Why are there so many homeless people in the USA?
March 3, 2013 9:24 AM   Subscribe

Please help my son (17 years) with a presentation about the homeless people in the US. We are from Scandinavia, and due to our welfare system, we don't have the same situation as in the US. We have explored several issues, and the more we search, the more questions we have.

For example, in our country, if you lose your job, you will get 2/3 of of your salary from the govnt. (under a certain amount) till you find a new job, or if you become sick/have an accident, you will be on welfare, also receiving about 2/3 of your salary (also limited to a certain amount) somewhere between one - two years. It has to be said that the "certain amount" is quite good. You can live well - with compromises of course (depending of course what your salary was). After that, if you are not able to work, you would still have sufficient means to manage (though for many, it is difficult). This basically means that you will get help - and still be able to live where you live, or move to a cheaper place. Hospital is free here. So, the questions are...

Is it correct that the main reasons for becoming homeless are;

- losing your job, not being able to pay a mortgage/rent
- becoming sick/having an accident without health insurance
- mentally ill people
- drugs/alcohol

What have we missed? But what about social service in the states? Welfare? Is it a fact that if you get fired, and you don't have a salary coming in next month, then there is no unemployment aid?

Do you always have to have a health insurance? What about Obama's new health care bill? Does this help?

What can the homeless do to get help; food, shelter, financial aid, get back into "real life" again?

Thanks in advance!
posted by dreamsandhope to Human Relations (45 answers total) 37 users marked this as a favorite
The reasons sound spot on. The sad part is an addendum to number 2: even with insurance, on certain (terrible) plans (deductibles, claim denials), hospital bills can be crippling.

Predatory lending is also a factor, which disproportionately affects the already-poor.
posted by supercres at 9:41 AM on March 3, 2013 [2 favorites]

Another important factor is our population of homeless war veterans. It's a significant population by percentage and sheer number.

Here's a useful resource that includes info on homelessness among vets.
posted by nacho fries at 9:47 AM on March 3, 2013 [2 favorites]

Here is a fact sheets that answer some of your questions:

Snapshot of Homelessness

It is not true that there is no aid available for people who lose a job. Provided that the job loss was not due to gross misconduct, there is unemployment insurance. If you have few assets and no or very low income you are likely eligible for what we call welfare (Temporary Aid for Needy Families), Medicaid (health insurance for the poor) and food stamps (SNAP). If you are disabled you can get benefits through SSI or SSDI, depending on how long you worked before becoming disabled. There are also special veteran's benefits, and public housing assistance. Then there are a whole lot of miscellaneous services for special groups, like housing benefits for people with AIDS.

So, as you can see there are a variety of resources for the poor, but the rules for qualifying are likely more stringent and the benefits less generous than what other countries offer. It is actually not uncommon to receive benefits of some kind: 15% of Americans receive food stamps, for example. All of these are federal programs, but many are administered by the states, so there can be variation in how available and generous help is. There are also homeless shelters which offer a place to stay and a connection to other services (like free mental health treatment, help applying for government benefits, job seeking assistance, etc.) in most cities and towns.

The Patient Protection and Affordable Care Act will make it easier for people to get insurance through Medicaid or buy it more cheaply on the market. It won't have any impact on other types of benefits.
posted by reren at 9:50 AM on March 3, 2013 [7 favorites]

Has your son done any research? A lot of your questions can be answered with Google. For instance, there are unemployment benefits in the US. You can usually find a Wikipedia page either about a specific policy or problem in the US (unemployment in the US, homelessness in the US, health care in the US, etc.), or go to the more general page ("health care") and check the table of contents to see if there's a section on "United States."

Obamacare requires Americans to either buy subsidized health care (at a subsidize rate if you don't get it from an employer) or pay a fine. It hasn't fully gone into effect yet, so we can only speculate about the effect of this law on homelessness. I don't think being forced to buy health care or pay a fine is going to be a huge help for homeless people.

Remember that losing your job or even your home doesn't automatically make you homeless. You only become homeless if those things happen *and* you have no support network (friends, family) willing and able to offer you a minimally adequate place to stay while you work on finding a new job or whatever's necessary to get yourself back on your feet.
posted by John Cohen at 9:51 AM on March 3, 2013 [8 favorites]

There is financial aid if you lose your job. Wiki
posted by willnot at 9:51 AM on March 3, 2013

then there is no unemployment aid

There is assistance available as reren points out. For unemployment, most people are eligible if they were working the same job for long enough and not fired for misconduct, however, it may take longer to receive benefits than it does in other countries and you can be denied unemployment if your former employer contests it and wins. There is also housing and food assistance available, but again, they require that you apply and wait for approval, and in some cities the wait for housing may be months or years. For those that find themselves suddenly unable to make rent or buy groceries, the only options in the very short term are friends, family and private charity.
posted by slow graffiti at 9:52 AM on March 3, 2013

Something that a lot of people don't consider is the existence of building codes and zoning rules that prevent people from just building a shelter anywhere, and the fact that Americans don't typically live together with their extended families in multi generation homes. If you visit the developing world, the homeless problem isn't even as bad as it is in the us, because people can just squat and build anywhere, or their families take care of them. The government certainly doesn't take care of them, in general.
posted by empath at 9:55 AM on March 3, 2013 [4 favorites]

Another important factor is our population of homeless war veterans. It's a significant population by percentage and sheer number.

