saying that it can't be the only thing and shouldn't necessarily be the first or the best way to address homelessness.

Who are the homeless?

Homelessness has many causes but there are some glaringly obvious ones. The homeless population is divided into two categories: the temporarily homeless (the minority) and the chronically homeless (the majority).

The first group includes those who are the victims of bad decisions, bad luck, losing a job… in other words victims of the human condition… but they are otherwise functioning and doing the best they can under their circumstances. They need a “helping hand” – temporary housing, financial aid, food security, job training, etc. -- to get back on their feet.

The second group is something else altogether, and although there have always been those we called “vagrants” and “bums” in our towns and cities, the explosive number of chronically homeless is a relatively new phenomenon and a much more serious challenge.

The vast majority of this group suffer from serious, disabling conditions: alcoholism, drug addiction, and a myriad of mental illness issues. As such, their problems have nothing to do with housing. (According to a 2021, Harvard University study, 88% of those in this category either refuse to go into shelters/homeless housing or leave soon after arriving due to strict conduct rules.) They need more than a “helping hand” and assistance that includes a suite of individualized support services, medical treatment, mental health counseling, psychiatric and addiction treatment, meals, legal assistance, etc.

Without this, this population also poses a public health and public safety risk for everyone else. Perhaps, this is where our primary focus on homelessness should be.

So, Mayor Bass’s goal is ephemeral because she is only addressing the symptom, not the disease. Simply warehousing bodies in motel and hotel rooms is, by itself, not even remotely helpful for the vast majority of chronically homeless people. And at $750,000 per “unit” for new homeless housing units, it’s a black hole of government spending and bureaucracy without end or any chance of positive outcomes.

To treat a person who is suffering from mental illness or drug addiction as if they are ‘just like anyone else’ and talk about their “right to housing” because it’s politically beneficial to ‘virtue signal’ that we care is an insult to the needs of desperate, chronically homeless people and shows a profound lack of human compassion. It’s just politically correct cover for ‘declaring victory and leaving the field’ without doing anything to really help them, to heal them, and to treat their illnesses and conditions.

Ironically, it's a bit like our theory that incarceration is a cure for crime.

Let’s consider some facts

A nonprofit called Skid Row Housing in Los Angeles was, until recently, one of the most successful homeless housing organizations in the country, ever. They were housing more people in better buildings (mostly brand new and designed by award-winning architects at a deep discount) than anyone else. They were a model that many tried to emulate.

Their recent demise shows just how challenging housing the homeless is and is additional evidence that chronic homelessness is not solved by housing.

As chief executive of Skid Row Housing Joanne Cordero noted,

“You get residents who have some kind of a meltdown, and they destroy their unit, and then they come back, and they destroy the new unit."

The reasons for homelessness are complex and idiosyncratic but what is obvious is that housing the chronically homeless without the suite of publicly-funded, individualized, social, support services noted above is a feeble solution.

According to a study by Stanford University, regarding the relationship between homelessness and mental health disorders,

“In 2020, about 25 percent of all homeless adults in Los Angeles County had severe mental illnesses such as a psychotic disorder and schizophrenia and 27 percent had a long-term substance use disorder. The prevalence is particularly high among the chronically homeless, over 75 percent of whom have substance abuse or a severe mental illness (Kuhn and Culhane 1998; Poulin et al. May 10, 2022” [Emphasis added]

There are, of course, dozens of studies that show correlations between being un-housed and having HIV, needing more hospitalizations for serious trauma, injuries, violence, malnutrition, hypothermia, etc. But these statistics, which ‘Housing First” advocates like to cite, ignore the reasons for being un-housed in the first place. And there is a profound lack of evidence that all things considered, housing itself contributes to overall, long-term mental health improvement or addiction reduction.

If anything, the preponderance of evidence indicates that our homeless policies are upside down and instead of spending all our funding on renting hotel rooms and building expensive housing, our policy should be “individual health first,” which includes all of the social, medical, psychiatric, and other services noted above, first and foremost, to help the homeless rebuild their lives in the way they chose to.

Homeless Veterans

Homeless veterans are a case in point: a group that is disproportionately represented in our homeless population. According to a veterans support organization, Pine Street Inn in Boston,

“About one-third of the adult homeless population are veterans. The majority of them are single; come from urban areas; and suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders.”

These are individuals who, without question, have suffered enormous trauma and stress. The correlation between their lack of physical and mental well-being strongly suggests that a ‘roof over their heads’ is not their top health priority and not a substitute for their need for extensive social services and support programs.

Who cares for the homeless?

In 1967, then-Governor Ronald Reagan signed the California Lanterman-Petris-Short Act. The original purpose was to stop people from being forcefully committed to state mental health institutions by third parties, against their will. It argued that such actions were being abused: certainly a worthy goal.

However, soon after, in the name of “getting rid of big government, “deinstitutionalization,” and a belief that markets can solves all problems, the newly elected Reagan Administration and a conservative Congress decided that local community treatment facilities were sufficient to deal with public mental health challenges and followed California’s example at the federal level with the repeal of the Mental Health Systems Act of 1980 -- a law passed by President Carter that funded local community health facilities to provide these needed services.

In true Orwellian style, the Reagan Administration called this repeal the “Patient’s Bill of Rights.”

Wikipedia adds,

“The most important factors that led to ‘deinstitutionalization’ were changing public attitudes to mental health and mental hospitals, the introduction of psychiatric drugs, and individual states' desires to reduce costs from mental hospitals.”

All this coincided with the prominence of trickle-down economics and the time when the average, middle-class wages and the cost of living began to negatively diverge, leading undeniably to the housing affordability challenges and the homeless crisis we have today, albeit for completely different reasons.

As a result, most state and federal institutions were closed and no new funding was ever provided, which, of course, led us directly to the mental health disaster we are witnessing on the streets. As it is, in California, no one can be held in a mental health facility against their will for more than a 72-hour observation period unless they commit a criminal act or they are proven to be a threat to themselves or the safety and welfare of others.

Or as writer Fiona Dourif recently wrote about a quandary to get treatment for her mother,

“When a social worker explained my mother would have to want treatment, [but I couldn’t force her to get treatment] I wanted to say, “She wants invisible men in trees to stop following her around. She wants me to buy a camera she can tie to a street lamp.”

I'm not arguing that we should go back to having people committed without checks and balances and due process, but without a more comprehensive and compassionate approach to the challenges of homelessness our current ‘you’re on your own’ mental health treatment system has only succeeded in having people camped out in every conceivable nook and cranny of our urban landscape, while drug companies inundate the rest of us with TV advertising about what medications we should be “asking” our doctors to prescribe for our collective stress-related conditions.

Bob Silvestri is a Marin County resident, the Editor of the Marin Post, and the founder and president of Community Venture Partners, a 501(c)(3) nonprofit community organization funded by individuals and nonprofit donors. Please consider DONATING TO THE MARIN POST AND CVP to enable us to continue to work on behalf of all California residents.