What should I have done when I saw this homeless man today?
October 5, 2014 1:27 PM   Subscribe

Today I was walking with friends when I passed a man sprawled on the street, passed out. It was pretty clear from his appearance he was both 1. probably an alcoholic (and perhaps drunk and sleeping it off?) and 2. homeless. I hemmed and hawed over calling emergency services, but the others in my party did not want to stop. I feel horrible. What should I have done?

This is not an unusual thing to see where I am currently living (in London), but I've been in the same situation in New York and Boston as well. I want to stop and help but don't know how. I don't feel comfortable trying to wake the person up (maybe they are just sleeping it off? should they have some privacy?) What made this seem like more is that the person was just lying on the sidewalk, not on a bench of some other place that looked like a home (i.e., under a tree, with a blanket.) He looked like he was breathing, but he was clearly not healthy.

I feel like calling 999 (911 equivalent) in this country would be dramatic (it would have been for the other people I was with, because this is not an unusual sight) but if it were a man in a suit I would have called immediately.

Should I have called? And/or what else do people do in these circumstances? Gotten him a sandwich and water? Tried to wake him? I just feel really awful that I walked right by a human in need, and want to have a plan for when this happens again (and I know it will.)
posted by EtTuHealy to Society & Culture (41 answers total) 4 users marked this as a favorite
It's one thing if they're on a bench, in a self-made shelter, or somewhere where they've holed up for protection. But in the middle of the street like that I try to shake them awake and see how they're doing. Then I go from there depending on their response.
posted by schroedinger at 1:31 PM on October 5, 2014 [3 favorites]

I called 911 before in NYC when I was concerned about a homeless man passed out on the sidewalk during a really intense summer heat wave. While I was calling 911, I watched someone leave a bottle of water next to him. When that person passed me I mentioned I had called 911 and he told he had already done the same.
posted by Majorita at 1:35 PM on October 5, 2014 [2 favorites]

Oh yes, I thought of shaking him awake, but to be honest I am a very small person and this man was quite big and perhaps drunk, so I wasn't quite comfortable doing this alone. (Of course that could just be an excuse).
posted by EtTuHealy at 1:35 PM on October 5, 2014

Last time this happened to me (in Boston) I called 911. I wasn't sure what to do- didn't want to try to wake him up as I was alone and it was a relatively deserted street, and didn't want to get someone 'in trouble' who might prefer to be left alone. But then I was worried that it could have been a heart attack or something more serious, and was thinking that this man could be someone's father or loved one, and wouldn't they want to make sure he was looked after? An ambulance came and took him after failing to wake him up. They seemed non - plussed so must be a relatively common occurrence. So yeah, I'd say next time call 911 and let the authorities handle it. It's part of their job.
posted by emd3737 at 1:37 PM on October 5, 2014 [7 favorites]

OP, I'm not a small person and I wouldn't physically approach or shake someone awake in that situation.
posted by Majorita at 1:38 PM on October 5, 2014 [14 favorites]

that's exactly what 999/911 is for, and I've called in several times in instances similar to yours. I'm not trained to tell if someone is passed out due to alchohol/other reasons, nor am I trained to handle it if they're violent, or even just confused, upon waking. It's not dramatic, and shouldn't take more than a few minutes of your time. YMMV, but I've never had to stick around until the emergency personnel show up, I just give clear directions to the dispatcher and continue on. .
posted by csox at 1:38 PM on October 5, 2014 [7 favorites]

I know where you're coming from. I suspect many people have had the same thought when they see a homeless person, especially in a predicament such as the one you describe. I know I have. It's natural to feel empathy for your common wo/man, and to want to help.

That said, I think you need to approach how to help individual people on an individual basis. If a homeless guy asks me for a few bucks, I will often try to oblige. But having done some work on homelessness policy, I know that just offering food (or money) to a homeless person who hasn't asked for help can make them feel shamed or even angry so I tend to try and avoid help that hasn't been asked for.

This may have been that kind of situation. A homeless person passed out on the street is not in a situation that help can naturally be assumed to be appreciated. So it is probably best you didn't get involved personally, because you need to be conscious of your own safety.

So yeah, you could have called emergency services, but chances are that they would either have been sent to a drunk tank in the local police station which isn't really helping and could potentially have made their bad day even worse (unless they were really in a bad way in which case they'd have been sent to hospital, I guess).

But if you really want to help this person, and the homeless on a more macro scale, you can do so by getting involved in influencing homelessness policy. On a basic level, help at a soup kitchen when you can or a street van giving out food.

