There are solutions, but is there the will?
Sunday, January 27, 2002
©2002 San Francisco Chronicle
People are fed up with homelessness. Local residents recoil from drug addicts and alcoholics sleeping on the streets. Numbed by compassion fatigue, they shove away aggressive panhandlers, shout back at people raving on the street corners, and demand that something be done.
Ask most Californians whether we can end homelessness, however, and they'll tell you it's hopeless.
But they're wrong. We know what works. We know what causes homelessness and we know how to end it. The problem is a failure of political will, not a lack of knowledge.
Thirty years ago, homelessness conjured up specific images -- the odd hobo who rode the nation's rails, the migrant worker who followed agricultural harvests, or the runaway teenager who turned up as a hippie on the streets of San Francisco.
Today, the tens of thousands of homeless people represent quite a different population. In 1969, California closed its mental hospitals, but never replaced them with community-based mental health treatment centers. Twenty years ago, the federal government, for all practical purposes, stopped building affordable housing.
As a result, most of today's homeless suffer from extreme poverty, drug or alcohol addiction or severe mental illness.
As the debate over the homeless heats up, expect to hear from vocal individuals and constituencies whose political agendas often compete for the public's loyalty.
THE POLITICIAN AND THE CRACKDOWN
Talk to an ambitious politician and you'll hear about plans to crack down and get rid of the problem. Soon, squads of police will swoop down on the homeless. For violating any number of municipal ordinances, some of them will land in the county jail. Still others will be crammed into crowded shelters.
For several weeks, the police will appear at the same location, scattering the homeless to other neighborhoods. Then the politician will call a press conference, declare victory, and call off the police.
Then the futile cycle begins all over again.
THE CIVIL LIBERTARIAN
Advocates for the homeless and mentally ill argue that politicians have no right to harass the homeless, who have nowhere else to go. In their view, the homeless have a right to refuse shelter, as well as medication.
Their message, in short, is that if the community refuses to provide the homeless with decent jobs, affordable housing and adequate treatment, then they have every right to live wherever they want.
What these advocates fail to acknowledge, however, is that homeless squalor robs the community of civility. And what they don't see is that there is nothing humane or dignified about allowing people to live on the streets.
Speak to the families of the homeless mentally ill and they'll offer you a somewhat different perspective. They are the people who have watched their relatives suffer from severe mental illness and it is they who rage against a system that allows their loved ones to end up living on the streets or in encampments. They are the activists who have witnessed their families torn apart as a result of violence, including suicide and homicide. They know that the severely mentally ill don't always know they need help. They are actively supporting forced outpatient treatment for the severely mental ill.
Unlike the politician, the families are against crackdowns. Unlike advocates of the homeless and the mentally ill, they don't believe society should allow people to live and die on the streets of its cities.
MENTAL HEALTH DIRECTORS
Listen to Steven Mayberg, director of California's Department of Mental Health, or other administrators of county mental health programs in the Bay Area. They will tell you that they already know what works.
What we need, they argue, are wraparound services that address the extensive needs of homeless people.
By this, they mean mobile teams of outreach workers who, because of their familiarity with the homeless as individuals, can offer shelter, medication and rehabilitation. They want mental health clinics to be staffed around the clock, so that the homeless can get help whenever they need it. They also want enough shelter beds for every homeless person, including the growing number of families left homeless by the recession and rising unemployment.
In addition, they recognize the urgent need for community-based centers and affordable housing where the severely mentally ill can meet and live -- assisted by mental health staff.
Create such housing and provide such wraparound services, they argue, and much of our homeless problem will disappear.
Before you dismiss these people as crackpot idealists, consider what they have accomplished. During the past few years, state-funded pilot programs have provided such wraparound services in Sacramento, Los Angeles and Stanislaus counties. The results have been impressive; homelessness declined dramatically.
These programs have demonstrated that voluntary care is the single-best way to reach the homeless and to get them off of the streets.
Despite their differences, all these constituencies can agree that voluntary outreach services are exactly what the homeless need. In other words,
this is a winning political solution around which a powerful coalition can be built.
So why, you may ask, hasn't this political solution taken the state by storm? Why, if everyone knows what works, don't we have a state fully staffed with such integrated care for the homeless?
The hard truth, alas, is indifference, a failure of political will.
Although every elected official will moan and groan about the expense of such services, we already spend millions of dollars on the homeless and the severely mentally ill -- by arresting them, housing them in prisons and paying the costs resulting from people living in the streets.
It would be far more decent and less costly to do what actually works. We have heard enough excuses. It's time to act.
©2002 San Francisco Chronicle Page D - 4