To be pedantic, it's not necessarily war veterans. Even in the decades between Vietnam and Iraq, when relatively few service members had served in combat, veterans (as in, people who were ever in the armed forces) were over-represented among the homeless.
posted by Etrigan at 9:57 AM on March 3, 2013 [2 favorites]

Note that although there are programs giving financial assistance to needy families there is almost no such support for needy individuals or childless couples. There is also a sad lack of assistance in identifying mentally ill or impaired people to bring them into the minimal support available to them. The factors that make assistance necessary are very often the barriers to obtaining it.
posted by uncaken at 10:05 AM on March 3, 2013 [1 favorite]

"Dual diagnosis": mental illness + addiction (addiction is often "self medication" for mental illness)
posted by KokuRyu at 10:11 AM on March 3, 2013 [3 favorites]

Thanks for great answers all, this is a tremendous help. A lot of this we didn't know, but I am glad to hear that there are solutions.
Question about (war) veterans; what happened to these people?
posted by dreamsandhope at 10:12 AM on March 3, 2013

To reinforce what neroli mentioned, here's a book on the history of deinstitutionalization.

You also need to distinguish between short term homelessness (which is more likely to have economic factors) and long term homeless (who, arguably, are more visible, since you see the same face in far more distressing conditions over and over again). The mentally ill and drug addicted are a large component of the latter.
posted by chengjih at 10:14 AM on March 3, 2013 [5 favorites]

When I just did some searching for numbers, I found that our % of homeless people is not too far off from some countries in Scandinavia. For example, in Sweden there are 17,800 homeless with a population of 9 million, which means that .20% of their population is homeless. In the US we have 600k homeless with a population of 312.6 million, meaning that .19% of our population is homeless. Population numbers are straight from the wiki for those countries.

Not to mention the fact that in the largest city in the US there are only 3262 homeless out of 8.2 million people, which is much lower-- only 0.04%. It's tough to compare countries in Scandanavia that have less than 3% the population of the US. I would highly suggest your son do his research instead of making generalizations/assumptions.

Sorry if my numbers are silly, I'm still in bed. Please do correct me if I'm wrong.
posted by two lights above the sea at 10:15 AM on March 3, 2013 [11 favorites]

People have mentioned unemployment insurance to you as a form of financial assistance for if you lose your job. However, the thing to understand about it is that the rules about unemployment insurance can vary wildly from one state to the next.

For the most part it is true that if you lose your job, and it was not for any kind of misconduct, you are eligible to receive unemployment income. However - there is often a time limit when it comes to how LONG you can receive it, how long you had to have worked before you ARE eligible for it, and in many cases, how much money you receive. And there are a few other complicating factors.

Let me use myself as an example; unemployment insurance income has been the only kind of welfare I've ever had to receive (knock on wood). I had to file a claim when I was laid off in order to qualify for the insurance in the first place; that process took two weeks. During that two weeks I had no income.

I was successful in my claim; however, my state has a law that the longest amount of time such a claim can be open for is 33 weeks, and that the most unemployment income I can receive each week is $450. Also, I would be eligible to pay tax on that income at the end of the year; I was able to elect to have tax withheld from my unemployment income, which brought the maximum amount of money I received down to about $420 each week. Bear in mind, though, that my usual income was about $900 per week after taxes, so this was a 60% DROP in income. I'll remind you again you again that I was receiving the maximum amount my state pays out for unemployment income.

And on top of that, I had to re-qualify for each weeks' payment by reporting whether I had done any work for anyone else over the course of that week. If I reported getting one days' work, I would receive a smaller amount of unemployment income (usually about a hundred dollars' less for each day I worked, regardless how much I'd been paid for that work). Oh - another thing: even if you get health insurance from your employer, you lose it when you lose your job. You are offered the option of buying into a continuance plan to extend your health insurance for a year or so, but it often costs a few hundred dollars a month - so the insurance itself was also taking a huge chunk out of the pittance I was getting from unemployment insurance income.

Having had to spend a year on unemployment income in 2002, and then another year on unemployment income in 2009, means I am much, much less well-off financially than many other of my peers -- I have no hope of owning a home and I have vanishingly little savings, because any money I'd saved up to those points had to go towards supplementing the pittance I got from unemployment income. And I was lucky in that I am single and childless, and have only a modest amount of debt. But if I had been raising a child or had some college debt or had some kind of medical problem, that would have been a disaster, and I very well would have been homeless.

And that's just one account of one person in New York State, which is actually somewhat decent with its unemployment payouts. There are states where the unemployment income is even less.
posted by EmpressCallipygos at 10:28 AM on March 3, 2013 [12 favorites]

One that I haven't seen really noted: Growing mismatch between available housing types and housing needs.

After WWII, a lot of veterans returned from the war and had government assistance for buying a house. Due to high numbers of two income families, low birth rates and rationing, savings rates were quite high during the war. The government created lending institutions and policies to help supply single family homes in sufficient numbers for the sudden demand as women left jobs and (for the most part) happily stayed home to have and raise kids. "Levittowns" began popping up all over and thus modern American suburbs were born.