On a more "advanced" level, volunteer with a local homeless community group and get involved with their policy creation unit, or join your political party of choice and get involved with their policy creation units.

Learn about why people are homeless, why some chose to remain homeless (yes, this is a thing) and what change is required to help start alleviating the problem.

Good on you for having a social conscience and wanting to help people in need. Now it's time to act on that! The question is, will you and if so, how? I've given you some ideas above. The rest is up to you...
posted by Effigy2000 at 1:41 PM on October 5, 2014 [2 favorites]

In the UK, this would probably be best handled by a 101 (police non-emergency) call. They'd probably get a PCSO to coffee and have a word, probably from the context of knowing them already. It's also worth remembering that plenty of street drinkers, even those who get passed out drunk, aren't homeless, so it's possible they could get sent home.
posted by ambrosen at 1:45 PM on October 5, 2014 [9 favorites]

My response is 'of course, call'. Once we let other humans lie in the middle of the street, what have we become?

I say that without judgement on you, btw, as you sounded a bit confused and friends were saying otherwise. But asking this question, so you have a plan next time is awesome.

As to specifics, you don't need to put yourself in danger by trying to wake him up, but calling 999 or flagging down a police officer is perfect.

Thank you for asking this question.
posted by Vaike at 1:46 PM on October 5, 2014 [14 favorites]

I walked by someone in this exact same situation a few weeks ago. I was really torn on what to do, for the same reasons you were. I told myself that if he was still there when I got out of class an hour later, I'd call 911.

When I came out of class, he wasn't there.

Two weeks later, someone had spray painted RIP [name] in the doorway where I'd seen him.

I've felt sick about it ever since. I don't have any way of knowing the details, obviously, or if I could have done anything to save him, but if this ever happens to me again, I will immediately and without hesitation call 911.
posted by pretentious illiterate at 1:46 PM on October 5, 2014 [4 favorites]

I am not a small person, but I wouldn't touch someone who was asleep/ passed out like that. I would have called 911, definitely.
posted by sarcasticah at 1:48 PM on October 5, 2014 [1 favorite]

I have called 911 in similar circumstances (people passed out on the sidewalk or on the steps up to a house). I figure they're at the very least in risk of dying from alcohol poisoning. In one case I didn't stick around, despite the dispatcher telling me I had to go see if he was breathing (um, no, I don't, that's what the paramedics are for); in the other case she looked like a student, my friend and I were instructed to wait for the ambulance to help them find her, and we left shortly after they arrived.
posted by jaguar at 1:50 PM on October 5, 2014 [2 favorites]

If the person is in danger: might get mugged, JDLR (just doesn't look right) or looks ill, call. Let the professionals assess the situation and make decisions. If it's just someone huddled down for the night in a doorway, then leave them be.

I don't give homeless folks money, I have my reasons, and I support programs that help the homeless.

You want to let people keep their dignity but keep them as safe as possible in a dangerous world.

There's no 100% right thing to do, or wrong thing to do. If you feel like the situation warrants it, call the police.
posted by Ruthless Bunny at 1:51 PM on October 5, 2014 [6 favorites]

Your friends were completely wrong, and in the future, I hope you set the better example by calling emergency services.

Homeless or not, drunk or not, a fellow human being was unconscious in an unusual place, a clear indication emergency assistance was required.

FWIW, I've also seen people walk past a perfectly well dressed woman who collapsed on the sidewalk with a seizure.

Some people have a strong aversion towards "getting involved" a/k/a helping strangers. They don't see the person as needing help, tho, hence the disconnect.
posted by jbenben at 1:52 PM on October 5, 2014 [1 favorite]

This is what I did when a dirty, smelly person was sprawled out in a really weird place:

"Excuse me, Sir?"

"Excuse me, SIR?"



I couldn't bring myself to touch.

And then I called 911 and ordered a couple random people to help flag in an ambulance. Ultimately, he was very confused and maybe was fine, but the EMTs decided to bring him in because of the confusion and a possible head bump. Somewhere in there he became just lucid enough to thank me. And the EMTs were very pleasant and un-annoyed seeming. I had no impression that I "did something wrong."

