This past week, Vanity Fair published a story on California politics in which Nancy Pelosi weighed in on the state’s homelessness crisis. Though the state has poured a number of resources into housing the homeless population, especially during the pandemic, there are “a lot of people who don’t want to come off the street,” Pelosi said. “It’s drugs and mental health. If we don’t get the mentally ill off the street, we’re never going to solve the homeless problem.” Pelosi, to her credit, has pushed for more affordable housing in the state, but her statement reflects a frustrating feature of homelessness discourse: an emphasis on drug abuse and mental illness, rather than a lack of housing, as the source of the problem. Many people talk about California’s homeless community as a monolith, yet the state really has three distinct homeless populations, and much of the public’s confusion about what should be done about the crisis comes from a fundamental misunderstanding of what homelessness actually looks like.
The first and biggest category (and arguably the least visible) is often called short-term homelessness, which describes about two-thirds of California’s homeless population. This might include, say, a young woman who recently experienced a mental-health crisis that caused her to lose her job and her apartment. She might patch together a series of temporary solutions—staying in a car, on the couch of a friend, maybe a few weeks in a congregate shelter, or, if things go badly, beneath a freeway underpass with other homeless people—until she’s placed in permanent supportive housing. If a person in this category makes it to permanent supportive housing, she will almost certainly stay off the streets.
The second category is chronic homelessness, which makes up about a third of the homeless population. The people who fall under this category might be living under a bridge or in a tent encampment in San Francisco’s Tenderloin district, or Skid Row in Los Angeles. Many suffer from severe mental illness, which, when combined with the stress of living on the streets, might push them toward methamphetamine and fentanyl, both of which are cheap and easy to obtain.
But among the chronically homeless population there’s an even smaller subset that doesn’t have an official label. This group is sometimes called service resistant, because they refuse most forms of shelter, including the traditional congregate model or the tiny-home villages that are being built all over the West Coast. In rare instances, they will have come to California from out of state. People in this category may be resistant to service owing to mental illness, or past traumas in the system. At times they will experience a break from reality and stagger into a shopping mall, grocery store, or onto public transit, where they become the most visible, graphic, and talked-about examples of the problem.
When the state of California talks about homelessness, it’s largely drawing upon a consensus of experts and advocates who want to employ an evidence-based approach to the issue, aiming to prevent people from slipping deeper into homelessness—whether from housed to unhoused, or from short-term to chronic. When aggrieved individuals talk about homelessness, they’re often talking about their visceral response to the “service resistant” individuals who make up just a fraction of the over-all homeless population. The average homeowner or renter in San Francisco or Los Angeles doesn’t really care who might be staying in the shelter system, nor does he care all that much if a family has decided to crash for a few nights in a car (as long as it’s not parked on his block). He cares when he walks down the street to his office and has to pass through encampments, or when someone walks onto a bus and starts to act erratically. He doesn’t see how building housing for mostly stable people who are quietly living in cars actually addresses the problem.
For the past two decades, the federal government has pursued a program called Housing First, which argues that all the corrosive effects of homelessness, for the unhoused individual and for the civic well-being of a community, can be better addressed once everyone is under a roof. In 2016, the State of California passed a bill requiring all housing programs to follow the Housing First model. But restrictive zoning laws and homeowner activism have effectively hamstrung the program in the state, making it nearly impossible to build anything, much less permanent supportive and affordable housing. Even with minimal interference, it would take years to either build or convert existing structures into permanent supportive housing; equip it with the necessary services, such as drug counselling, job support, or meal programs; and then fill the units with residents. Given the growth of the homeless population during the pandemic, the spike in overdose deaths in California’s biggest cities, and the spread of tent encampments, the immediacy of the problem has overwhelmed what Housing First can reasonably promise to an increasingly angry public.
For those raising the alarm that drug addicts and drifters are flooding California’s cities, Housing First has become an epithet for the government’s inefficacy in addressing the homelessness crisis. It’s an intractable bind: if a program gets a lot of short-term homeless people into housing but doesn’t do much about the chronic and service-resistant homeless populations, the angry part of the public will still decry it as a failure. A program that sweeps all homeless people out of the public’s eye (whether into forced treatment or jail) will be seen as a success, even if it allows the short-term homeless to circulate between bad options until they, too, become “problems” to be booted off the streets.