In the decades since, the nuclear family has become less common as our population has differentiated demographically but the entire housing infrastructure is geared towards the single family home. Tax credits are structured such that well off families are encouraged to buy or build larger homes but it is nearly impossible to find anything appropriate for a single adult. We used to have more boarding houses, SROs, etc but those have become less common. It is extremely difficult to build co-housing projects here because you can't get them financed. They wind up being self-financed by wealthy people, which tends to undermine opportunity for low income individuals to participate.

So we have an outdated housing infrastructure, both physically and in terms of policy/financing mechanism, and it creates a situation where new homes are larger than ever but fewer people can afford them. Right after WWII, the average new home was about 1200 sq. ft. (or less) and the average family had two or three kids. The last figures I saw: The average new home is over 2000 sq. ft. and the typical American family has one child. The families who can afford to buy at all are living in McMansions. Many other people can't find housing that really fits their needs, even if they have money. Well-to-do singles also buy McMansions. They are easier to sell and maintain their value better.
posted by Michele in California at 10:34 AM on March 3, 2013 [15 favorites]

Your son might be interested in this widely covered incident (plus some back story) from a few months ago in New York. It's a good little view into how this problem can be very complex, not the sort of thing that can be explained fully in one school paper (or one anything), and how these questions can sometimes just lead to more questions. And how "homeless people" are (obviously) individuals, with lives that can fit into several of the usual narratives/statistics, but also have their own unique circumstances.

Also, to reiterate what others have alluded to above, asking "How does X work in the United States?" can lead you down a road of total confusion, because resources and attitudes and laws can vary widely. It might be easier for him to pick a state (or city) or two, if possible, or at least keep that in mind.
posted by DestinationUnknown at 10:36 AM on March 3, 2013 [2 favorites]

Don't forget the working poor 1 and 2 who have jobs but no homes.
posted by jadepearl at 11:03 AM on March 3, 2013 [2 favorites]

Also stopped in to mention the working poor. Locally, in my area, we have a relatively low homeless population in the traditional sense, and a growing number of hotel homeless. Often families, people who work as they can, but cannot afford the down payment and long term stability of a traditional rental situation. So even if they are paying the same amount per month as you would for a small rental place, they can't get together the money needed at one time to manage that. Drug use is certainly an issue as well, though perhaps not as much overbearing mental illness as you see with people actually on the street.
posted by shinynewnick at 11:14 AM on March 3, 2013 [2 favorites]

"Levittowns" began popping up all over and thus modern American suburbs were born.

This is vitally important, because it also reflects how the post-war settlement in the US was largely delivered in terms of subsidies for home ownership and tertiary education -- individualised benefits distributed in uneven ways -- while in Europe, it was delivered through social housing and social welfare institutions. The passage of time means that many Americans whose grandparents bought a house through the GI Bill and whose parents got a relatively cheap education don't see their middle-class status as a consequence of government intervention.

While private charity fills a number of roles in the US that are delegated to governmental institutions elsewhere, it's often capricious. In addition, it's often hard to find access to assistance of any kind.

One final point: the US is a large country with relatively low population density, and urban areas with sufficient population density to provide rudimentary shelters (or begging opportunities) for the homeless are often those with lower tax revenues on account of suburban flight beyond metropolitan boundaries. That, I think, shapes the perceptions of European observers, who expect American cities to resemble ones at home.
posted by holgate at 11:23 AM on March 3, 2013 [19 favorites]

One of the issues with veterans is that the Veterans Administration hospitals are overworked and understaffed. (Though that is being rectified, I'm told.) And getting care can sometimes be a bureaucratic nightmare. There are byzantine rules depending on length of service and whether injuries were recognized within a certain amount of time. For example, for a veteran to receive care for PTSD, they have to exhibit and report symptoms within (something like) two years after separation.

So if a veteran's troubles include things like not trusting institutions and stress/anxiety, they are going to have a lot of trouble navigating the system. Doubly so if they don't have a family or friend support system.

Overall, one of the problems is our substandard education system. We don't spend enough time educating people on practical things.

(for example, at my high school, one of the elective courses was called American Legal Systems and it was a highly sought after class. It was a fun, blow-off class that amounted to an ex-cop with a law degree telling us war stories. But we learned a lot of good stuff about our rights and how to interact with the legal system. However, instead of going to the students who most needed it, it went to the ones who were statistically less likely to need the knowledge. Things like that should be in the base curriculum.)
posted by gjc at 11:26 AM on March 3, 2013 [2 favorites]

"And getting care can sometimes be a bureaucratic nightmare. There are byzantine rules depending on length of service and whether injuries were recognized within a certain amount of time. For example, for a veteran to receive care for PTSD, they have to exhibit and report symptoms within (something like) two years after separation."