Still, I had to steel myself that time, and I'll have to steel myself just as much the next time. And it was time consuming, etc., etc., etc.
posted by zeek321 at 2:01 PM on October 5, 2014 [1 favorite]

OK, now I know I really was wrong and should have called for emergency help -- thanks everyone! Special thanks in particular to ambrosen for pointing out another good way to do this specifically in the UK. And thanks to those who recognize that I really do want to do the right thing and am just trying to figure out how.
posted by EtTuHealy at 2:01 PM on October 5, 2014 [12 favorites]

Another vote for a call to the emergency services. There are all kinds of things that could kill somebody like that in short order (poisoning and hypothermia for example). He could also be a mentally disturbed guy you could harm anybody who tries to help him. The police and ambulance services can help most rapidly. (I would not assume that 999 would be overkill for this - let them decide whether it is really an emergency or not).
posted by rongorongo at 2:05 PM on October 5, 2014

(I would not assume that 999 would be overkill for this - let them decide whether it is really an emergency or not).

Yeah, different country, but I once had a big-US-city police officer say that it was much better for citizens to call the emergency number (911) because the dispatchers there were trained to sort out what was an emergency, how to prioritize it, how to keep track of non-emergency items, etc. Administrative questions could go through the non-emergency number, but it was just easier for everyone if potential problems went through the central emergency number.
posted by jaguar at 2:14 PM on October 5, 2014 [2 favorites]

Sometimes homeless people die because other people don't call emergency services when they should. The decision to call can sometimes feel uncertain or uncomfortable—but if in doubt, call.
posted by EXISTENZ IS PAUSED at 2:19 PM on October 5, 2014 [1 favorite]

Yes, please call. Homeless or not, anyone who collapses on the street needs help. If you are unsure about approaching them, you can at least call emergency services for them.
posted by GoLikeHellMachine at 2:20 PM on October 5, 2014

It's depended on the situation, but I used to live in an area with a very high homeless population, many of whom would frequently sleep out in the open, and I'd see them quite frequently since I was walking my dog around all the time. Most of the homeless I saw I knew or recognized from seeing them frequently, and would pretty easily be able to tell if they were someplace they normally wouldn't be or if something was wrong, but I did make the call 3 times in my 3 years living in that place. Once, a guy actually sort of needed attention. In all 3 cases, it was someone sleeping where there normally wouldn't have been anyone (a front lawn, the entry walk to a dentist's office, the middle of the sidewalk), but not in any location that immediately threatened them, so I just called the police non-emergency line or grabbed a police officer (this was across the street from a 7-11 that cops frequently used for bathroom breaks, so there was one handy quite often). If there was someone in a traffic lane, that would probably push me over to calling 911.

I don't know if it generally held to be true or not, but in most cases I didn't want to get people in trouble with the police, I just wanted to have someone qualified make sure they were ok. So, when I called the non-emergency line, I'd describe the situation to whoever answered, and they'd usually have a fire truck go check it out. Homeless guys got hassled way too much by the police in my neighborhood for no real reason anyway.
posted by LionIndex at 2:21 PM on October 5, 2014

Yes call.

Many homeless have tons of health conditions on top of any substance abuse issue (not all homeless use substances either). You just can't tell. Anyone passed out should be considered having an emergency by you. Let the paramedics figure it out and make a call.
posted by AlexiaSky at 2:27 PM on October 5, 2014

Please don't call 911 on homeless people in the US unless you either think they are dying, or think they need to be arrested. Because unless they are dying (and sometimes, even if they are dying), they're going to be arrested 9 times out of 10. And there is no way that makes the situation any better for them. I have no idea what the practice is in other countries, but in the US, we use police and jails as a substitute for any sort of proper social services or mental health care for the very poor, and it is terrible. You are absolutely not helping when you call 911 on a homeless person in the US unless it is the only way you can save his life (and sometimes not even then).
posted by decathecting at 2:32 PM on October 5, 2014 [5 favorites]

Many first aiders are taught the acronym. "DR ABC". This is intended to summarise what you should do if you come across somebody in a situation that you describe - and the order you should to it in:
D: Danger: Are you going to be in danger as a helper? - if clearly "yes" then you may need help or to hold off at this stage.
R: Response: As them if they are OK - or what their name is. If you get any sort of response then things are not so bad - if you don't then you will need to carry in - but in any case we now have
DR: Now is the moment to call a doctor - or 999 in this case.

- From here on I would proceed with the following only if you, or somebody around, has a knowledge of first aid. In a crowded city environment you may be best off asking passers by until you get somebody.

A: Airway: If there anything preventing the guy from breathing - a swallowed tongue for example. If so then clear it.
B: Breathing: Is he breathing - if not then you give him mouth to mouth resuscitation.
C: Circulation: Check for a pulse. If there is no circulation then give CPR.
posted by rongorongo at 2:38 PM on October 5, 2014 [2 favorites]

I'm just going to add, if you call 911, do not mention the word "homeless" or "vagrant" or anything of the like. Just say, "There's a person lying on the ground at [street address] and they look like they're breathing but I'm concerned they may be hurt or maybe had a seizure and I'm not comfortable approaching them by myself."