This dynamic—two sides talking past each other about related but different problems—has deepened an already polarized debate about the root causes of homelessness. Critics of Housing First argue that the narrow focus on housing neglects the social ills, such as drug abuse and mental illness, that are actually causing the crisis. Advocates of Housing First rightly point out that problems with mental illness and drug use would be better addressed under a roof, where counsellors and support could reliably reach a person experiencing distress. They also argue—again, correctly—that years of precarity exacerbate treatable problems, and that people need earlier interventions before they become chronically homeless or service resistant. Their opponents say something like “O.K., but what are you going to do about all the mentally ill people who are on drugs?”
A new report by the Benioff Homelessness and Housing Initiative, of the University of California, San Francisco, brings a bit of clarity to this conversation. The study, conducted with more than three thousand participants in the course of a year, contains key findings that would, in more reasonable contexts, bridge some of the divides between Housing First advocates and their opponents. In a number of ways, its findings confirm the fears of the most fervent alarmists: eighty-two per cent of respondents, for example, “reported a period in their life where they experienced a serious mental health condition.” Sixty-five per cent “reported having had a period in their life in which they regularly used illicit drugs,” and almost just as many reported problems with alcohol. A full thirty-one per cent reported “regular use of methamphetamines.” But the research also shows that the full scope of the problem is more nuanced, and calls for interventions other than whisking homeless people off the streets.
The study dispels some of the more pernicious myths about the homeless population, namely the increasingly popular claim that most of the people you find on the streets of San Francisco and Los Angeles are transplants from other states who have arrived to take advantage of lax drug and public-camping laws. In fact, the survey found that “nine out of ten participants lost their last housing in California.” And it disproves the fearmongering talking point that California’s homeless population has no desire in getting off the streets, reporting that “nearly all participants expressed an interest in obtaining housing, but faced barriers,” including documentation, prior evictions, and poor credit. In my own reporting on encampments, I’ve found some mixed responses to this sentiment: most people do not want to go to congregate shelters, where many people sleep together in a room, and where theft and abuse are rampant, but nearly everyone seemed open to any situation where they would have a locking door and some measure of privacy.
The report also shows that the makeup of California’s homeless population is more varied than a lot of public discourse about it makes it seem. The study found that thirty-two per cent of respondents were leaseholders or homeowners at the time when they became homeless, compared with forty-nine per cent who were living in a place without being legally obligated to pay either rent or a mortgage each month. (The remaining nineteen per cent came from prison or jail.) About half of the people who were not on a lease when they became homeless paid no rent in the months leading up to them becoming homeless; the other half were paying a median monthly rent of four hundred and fifty dollars. What all of these people have in common is that they could have benefitted greatly from interventions early on. The vast majority of respondents said that a small amount of cash could have helped them avoid homelessness in the first place.
The researchers’ policy recommendations are mostly in line with the usual Housing First approach. The authors suggest increasing “access to housing affordable to extremely low income households,” which would be achieved through a mix of building new housing, expanding the voucher system, and making it harder for landlords to refuse renting to someone using government assistance for housing. They also call for an expansion of “targeted homelessness prevention,” which would provide economic support for people who are about to be evicted or tossed from their homes for any number of reasons, including domestic violence.
Such measures would undoubtedly help people who, for whatever reason, have recently fallen behind on their rent and have been forced out onto the streets. They probably wouldn’t appease the very vocal contingent that wants the encampments cleared and the chronically homeless population completely out of sight. The Housing First approach remains, in theory, the best way to address the issue of homelessness in all its forms, because it tries to address the source of the problem. But the impediments to providing housing are stubborn; even if it were feasible to seamlessly build new developments, it would be impossible to persuade the public to simply wait a decade for the housing supply to catch up with demand. For now, all we have is our existing vicious cycle, in which the government tries to intervene in less visible ways, and the loudest members of the public claim that nothing is changing. ♦