The length of time before claims are processed varies wildly throughout the country — in places like Utah or Montana, where there are fewer people, claims get processed on the order of six weeks. In the big VA centers of places like LA, Texas and Virginia, that process is more on the order of 30 months. There was a MeFi post with a pretty great infographic on it not too long ago, but I can't seem to find it in search.
posted by klangklangston at 11:32 AM on March 3, 2013 [1 favorite]

and that the most unemployment income I can receive each week is $450. Also, I would be eligible to pay tax on that income at the end of the year; I was able to elect to have tax withheld from my unemployment income, which brought the maximum amount of money I received down to about $420 each week. Bear in mind, though, that my usual income was about $900 per week after taxes, so this was a 60% DROP in income.

Yeah, and how much you're allowed is based on a SMALL percentage of your most recent income. I think I got maybe around $250 for two weeks when I was on unemployment because I didn't make nearly the amount that Empress used to. That paid utilities in the winter or so and maybe one grocery store trip, but sure as hell wouldn't pay rent.
posted by jenfullmoon at 11:33 AM on March 3, 2013 [1 favorite]

We are from Scandinavia, and due to our welfare system, we don't have the same situation as in the US.

Well I am American living in Stockholm for 20 years and the difference is not so much economic as people would like for it to be. There are homeless people on the streets here in Stockholm - not nearly so many - but the one thing I notice is that the homeless people I see here are not mentally ill. In Sweden the government has broad authority to declare someone incompetent - "omyndigförklarad" - and then to whisk them off the streets into a mental heath care facility. It is more this than A-kassa (unemployment insurance) that keeps the streets free of homeless people.

Since the 1970s - and as a result of political pressure from the left it has to be said - America has gone in the other direction making it much harder to do this so a lot of people who should be "against their will" put into a mental health care facility - are allowed to exercise the constitutional rights to remain on the streets.
posted by three blind mice at 11:38 AM on March 3, 2013 [23 favorites]

For housing assistance, you can read up on Section 8. It's a federally funded program that's administered at state/county levels and provides housing vouchers to people who are eligible (very low-income families, the elderly, the disabled). Depending on the region, waiting lists to actually get a place to live can be very long. Certain kinds of criminal convictions will render one ineligible to apply - not just convictions of one's own, but also that of a close family member (so, for example, if your son were convicted of dealing drugs, you might be ineligible for assistance even if he doesn't live with you).
posted by rtha at 12:18 PM on March 3, 2013

I think another aspect to this is the dwindling of casual or seasonal jobs, for various reasons. There's always been a group of Americans who don't like to be tied down to one place for very long, and for many years, they could travel around, picking fruit, working warehouse jobs, knocking on doors and seeing if there was any work going. (And I'm not romanticizing hobos, trust me.) But as agriculture changed from small family farms to large corporate agri-business, those people were no longer tolerated. I live near LA's Skid Row, and there's a certain segment of the population there who like life on the road--I'm sure drugs or alcohol and/or trauma are involved, but there's also a non-comforming aspect that attracts certain people. Death of the American Hobo on Vice.
posted by Ideefixe at 12:20 PM on March 3, 2013 [1 favorite]

Here in Southern California, the generally warm climate makes living outdoors a slightly-less-unbearable prospect than in colder climates. Not that it's in any way an ideal living situation, but of the myriad awful things about living rough, at least freezing to death is unlikely to be one of them.
posted by Conductor71 at 12:58 PM on March 3, 2013 [1 favorite]

The question is not as clear cut as you think either, and as it is stated implies that you guys might want to learn a little more about the class system in Sweden. And yes, it absolutely does exist.

Sweden has plenty of homeless people, it just doesn't have as many street people. Thousands of people are living in homeless shelters and hotel/hostel rooms, often with small children and often for a long time. Thousands more, young people especially are without fixed addresses, basically moving between friends rooms or apartments.

You refer to the a-kassa system, which emphatically does not cover all workers. It is a voluntary insurance program with quite a high threshold and cost. This means that you have to a) know about it, b) be sufficiently organized to join and consistently pay in, c) be employed for a minimum of six months, but in practice over a year for it to activate and d) be able to afford the fee, which in some cases is very high, especially in jobs that pay badly or have hight un- or underemployment, such as retail and restaurant (around 300kr excluding union membership).

You will otherwise have to rely on social welfare, which is a •very• different kettle of fish that I won't derail with here, but the requirements to qualify for that support may well "force" you into a financial position that can be impossible to recover from.
posted by Iteki at 1:45 PM on March 3, 2013 [3 favorites]

Dwindling single-room-occupancy (SRO) housing. Even small towns, and I mean really small, used to have small hotels and many people lived there prior to marriage. There were also "rooming houses" or "boarding houses."
posted by jgirl at 2:07 PM on March 3, 2013 [1 favorite]

I don't know whether this has been mentioned above, but as someone who has used social services in the USA (unemployment for me) or watched friends do it (unemployment, food stamps), it can be extremely difficult to navigate getting these services. For me, it was not too hard, but I come from a financially and intellectually privileged background. If I had literacy issues; didn't have a car to get there; didn't have childcare; didn't have the savvy to negotiate bureaucratic systems, it would be a nightmare.
posted by linettasky at 2:07 PM on March 3, 2013 [6 favorites]

Another thing that hasn't been mentioned: to get into apartments or to buy houses, you often need to have relatively decent credit. If you don't have that, you might be SOL.
posted by corb at 2:22 PM on March 3, 2013

it can be extremely difficult to navigate getting these services

And I think there are all sorts of different forces at work there: there's the official layering of voter-friendly "no shirkers" bureaucracy that ends up excluding those who are eligible but are either intimidated or turned away; there's the tacit attempt of many states (e.g. Georgia) to avoid spending welfare budgets on their intended use because the funds are fungible, and there's the basic social pressure that says it's a bad thing to ask for help from government.