This does not guarantee the cops WON'T show up, depending on who's closest, but they will at least dispatch EMTs in addition to (possibly) cops. But if you say the words "homeless" or "vagrant", it's going to be enforcers who show up and not medical personnel, and at least with EMTs you might get a nice one who wakes them up and asks them to move (or actually provides some medical care, if needed) instead of just arresting them on sight.
posted by WidgetAlley at 3:35 PM on October 5, 2014 [10 favorites]

If someone is sprawled in the *street* and unresponsive, I'm calling for help. If someone is sprawled on the ground/sidewalk/median/whatever and appears not to be in physical distress, I'm going to leave them alone. I live in an area frequented by homeless people (we have commuter homeless people, in addition to our regulars), and I don't want them being hassled by the police, if they're not otherwise harming anyone. Yeah, it's not all that aesthetically pleasant to see homeless people ravaged by physical and mental illness all over the place, but it's also not all that pleasant to be mentally/physically ill without a support system.

I have no idea what particular circumstances exist to make the UK homeless situation different from the US, so take all that with a grain of salt. Here, contact with authorities seems like it rarely works out to be a net positive for homeless people.
posted by nobejen at 4:01 PM on October 5, 2014

Yes, call. Then, what will happen?

When I lived in DC one morning we discovered a disheveled person, sprawling inert on the front steps.

The policeman took his nightstick and rapped the sleeper smartly on the bottom of his shoes. This did provoke a reaction, and after a while our steps were clear again.
posted by Rash at 4:35 PM on October 5, 2014

"There's someone passed out on the sidewalk at XYZ address and I'm not sure if he's breathing" is more likely to bring EMTs/paramedics.
posted by jaguar at 5:03 PM on October 5, 2014

Just to present the other side, a friend of mine called 911 in exactly this situation, and the responder asked why it seemed to my friend that this individual needed assistance and wasn't just sleeping.
posted by mchorn at 6:03 PM on October 5, 2014

Which is another reason not to call the non-emergency police line, actually. You want to call the number you would use for an ambulance, not the police.
posted by jaguar at 6:04 PM on October 5, 2014

Kick their sole.
When I came across a passed out sketchy looking guy in NYC, I called 911. I could not tell if he was breathing or not. I was afraid of being attacked if I tried shaking him or checking his pulse/breath. The cops showed up in a few minutes, and the first thing one cop did was kick the bottom of the guy's foot.
Cop said it was the best way to check, as the guy can't reach you, and you can't hurt him.
Fortunately guy got up and was basically ok.
posted by Sophont at 6:29 PM on October 5, 2014 [2 favorites]

I used to work as a doorman at a bar. So I should know what drunk looks like. Twice, - once in a grocery store at mid-day, and once when I witnessed a single car accident, what I thought was "drunk" was diabetic blood sugar issues. They look a whole lot alike.

Even if you can smell booze, if someone is drunk enough to pass out on a sidewalk or on a street, they need some sort of help. Last one, I woke his butt up and took him to my AA meeting.
posted by rudd135 at 7:25 PM on October 5, 2014 [5 favorites]

"There's someone passed out on the sidewalk at XYZ address and I'm not sure if he's breathing" is more likely to bring EMTs/paramedics.

Just a quick word about this: the magic words "not breathing" wil actually dispatch the nearest responder regardless of what their job is in most districts, since almost everyone in any response position is trained on the DR ABCs that rongorongo mentioned above. So if you say "not breathing", cops and EMTs both are going to be dispatched, on the basis that the cops usually get there faster, and they'll be expected to try and maintain the airway (if he's really NOT breathing) until EMTs arrive.

If you just make it sound like a not super urgent medical problem, they won't get help as fast, but it's more likely that EMTs show up instead of every Tom, Dick, and Harry within a certain radius.
posted by WidgetAlley at 8:11 PM on October 5, 2014 [3 favorites]

I don't tend to bother people when they are just passed out on the sidewalk sleeping something off, but when I do see someone that is so far gone that I can't even tell if they are breathing, I call the police to see if someone can come check on the person. I've come across this more times than I'd like to have in my life, in San Francisco and the worry that they are dead and people are just walking around them acting like it's no big deal basically breaks me. It can't hurt to make the call- in my experience the police ask for the location and send someone right out to check on the person, and I think/hope they can help put that person in touch with an organization that can help them out.
posted by mochilove at 8:26 PM on October 5, 2014

I watch for breathing; and move on ( assuming they aren't laying like, in the street, by a dumpster that could be picked up and put back on them, or otherwise; then I would call 911 ... getting bit or worse is not worth the risk of trying to wake or move anybody ). If no breathing, I'd call 911.

