I can’t prove it nowadays, but I once remarked that society should find a way for homeless people to be separated by how they became homeless.
The context was that homelessness is a spectrum and that being indiscriminate when doing anything related to the homeless downplays the enormous gap between forms of it. I’ve been on both sides of it before; I’ve technically been “homeless” (I’ve had a roof over my head for as long as I can remember, but it was often couch-hopping), as well as have done things related to the homeless. Sometimes I ask about it, I expect by now it might range between “I’m a teetotaler whose house burnt down and I’ve been on the streets ever since” to “I keep getting a home but keep losing it in shady gambles”. Surely homelessness is a case-by-case thing, right?
People are blind to these differences, however. To most outsiders, homelessness is just homelessness. From the outside, these things don’t come to mind when people are protective, so if you mention wanting to do it case-by-case, you feel the wrath of the population who I have seen seemingly insist I’m being discriminatory over victims of a sensitive topic. I think maybe a few hundred or so people weighed in against me. It was not only what many might call the most particularly severe example but also one of the earliest. The tragically “funny” thing is that it’s one of those things where most people immediately learn the reality of as soon as they become a victim of homelessness, actually interact with them, or even spend time in a psych ward like me because a lot of them turn themselves in because it means you’ll get care, so it becomes one of those things that’s said to be like a litmus test for if someone is genuinely associated with it versus someone who sees portrayals of it and tries to look like they are.
This was probably all in the phrasing or maybe people just don’t understand the reality of the situation?
I worked for several years doing mobile therapy that included a significant amount of homeless outreach and crisis management. Everyone deserves to be housed, bottom line, but what it takes for that to happen is a complex situation
There’s the “xxx,xxx amount of homeless but xx,xxx,xxx amount of empty homes in america” statistic that people throw around. I forget the exact numbers but I’m pretty sure thats the scale, if not the take away is that you could literally give each homeless person a free house and still have millions of empty houses. But this would not solve homelessness, at least in the current system. The overwhelming majority would be back on the street fairly quickly. Even if you eliminate the need for mortgage there’s still the need for property taxation; if you eliminate that then communities start to get real shitty. Even if you eliminate that there’s still utility and food costs. Even if you eliminate that there’s still maintenance and not actively destroying the place.
Institutionalization isn’t necessarily the answer although in extreme cases it can be. We had supported rehabilitation programs that were pretty successful, basically apartments with staff that would keep tabs on you, help you budget, do resumes, help you get to drs appointments, make sure you took medications (but didn’t force you to unless there was a court order/probation situation and even then it wasn’t like a “force” situation although there was inherent coercion as not taking meds would be reported to po/court), apply for section 8, etc. you would stay there for a year or two and then move to a more independent placement once supports were in place.
There were also longer term programs for people who genuinely struggled and just couldn’t get that step down to work. These were similar but had less focus on connecting to services and were more akin to nursing homes with more psychiatric care
But then there were also more intensive residential programs we referred to for people with more serious mental illness or addiction issues
The issue, of course, was funding. We had like 32 beds in the short term and 11 in the long term. Funding was like 50% state funding, 20% grants, 30% donations and fundraising and the budgets were tight. Meanwhile the town probably had 30-50 actively homeless at any given point on top of whoever wasn’t in the program and another 50-100 with insecure housing. Even the intense programs, which generally had more secure state funding, still had an overall lack of beds and would have very long wait lists. Sad stuff.
That was about a decade ago now, I feel like it has to be worse now post Covid and trump. I can only imagine what the next 4 years will do to their funding
It’s almost as of there are archetypes for patients in hospitals due to common, middle of the bell curve occurrences of comorbidities. Example: diabetic dialysis patient with anemia and 1-2 amputations above/below the knee due to pernicious vascularization complications. No, that’s not your family member, that is a common scenario given the convergence of certain conditions.
Should medical professionals be indiscriminate here? Treat everyone like a dialysis patient? No. That sounds ridiculous because it is. People are wild and varied within every context including homelessness.
Here’s an archetype situation seen among the homeless population. A pernicious issue with lower extremity circulation occurs (due to diabetes, frostbite, infection left untreated) such that patient can no longer walk after receiving medical care (often amputation). Patient is also homeless and can’t just be discharged to street due to inability to walk. Patient needs to be placed, on Medicaid, in a nursing home. Patient is on the sexual predator list and thus no nursing home will allow them in their facility. Patient sits in hospital room taking up space, not receiving medical care because they no longer need any, waiting, for months. That hospital room is now a hotel room with medical professionals supplying room service.
Go to the sex offender registry and do a 3 mile radius search of your own address. Good odds you’ll find some, and more than you think you should. No address, then how do these guys get registered by their location?
It’s not as daily scenario, but a memorable one that happens every 3-6mos like clockwork. And those are just the homeless sex offenders coming in for medical treatment that cannot then just be discharged back to street.
People are not the same and should not be treated as such. You are not wrong there. Destroying children shouldn’t receive the same consideration for an apartment as someone living in their car due to a bit of bad luck.