As Steinbeck said, the poor in America see themselves as temporarily embarrassed millionaires. When 60 Minutes ran a report on homeless children in Florida a year or so ago, it didn't put state officials on the spot in front of the camera, and it ended with some of the children talking about how they still kept their hopes and dreams even though they slept in the back of cars. From my foreign perspective, that's a very American cop-out.
posted by holgate at 2:40 PM on March 3, 2013 [2 favorites]

Dwindling single-room-occupancy (SRO) housing. Even small towns, and I mean really small, used to have small hotels and many people lived there prior to marriage. There were also "rooming houses" or "boarding houses."

I can no longer find the link, but my understanding is that this is a direct consequence of a combination of liability issues, access requirements (ramps, etc.) and rent control policies. It would be interesting to know if there are any modern studies of this.
posted by rr at 2:50 PM on March 3, 2013

Two lights above the sea has made a good point. Here's the best point estimate of the homeless population in the U.S.:633,782. And a comparable figure for Sweden: 34,000. Given that the population of the US is more than 20 times greater than Sweden's, this suggests that the problems are not of a totally different magnitude. Of course the definitions and methodologies of these studies may be very different, but I mention this to highlight the point that the U.S. homelessness problem may be more visible to Scandinavians but it shouldn't seem like an utterly foreign phenomenon -- its going on at home, too. (I don't mean to say, I'll take pains to say, that homelessness rates in the U.S. are not a national disgrace. Far too many people are sleeping rough or in shelters.)
posted by reren at 3:04 PM on March 3, 2013 [4 favorites]

rtha mentioned legal status due to criminal conduct briefly and, of course, many of those summary resources bring it up, but I just want to highlight the relationship of "having a record" with homelessness in the USA.

The first thing to know is that people with any kind of criminal background featuring convictions have a very difficult time getting jobs. There are special programs to help some classifications in some areas, but most have to fend for themselves. It's one of the top reasons for recidivism.

There is very little incentive to rent to people with a criminal record. Some people are able to escape this by buying a home at some point, but they are a very small percentage. This is a very common rule for a rental property to have. Section 8 housing will sometimes have more relaxed rules in this area, but, again, the approval process is complicated and takes a long time. And once approved, there's the problem of finding a property who will rent to someone with a record and then waiting for a spot to open within the income capability/restrictions of that individual. And many people with records can't do Section 8 at all, because certain convictions aren't allowed to apply for certain (most - even food) benefits, including housing.

Primarily because of rules enacted during the Reagan/Bush I presidencies, there's actually a disincentive to house (commercially or otherwise) people with any kind of drug conviction. No matter how "soft" the drug or non-violent the crime, property owners can actually lose their properties (including vehicles on the property) and, if family, any ability to collect most social benefits.

You can imagine how it is for anyone on the sex offenders registry.

Like others have said, it's very complicated and the reasons are as varied as the individuals who become homeless.
posted by batmonkey at 3:05 PM on March 3, 2013 [2 favorites]

This is a bit like asking "why are there so many riots in Europe," in terms of the underlying assumptions and complexities involved.

The very short answer is that, while I'm sure there must be some fully healthy English-speaking adults with a solid 8th-grade-level education who fully understand their own situations and know that they could get help and how to get help, but choose to live on the streets or rely entirely on emergency shelter (long term) rather than either getting the help or being forcefully "helped" by others, it's a very small segment of the already small on-the-streets/shelter group (when compared to everyone in need of housing assistance.)

