Saturday, December 3, 2011

Ask Not What The Homeless Can Do For You, Ask What They Can Do For Themselves

Article first published as Ask Not What the Homeless Can Do for You, Ask What They Can Do for Themselves on Blogcritics.

In an earlier article I wrote briefly about homelessness, and stated that a primary cause was mental illness, followed by substance abuse.  I would like to clarify and elaborate on that, give some cites (and sites) for more information, and posit a possible solution.

I started my recent reading using the Wikipedia Article on homelessness in the US.  [Note on Wiki articles – Some of you don’t trust Wiki articles and you are right to be suspicious, but there is frequently good information to be found there.  I have been using it for basic research for many years and found that it is mostly reliable.  The best articles will be lengthy and detailed, have extensive references, and plenty of external links.  At the least, it is a good place to start for a basic understanding of a topic.]  I followed several of the internal and external links to find more information, and also checked many of the references to satisfy myself that the information presented was good.  I think that it is, but Caveat Emptor.

The actual numbers of homeless are hard to quantify, since there is no national effort to do so, only the collation of local and/or state reports.  Most large cities have a fair estimate of those using shelters, but the numbers for those not using government or charity shelters is at best a guess, and as for small towns and rural areas, it is worse than a guess.  Lest you think that Congress is not in this loop, here is the annual report to them for 2011.

This article about criminalizing homelessness and the source of the statement that the UN was concerned about safe drinking water in our homeless population.  I have wondered in the past why so much advertising money is spent on charities to provide food, water, and shelter for foreign children (“Please help. For only $0.23 per day you can…”), when we have adults AND children in our own country that have those same needs.  The cynic in me believes that most charities are scams to provide money to the organizers, but realistically, I know that SOME of them probably do some good.  As Thomas Fuller said, “Charity begins at home, but should not end there.”

The Prime cause for homelessness is said to be a lack of affordable housing, and I can’t argue against that.  But as I recall, in almost every large city, there are what we call “projects” that were supposed to be low-cost housing.  I also recall that these have become breeding grounds for drugs, gangs, violence, and crime.  It shows up in the news like in this story, or this one.   I don’t know why this doesn't work like we expect, but it may have more to do with racial or ethnic segregation and discrimination than we would like, as described in this paper.

We can trace the genesis of the mentally-ill homeless to the late 1960s and early 1970s when there was a movement towards deinstitutionalization.  The idea had lofty goals; to move mentally ill people from large, impersonal institutions into a more community-centric care system.  Unfortunately, and to our shame, this did not work as planned, and I hope that this was not done at the behest of a rich cabal solely to make more money.  This article  has both a good description of the problem and some references.  For those of you that want to understand the numbers better, here is a paper using 29 different studies.  This
PBS site has a good list of the statistics and some links to other good information.

There is some question as to whether homeless people are more likely to become mentally ill while living on the streets, or that mentally ill people are more likely to have no other place to live.  I don’t see that being homeless is causative; it seems more likely that homelessness makes their illness worse, if only because they lack access to medical treatment and counseling.  It would seem more likely that this is true of substance abuse than of mental illness.

Here is an article that discusses the problem in our friendly neighbors to the north, Canada.  I have run across several studies that were performed in Western Europe, so we know that the problem is not isolated to America, or even the North American continent.  I’m not going to cite those since I am most concerned in the immediate US problem (and this is getting kind of long).

There is also a high incidence of co-morbidity with mental illness and substance abuse, probably stemming from the prevalence of using drugs to self-medicate.  It is much more difficult to treat a mental illness when drug abuse is present.  Here is an article describing this dual diagnosis from the National Alliance on Mental Illness.  There have been some studies looking into all three of these co-linked problems: Housing, Mental illness, and Substance abuse.  This article talks about all three.

We don’t want to forget that a large portion of the homeless are veterans, to whom we owe a large debt.  They, being a subset of the overall population of the US, have similar ratios of substance abuse and are more likely to have a mental illness with the additional possibility of PTSD.

On my personal blog I wrote an article about how we might provide some jobs to the unemployed.  One of my solutions was to copy, as much as feasible, the CCC and WPA programs from the 1930s and 1940s – this was the same “New Deal” that is currently being disparagingly talked about in Washington.   These programs spent a large amount of government money, but also provided work for those that needed it and built up some national infrastructure.  It looks to me like we could stand to do both of those things again, now.

So, here is my basic plan – we build small, self-sufficient villages for these people, as near major population centers as reasonable.  The homeless will help construct and maintain these small towns, each contributing as their ability and health permits.  Overseeing these projects are the thousands of returning military service-people, many of which will need facilities such as are being built for themselves.  For those requiring it, medication can be supplied, or in the case of abuse their recovery and rehabilitation can be monitored.  In both of these cases this would be an absolute requirement for living and working in this place.  It may turn out that some of the severely mentally ill people can never significantly contribute to society, and if that is the case, they will have a pleasant location to live out their lives in safe surroundings.

As skills and abilities are acquired or enhanced, these newly enabled people can move back into the general population.  This would seem to satisfy the basic need of housing, the secondary need of work and building self-esteem, and a tertiary need of gaining education and skills to be able to re-enter the workforce.  The concentration of efforts should allow for maximum efficiency in distribution of funds to start and maintain these facilities.

I don’t have any estimates on what this program might cost, but whatever that is; doesn’t it seem like a good investment?  If this basic idea works, then it seems possible to expand it to the original goals of the CCC and WPA; having the newly skilled work force apply themselves to infrastructure projects.  Construction and maintenance of the levee system looks like a good place to start.

I’m sure that there are people out there that have a better understanding than I do of what needs to be done, so please speak up.  I would think that it is possible to get, even the ultra-conservatives behind this.  We sell it as “making the streets safer”, or “making the city more attractive”, or something similar.  Advertising agencies could be hired to make it sound compelling to the rich.

What do you think?

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