Dittos for the mochilove comment I guess.
posted by buzzman at 9:09 PM on October 5, 2014

In future if you spot rough sleepers in London you can report them here: Streetlink and help connect them to local services. Of course if they have medical concerns please call 999. I volunteer at a London homeless shelter and can confirm this is a legit way that gets people help.
posted by teststrip at 12:38 AM on October 6, 2014 [1 favorite]

if you say the words "homeless" or "vagrant", it's going to be enforcers who show up and not medical personnel, and at least with EMTs you might get a nice one who wakes them up and asks them to move (or actually provides some medical care, if needed) instead of just arresting them on sight.

In the UK you can expect that the call taker will use common sense in deciding to dispatch the police if they believe the ambulance crew will be in danger, and you can expect that any police officers will do their job by keeping the ambulance crew, bystanders and homeless person safe. Our police don't go randomly arresting people for no reason, partly because they don't want to do the paperwork.

So if you say "not breathing", cops and EMTs both are going to be dispatched

This is not a rule in the UK. We have "first responder" paramedics who drive regular cars and can often arrive sooner than an ambulance, and who could save your life if they weren't inappropriately diverted to some other person by a false "not breathing" call.

In the UK the appropriate thing to do is to call 999 and to accurately describe the situation so that the call taker can prioritise the case appropriately. The ambulance crew will huff and puff privately about how much of their time is spent checking on homeless people who turn out to be well, but their huffing and puffing will be directed at the failures of Social Services, not at you.
posted by emilyw at 2:10 AM on October 6, 2014 [6 favorites]

One other point, if calling 999, is that you may not be the first or only person to report the case. But that should not dissuade you from calling; the operators are trained to link the related calls together and to add in any additional information that they can get from subsequent calls. In such cases you may be able to give them a useful update - and they can update you on the progress of help.

Unfortunately the mere presence of a crowd can lead to what Psychologists call bystander apathy - somebody who passes out where there are relatively few others is more likely to be assisted by the first passer by than one who does so in a busy city centre.
posted by rongorongo at 2:31 AM on October 6, 2014 [1 favorite]

One of my colleagues was hit over the head and mugged, and left unconscious in the street. Nobody called an ambulance because they thought he was passed out drunk. My dad slipped on ice and fractured his skull, and nobody called an ambulance because they thought he was passed out drunk.

People can also die from alcohol intoxication itself - either alcohol poisoning, hypothermia, or choking on their own vomit. Plus you don't know what else they've taken, or if the person passing by before you thought it would be funny to give them a good kicking.

Call an ambulance. I don't think there's much point in trying to wake them up - confusion looks a lot like drunk. I have worked in A&E, it is hard enough for us to tell sometimes. We always hang on to passed out drunk people until they wake up just to be on the safe side - we aren't going to think "God what an over-reaction". I can think of a couple of missed head injuries we found when the "drunk" person still hadn't woken up the next morning, so this isn't something you should be trying to diagnose yourself on the pavement. I agree you can't call an ambulance for every homeless person asleep in a doorway, but if they don't look like they've purposefully settled down for the night I would err on the side of caution.
posted by tinkletown at 3:11 AM on October 6, 2014 [10 favorites]

When I worked in a busy urban ED in the US, we had a lot of these. When they come to us, they get an exam and a few labs to make sure that other causes of being passed out aren't at work even if they are clearly intoxicated; usually they will wake up to painful stimuli and tell you that they have been drinking heavily. For liability reasons the hospital has to hold them until they are sober enough to safely leave; drunks who want to leave and get fighty are physically restrained and may get an anti-psychotic. The other bad thing is that it fills ED rooms and generates a significant bill for those who aren't judgement proof and higher rates for the insured picking up the bill for the rest. OTOH they get vitamins, a sandwich, and juice.
posted by a robot made out of meat at 12:00 PM on October 6, 2014

how the heck did I miss the part where the poster was living in London

Ignore all of my advice, which is pretty much designed to minimize potential contact with the awful species of cop that tends to inhabit large cities in the US
posted by WidgetAlley at 10:45 PM on October 8, 2014

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