The overwhelming majority of the people actually living on the streets or relying on emergency shelters ( long-term) are facing one (probably several) of the following issues:
  • Having a criminal record (felonies make it very hard to obtain leases, the institutional environment screws with your ability to cope with normal non-institutional life, your social network is totally wrecked, your stuff probably all got thrown away when you were arrested because you stopped paying your rent, your relationship with centralized authority is distrustful at very best, etc.)
  • Having a serious mental illness or organic brain damage (after deinstitutionalization, and some significant changes to how involuntary commitment AND inpatient treatment are handled, many of those people requiring institutionalization to function moved from hospitals to prisons, some actually did get the community support they needed to at least stay off the streets AND out of prison, and the true street-dwelling segment is the smallest group by far.)
  • Are under the age of 18 (these are almost invariably victims of abuse or at least neglect - since it's by definition abuse to kick your kid out, and by definition neglect to let them live on the streets; minors in the US face substantial hurdles in terms of getting ID, finding work, etc., and those who run away or are kicked out or whatever have HUGE problems in terms of knowing who to ask for help and how to ask for it, and those who have been physically or sexually abused at home or by someone after they left home have understandable trust issues that keep them from getting help.)
  • Suffering from a current substance addiction (substance abuse messes with your basic competency and decision-making capacity - just like serious mental illness, honestly - which means your ability to ask for help, and desire to get it, and so forth, are impaired.)
  • Having a serious mobility impairment (by themselves these don't cause homelessness, but needing a sufficient amount of physical help can actually be a barrier for accessing a lot of the substandard transient housing available, like sharing with friends, and it can make it harder to move from where you are now to where the help is.)
  • Having significant deficits in either education or intellectual functioning (not understanding how bad your situation is, becoming deeply frustrated with the process, people not knowing how much help you need, etc.)
  • Having one of a small handful of specific catastrophic diseases directly associated with detachment from supportive social networks or neurological deterioration (this basically means HIV/AIDS and liver failure - I'm trying to think of other diseases so directly affiliated with on-the-streets homelessness, and I'm not coming up with anything.)
  • Having fundamental communication barriers (in some cases - especially in places where there are only a handful of dominant immigrant groups - language can be enough of a barrier that someone who could navigate the system and who doesn't have any other issues above could, conceivably be on the streets long enough for it to be a lifestyle rather than a temporary crisis.)
Which brings me to this: I think one of the first things you need to look at (in order to write this report) is the degree of "housing insecurity" ("I don't really have an address" vs. "I'm sleeping on park benches,") and the second is whether someone's situation can be classified as "transient" or "chronic."

Which is to say, in the US, that the number of people living on the street is vanishingly small compared to the number of people living in all the other varying degrees of housing insecurity, and the number who are living on the streets for years is vanishingly small compared to the number who are on the streets or in shelters for a few days or weeks. We have thousands of people living on their friends' couches, or in various extended-stay motel situations, or what have you, for every person sleeping on park benches.

And most of the people on the park benches could be in homeless shelters (which many of the extended-stay motel residents would be eligible to stay in but choose not to because the homeless shelters are unpleasant and have many rules,) but things aren't "bad enough" for them to to be there or in jail/hospital/etc. settings.

By "bad enough" I mean that either they are motivated to seek out the shelter for themselves, or someone else is motivated to do it for them. We nearly double the population in our homeless shelters whenever the temperature goes down enough; NYC has, at least in some years, actually deployed social workers on cold nights to beg, cajole, or force street-dwellers into some kind of a safer environment. And, when someone with significant positive schizophrenic (hallucinations, delusions, etc.) symptoms becomes very disruptive, they typically find themselves arrested, or committed for a short period. I've read stories where police forces deliberately make more arrests when the weather gets cold, because they literally have no other way of keeping the homeless safe - in the summer, they'd tell the guy to move, and in the winter, they'd arrest him for trespassing or loitering or whatever. Assertive Community Treatment programs are largely designed to address this issue, but not all states have it, and you need to get pulled into the system due to someone noticing you and taking initiative - no one is out looking for new people to add to it; we're better about finding stray dogs than people with untreated serious mental illness in need of care.

The "on the streets" or "would be on the streets if it weren't for a temporary shelter provided by someone else" population is BTW overwhelmingly single, male, and over 18 (except for the runaways/abused kids I mentioned earlier,) in large part because when you're a kid, or you have a kid, or you're married to someone, there is someone looking out for you more or less by definition (and because we have a huge, if dysfunctional, child protection system - if nothing else, teachers notice that children are coming to school without bathing.) All of that means that the difference between "in a shelter" and "on the streets" groups is primarily one of cooperation/information/trust/competency rather than capacity; the "in the shelter" vs. "in a better solution" group difference adds in capacity issues, and in some cases funky eligibility stuff, but it's more a matter of waiting lists than "we're this close to being out on the street again" stuff.

An example of how this breaks down, from my city: in 2004, the Open Shelter provided services to about 1,800 people, divided up as follows:
  • Living “on the streets”: 412
  • A CSB Men’s Shelter: 449
  • A CSB Women’s Shelter: 161
  • A CSB Family Shelter: 28
  • The Engagement Center: 28
  • Supportive Housing Programs: 383 (these are government-funded but usually privately operated, and often involve federal programs like Medicaid)
  • Marginally Housed: 431 (these are the motel residents and folks on couches)
Unsurprisingly, in a typical year my city thus adds a few hundred emergency beds during the cold weather periods (think under 5°C) to the few hundred regular beds that are always present, given a population of about 750,000 (over 1.5 million in the greater metro area; the majority of those needing emergency shelter are in the city proper - most of those depending on shelters or on the streets are within a few blocks of City Hall.) You can see from this PDF the kinds of resources available to those experiencing housing insecurity (and related problems) here; there are typically five to seven total shelters (depending on funding and organization health; we have less at the moment than we have had lately.) By the way, these kinds of organizations are pretty common in bigger US cities - look at different AskMe questions about help for homelessness and shelter resources to get an idea of the different ways of organizing local charity efforts.

My city also works very hard to get people out of the short-term shelter environment ASAP: you have to be in an unusual situation, or at least be uncooperative (in a way that won't get you committed/arrested) to stay in the shelter/street cycle for very long. To see how we help with housing insecurity, go to the Columbus Metropolitan Housing Authority, particularly the prospective residents page. For bigger employment/food/health/income insecurity issues, go where we send them: the Ohio Benefits Bank.

