It's interesting the response to my provocative list which is literally the exact same list as SurrealPlaces with the cruelty removed. All of their more complex sophisticated solutions involve the state providing public housing. Jail is housing, plus meals, plus cruelty. Forced inpatient treatment in turn is jail plus deniability. Nobody said that housing was too simplistic because it didn't offer meals, which suggests that whatever we do with the homeless, it better be cruel to at least some of them.
I think one of the core problems in dealing with the homeless population is the just world fallacy; if we admitted that anybody could become homeless and it is just their bad luck, then we are also admitting we might be in this group tomorrow, which is terrifying. Better to treat them with 'sin talk' where they are all criminals or 'sick talk' where they are all uncontrollable addicts; we're neither of these things so we're safe.
The other interesting thing is how much pushback I got because housing isn't a total solution. We have a problem with unemployment; when someone posts about a new company expanding operations nobody scoffs that that isn't going to employ everybody. We have a problem with downtown office vacancy; a building being converted is seen as a positive step, not an unrealistic approach because there are other buildings still empty -- how could this be a realistic solution unless every square meter of unused floorspace is taken care of?
The third interesting thing is how much more pushback I got for suggesting housing than InfrastructureEnthusiast got for
suggesting mass murder extermination.
When it comes to homeless people it would be good if we had a degree of severity index or such. The only thing all homeless people have in common is being unhoused, but that’s it. It’s not a good way to label group of people who have various issues. Solutions have to be applied to the address each issue.
Housing helps, but like many have already pointed out, it’s not the solution only part of it. For some, addictions and mental health issues caused them to be homeless, and for others it’s reverse, homelessness caused the addictions and mental health issues.
Also the question remains about those too severe to be helped. Housing isn’t going to help them.
I think this is actually working towards the key point; thinking of homeless people as a single group is useless for policy purposes and comes up with simplistic solutions. Any caseworker will tell you that every person who is unhoused has a unique set of issues and concerns. But this is too fine-grained to be workable.
As a straw man, let me propose three groups. Group 1 are people who would function perfectly well in society and a little help with housing for a few months is the only thing they need. Maybe they've left an abusive partner, or been thrown out from their parents home after coming out of the closet, or they drive as a gig job and their car's timing belt blew and they couldn't afford both repairs and rent. They could certainly benefit from other supports, but so could many or most people with stable housing. Group 2 are people who probably need housing for longer, and also more treatment or assistance; perhaps a fair portion of people at this level have some level of substance abuse or mental health issues or trauma that will cause an issue in supporting themselves in stable long-term housing. Group 3 are people who need long-term housing support as well as more intensive supports, and this might be for the rest of their lives.
What this suggests -- beyond different policies -- is the value of housing in prevention. Where do Group 2 and Group 3 people come from? Were they working a normal job, then the day they left their abusive spouse they wound up completely unable to stay in housing for the rest of their lives? Did they run out of couches to surf on and the next morning wake up addicted to fentanyl and threatening passerby? Or did they begin as Group 1, and then after spending time on the street, they 'graduated' to Group 2 and then if really unlucky Group 3? Homelessness is an extreme lifestyle compared to the 'norm', and people who spend time in situations with extreme lifestyles (prison, the military, in war) have a very difficult time adjusting back to the 'norm' when they leave those lifestyles. All of the behavioural choices that are adaptive for the extreme situation are not for the 'normal' one.
Fundamentally, homelessness causes homelessness. Being homeless is a great position to increase exposure to substance abuse, to be traumatized, to be injured, to become antisocial. And it's a terrible way to overcome mental health problems, to get a stable job, to kick a habit. And those problems make leaving homelessness more difficult. The second most important thing to reduce the homeless population is to minimize the time people spend being homeless.
The most important thing is to prevent people in Group 0, those at risk of homelessness (
115,000 people in Calgary by recent estimate) from becoming homeless.
This study shows that by far the strongest predictor of homelessness in Canada is low-end market rental rates. It also shows that Calgary is an outlier in having higher homelessness rates than expected; some of that I suspect is that Calgary is a city of migrants (both internal and international) so we have people with smaller social networks to fall back on, but I also notice in figure 18 that Calgary is an extreme outlier in having the lowest share of people in non-market housing or with cash supports; about 2.5% versus more like 4% on average.
Substance abuse and mental health disorders are both much more prevalent in the homeless population than the population at large, but they are not a 1:1 cause. Based on
federal rates, Calgary has around 36,000 users of crack or cocaine, and 120,000 users of opioids. But the most recent
point in time count for homelessness found 3600 people; 10% as many as the number of crack/cocaine users. And that point in time count showed only 11% citing health and 16% substance use issues as being the cause of their homelessness; 35% blamed the lack of income. Certainly having an opioid addiction makes it more difficult to maintain stable housing, but nevertheless the majority of people who are addicted to opioids do so.
A different approach to three groups is in
Kneebone et al's profile of homelessness in Calgary. They group shelter users into 'Transitional', 'Episodic' and 'Chronic'. Transitional users have an average of 1.74 episodes of homelessness lasting 8.4 days on average; episodic have 8.28 episodes of 15.9 days duration on average; chronic have 3.48 episodes of 927.1 days duration on average. Transitional users are 86% of shelter users, episodic are 12% and chronic are 2%. But in terms of resource use, the three groups are nearly equal; transitional users are 31% of beds, episodic are 34%, and chronic are 35%. Interestingly, further work by his group found about the same success rates for Housing First programs for transitional and chronic shelter users (58% and 51%; 55% across all populations), although lower success rates for episodic interestingly.
Housing first is not housing only, but it is housing first. Once the vast majority of people experiencing homelessness have housing and help, perhaps there is still a small number of people who remain homeless and who cannot be helped. At that point, we can be confident that our society is not creating more people in that condition, and we can decide whether we need to do something more drastic or whether a few eccentrics are alright.