I can’t prove it nowadays, but I once remarked that society should find a way for homeless people to be separated by how they became homeless.
The context was that homelessness is a spectrum and that being indiscriminate when doing anything related to the homeless downplays the enormous gap between forms of it. I’ve been on both sides of it before; I’ve technically been “homeless” (I’ve had a roof over my head for as long as I can remember, but it was often couch-hopping), as well as have done things related to the homeless. Sometimes I ask about it, I expect by now it might range between “I’m a teetotaler whose house burnt down and I’ve been on the streets ever since” to “I keep getting a home but keep losing it in shady gambles”. Surely homelessness is a case-by-case thing, right?
People are blind to these differences, however. To most outsiders, homelessness is just homelessness. From the outside, these things don’t come to mind when people are protective, so if you mention wanting to do it case-by-case, you feel the wrath of the population who I have seen seemingly insist I’m being discriminatory over victims of a sensitive topic. I think maybe a few hundred or so people weighed in against me. It was not only what many might call the most particularly severe example but also one of the earliest. The tragically “funny” thing is that it’s one of those things where most people immediately learn the reality of as soon as they become a victim of homelessness, actually interact with them, or even spend time in a psych ward like me because a lot of them turn themselves in because it means you’ll get care, so it becomes one of those things that’s said to be like a litmus test for if someone is genuinely associated with it versus someone who sees portrayals of it and tries to look like they are.
This was probably all in the phrasing or maybe people just don’t understand the reality of the situation?
I worked for several years doing mobile therapy that included a significant amount of homeless outreach and crisis management. Everyone deserves to be housed, bottom line, but what it takes for that to happen is a complex situation
There’s the “xxx,xxx amount of homeless but xx,xxx,xxx amount of empty homes in america” statistic that people throw around. I forget the exact numbers but I’m pretty sure thats the scale, if not the take away is that you could literally give each homeless person a free house and still have millions of empty houses. But this would not solve homelessness, at least in the current system. The overwhelming majority would be back on the street fairly quickly. Even if you eliminate the need for mortgage there’s still the need for property taxation; if you eliminate that then communities start to get real shitty. Even if you eliminate that there’s still utility and food costs. Even if you eliminate that there’s still maintenance and not actively destroying the place.
Institutionalization isn’t necessarily the answer although in extreme cases it can be. We had supported rehabilitation programs that were pretty successful, basically apartments with staff that would keep tabs on you, help you budget, do resumes, help you get to drs appointments, make sure you took medications (but didn’t force you to unless there was a court order/probation situation and even then it wasn’t like a “force” situation although there was inherent coercion as not taking meds would be reported to po/court), apply for section 8, etc. you would stay there for a year or two and then move to a more independent placement once supports were in place.
There were also longer term programs for people who genuinely struggled and just couldn’t get that step down to work. These were similar but had less focus on connecting to services and were more akin to nursing homes with more psychiatric care
But then there were also more intensive residential programs we referred to for people with more serious mental illness or addiction issues
The issue, of course, was funding. We had like 32 beds in the short term and 11 in the long term. Funding was like 50% state funding, 20% grants, 30% donations and fundraising and the budgets were tight. Meanwhile the town probably had 30-50 actively homeless at any given point on top of whoever wasn’t in the program and another 50-100 with insecure housing. Even the intense programs, which generally had more secure state funding, still had an overall lack of beds and would have very long wait lists. Sad stuff.
That was about a decade ago now, I feel like it has to be worse now post Covid and trump. I can only imagine what the next 4 years will do to their funding
It’s almost as of there are archetypes for patients in hospitals due to common, middle of the bell curve occurrences of comorbidities. Example: diabetic dialysis patient with anemia and 1-2 amputations above/below the knee due to pernicious vascularization complications. No, that’s not your family member, that is a common scenario given the convergence of certain conditions.
Should medical professionals be indiscriminate here? Treat everyone like a dialysis patient? No. That sounds ridiculous because it is. People are wild and varied within every context including homelessness.
Here’s an archetype situation seen among the homeless population. A pernicious issue with lower extremity circulation occurs (due to diabetes, frostbite, infection left untreated) such that patient can no longer walk after receiving medical care (often amputation). Patient is also homeless and can’t just be discharged to street due to inability to walk. Patient needs to be placed, on Medicaid, in a nursing home. Patient is on the sexual predator list and thus no nursing home will allow them in their facility. Patient sits in hospital room taking up space, not receiving medical care because they no longer need any, waiting, for months. That hospital room is now a hotel room with medical professionals supplying room service.
Go to the sex offender registry and do a 3 mile radius search of your own address. Good odds you’ll find some, and more than you think you should. No address, then how do these guys get registered by their location?
It’s not as daily scenario, but a memorable one that happens every 3-6mos like clockwork. And those are just the homeless sex offenders coming in for medical treatment that cannot then just be discharged back to street.
People are not the same and should not be treated as such. You are not wrong there. Destroying children shouldn’t receive the same consideration for an apartment as someone living in their car due to a bit of bad luck.