By the way, federal programs that are involved directly with housing issues usually get administered by Housing and Urban Development or Medicaid for supportive housing services; disability payments come from Social Security and unemployment benefits come through the states and sometimes the Department of Labor.

HUD has a nice chart summarizing the different kinds of housing insecurity that gets their attention, by the way - the stuff that means, to them, "this person will be in the streets or a shelter if we don't act." HUD's definition of homelessness is more informative but also kind of irritating to read.

The "not bad enough to go to a shelter" effect is huge, by the way: I really doubt most cities would have any on-the-street homeless people if either those homeless people really wanted to get into the shelters or society at large really wanted them off the streets. Homeless shelters are unpleasant for many reasons (lots of rules, old facilities, lots of rules, other residents may be intimidating/dangerous, lots of rules,) and it's rarely considered worth the effort it really takes to push/pull the on-the-streets homeless into better situations. Those situations require both a medical intervention and a social work intervention (it's rarely just one) and an extensive, almost certainly permanent commitment. What usually makes the effort seem worth it is either "oh crap people are dying" or "oh crap we can't possibly put more people in prison" moments.
posted by SMPA at 3:05 PM on March 3, 2013 [17 favorites]

Oh, and changes from Obamacare will (potentially) have an impact on one housing issue: supportive housing for people with disabilities. See here for more information. It depends on state and local decisionmaking; Medicaid is paid for by both the feds and the states, and some decisions are up to the feds and others to the states. My state is definitely planning to work on supportive housing as part of an overall "transformation" of Medicaid services.

From what I understand, people with disabilities working lower-level jobs and receiving SSI/SSDI are going to be a large segment of the population added to Medicaid - and almost the first question out of any supportive housing provider's mouth when you apply is "do you have Medicaid." However, most people moving into supportive housing are moving from either an institution (nursing homes, hospitals) or a family/friend setting; supportive housing isn't really a homelessness solution as much as a "spending insanely largely amounts on expensive institutional care" solution. In the US non-institutionalized people with serious disabilities are far more likely to be desperately poor and in inadequate housing rather than actually homeless.

On the other hand, supportive housing bridges the gap between the level of support you often see in a homeless shelter and the level of support you see in a Section 8 or public housing situation, let alone what you get when you're on your own and finally get an apartment. A segment of the homeless/insecure housing population (most with mental illness or other neurological/behavioral issues) keeps failing at keeping their situation together after the social workers have gotten them into a place to live and a job. Supportive housing is supposed to basically provide services like you're sitting on a cot in a homeless shelter even though you're in a one-bedroom apartment in the community: it's supposed to fix the situation for those incapable of living fully on their own, and that absolutely includes the mentally ill and addiction portions of the on-the-streets population.

After two years on Social Security Disability payments, by the way, individual recipients are eligible for Medicare - but the first two years, if they're not eligible for Medicaid on an income basis, they're SOL; the income level eligibility change is why the working-low-level-jobs types are going to be such a huge number of people added to the Medicaid rolls.
posted by SMPA at 3:28 PM on March 3, 2013 [2 favorites]

As someone who is homeless with a medical condition and "could be" in a shelter, let me suggest that for some people, being homeless is partly choice, partly maddening lack of viable options. I would like to be in housing, but it needs to be housing which won't land me in the hospital. A shelter will only make me sicker. I have looked into that and started the intake process more than once. It won't work. I need another answer.

Also, they won't take me and my adult sons as a family. They would place us as individual adults. My ASD sons cannot cope with the group setting of a shelter and trying to place them there would potentially land my oldest son in jail, even though he is routinely described as remarkably polite and respectful. In such a setting, he would be highly likely to wind up in a fight, very probably started by someone else but it wouldn't really matter because it would still result in jail time. Since he still lives with me, when he is having a bad day and cannot figure out how to talk to people, it doesn't matter. I do the talking for him. I have watched him try. It isn't a case of personal discomfort. It is a case of failure to communicate which goes catastrophically bad and only gets worse with additional attempts to clarify.

I cannot get the type of assistance I need. In some sense, it does not exist. In another sense, prejudice helps close doors and keep me here. I really don't want to make this about me but some of the subtext here is really ugly and blaming, even from people who are overall being reasonable and compassionate, and my hope is that an insider point of view might cut through some of that. Plus, years ago, I had a class on Homeless and Public Policy and interned at a homeless shelter. Generally speaking, people on the street have multiple intractable personal problems and too little social support for their needs. It isn't due to laziness, not trying, or other character defects. If they reject asdistance, it is because the type of help offered creates problems, not because they are merely being difficult or something.

Our current policies leave much to be desired. But it isn't even that simple. I currently live in a tent rather than a germy public shelter. I have seen news pieces about people with health issues who built a yurt on land they owned. If I had more resources, I might be an "eccentric" living in a yurt. But I don't. So I make the least harmful choices available to me and, currently, I cannot afford housing which would improve my health instead of harming it. The social stigma and judgementalism and people who think I am neurotic are generally far more frustrating than where I sleep at night. I am in Southern California. As someone else noted, the climate is mild and freezing to death is not a big concern.
posted by Michele in California at 3:38 PM on March 3, 2013 [11 favorites]

Thank you all for taking time to share your most valued knowledge! We have gained a lot of insight, and we see this is really a complex issue with many, many variables. Same percentage for our country is 0.1%, people living on the streets (around 5000), major reason; alcohol/drugs, though always an option for shelter (tough climate). Mentally ill would be "picked up" here.
Good point, SMPA, looking into the degree of "housing insecurity".
Thank you all so much!
posted by dreamsandhope at 3:53 PM on March 3, 2013

I am so sorry and sad for your difficult situation, Michele, and thank you for sharing your story. I wish you and your sons all the best!
posted by dreamsandhope at 4:02 PM on March 3, 2013 [1 favorite]

I only meant to clearly convey the point that my problem is not "homelessness." Instead, I have other very real problems which have resulted in homelessness. I am working on solving those and when those are solved, I expect to eventually get off the street. This is generally true for homeless people, that lack of housing is more like the symptom, not the real problem. My problems were much worse when I was sick from a crappy apartment than they are now.

That is the point I hope to make: Homelessness is mostly rooted in other problems. When one individual has too many problems and too few resources, the result is homelessness. I think that is part of why it is so stigmatizing and why people don't know what to do about it. Any human problem can be part of this equation but no one thing causes it. Having the same resources but one less problem can mean you don't land in the street. Having the same problems but one more resource can mean you don't land in the street. It isn't any one thing, much less something in particular.
posted by Michele in California at 4:19 PM on March 3, 2013 [8 favorites]

Question about (war) veterans; what happened to these people

I can actually tell you a woeful personal tale about how that worked for me, and continues to work for countless thousands of veterans in America. Too many ex-military people have been wasted for lack of medical care after they've been discharged from the service. The image of the veteran living under a bridge has its genesis in cold, dismal fact. The facts are myriad and subtle, and not just related to problems with adjusting to civilian life. Please allow me to spare you those details in favor of a few general statements about veterans and the VA.

Health care for veterans is available, and in many cases it's first rate, but it's a layered system, and sometimes difficult to navigate. Broadly speaking, veterans with service-connected conditions may qualify for full care, at no cost, through the Veterans Affairs Administration. In many cases, these veterans' spouses and minor children are covered by Tri-Care or perhaps CHAMPUS, but they cannot get care at a VA hospital.

For service connected disabilities, the VA has a pension system that can amount to about $3300 per month, for a person who's rated 100% disabled. If the veteran collects Social Security disability benifits he may add another $1400 or so dollars to his pension.

Some veterans are treated via a co-pay theory of payment that is based on the veterans medical condition and the amount he earns at his job. These folks will have a non-service connected medical problem.

The problem is that many veterans have only the foggiest notions about what their benifits are.

These VSO's are available in several flavors, and can be found by looking up your State office of Veterans Affairs, or such orgs as the VFW. The state VA offices are not the Federal VA. The state offices are the ones that help the disabled veteran to connect with property tax breaks, free hunting and fishing licenses, National Park passes, and other benifits. These benefits vary by state. In all cases, help from the VSO is free to the veteran. You don't need to pay a lawyer to help you with your claim.

I urge any veteran who hasn't done so to visit with a Veterans Service Officer to examine his terms of elegibility. The patient advocates at the VA are not the ones to help you with this. The VA is not your enemy here, but they are not organized to do what you (as a veteran) need to get done to properly handle your claim. I know that sounds weird. If you are a veteran and need help, look up Veterans Service Officer in your County directory.

Sorry if this was a bit of a derail. I believe you'll find that Veterans hold a variety of opinions about their treatment with the VA. I knew some men who are dead now because they didn't know how to navigate the system of health care that was available to them. Patient advocates in the form of VSO's seem to be the great secret. Too many veterans try and fail to handle this on their own.
posted by mule98J at 7:26 PM on March 3, 2013 [1 favorite]

One of the big differences between America and Europe is the presence of the homeless on the streets. In Europe, especially Northern Europe, you very rarely see homeless people on the streets. Whereas in American cities they are very present, very visible, even in the downtown core. To Europeans that high visibility represents a large contrast to the situation back home.

Also, beware of comparing the number of homeless between the US and Europe. By and large the Europeans do a much better job of counting their homeless, whereas in the US there are many homeless not included in the numbers (mostly because they don't have proper papers and cannot be tracked).
posted by Vindaloo at 7:11 AM on March 4, 2013 [1 favorite]

"Are under the age of 18 (these are almost invariably victims of abuse or at least neglect - since it's by definition abuse to kick your kid out, and by definition neglect to let them live on the streets; minors in the US face substantial hurdles in terms of getting ID, finding work, etc., and those who run away or are kicked out or whatever have HUGE problems in terms of knowing who to ask for help and how to ask for it, and those who have been physically or sexually abused at home or by someone after they left home have understandable trust issues that keep them from getting help.)"

Of this cohort — homeless youth — around 50 percent are LGBT, homeless in large part because they've been kicked out of their homes by parents.
posted by klangklangston at 9:30 AM on March 4, 2013 [3 favorites]

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