Tuesday, March 22, 2016

SHARE's troubles

SHARE is having financial troubles again.

From sharewheel.org:
... although we have been working on this to get more funding our efforts have fallen on deaf ears. ...

Unfortunately, we have reached the point when we can no longer AFFORD TO STAY OPEN, literally. To date we have $70K in unpaid bills, our staff has been withholding their salaries, and we don’t have enough bus tickets to last thru the end of the month.

The Central Committee has MSP’d to have the last night be on March 30th, hopefully we’ll have enough bus tickets to last us until then. On March 31st we will be marching to the King County Administration Building Plaza and staying there until such a time that we can negotiate the needed funding in order to reopen our shelters. We hope many of you will join us because this is the only way we will be successful.

We have faced similar crisis in the past and by staying together we have managed to prevail. For over the 25 years we have had many victories through direct action. These we achieved by staying together and UNITED. Our strength is in our numbers. NOW is the time to show our strength as a COMMUNITY.
Further on in their website, they comment on the reason given for refusal of funding by King County:
SHARE has been hobbled with debt the past two years. We’ve still managed to keep people safe and alive. Now though, through funding cuts and general increases in operating costs, we can’t promise we will be able to keep going much longer.We simply can’t function without more stable funding.   In spite of this King County rejected our two funding proposal requests without consideration in late February. In one case, the reason for denial was because “King County does not consider Tent Cities to be shelters.”
Tell a backpacker, "a tent isn't shelter," and he'll laugh at you.
We must demand that King County follow their own emergency plan, and fund SHARE. King County says they follow the “All Home” Plan (to end Homelessness) but they don’t.  That Plan is clear – existing shelters like SHARE’s should be preserved, not bankrupted.
King County is incorrect about tent cities, and a judge in 2002 commented on this. Tents have a long and well-established track record as emergency shelter. They've been around for thousands of years, and they still work.

That's not the real reason, though. That's the "ostensible" reason, and since it's clearly false, there must be another -- unstated -- reason. We know that the Human Services people of both King County and Seattle act as though they utterly despise SHARE.

I agree that tent cities are not a solution to homelessness. They are not. You will not get any staffer at SHARE to agree that tent cities are a solution for homelessness. Tent cities are an interim survival mechanism -- as are all other homeless shelters. That's all they are. And an "interim solution," it seems to me, should be as cheap as possible, on the very grounds that it's not a permanent solution. We should be spending our money on permanent solutions, not on temporary ones, if we can at all avoid it.

Tent cities are one of the cheapest forms of shelter available. Even at $90k a year for 100 people, this is $2.50 per day per person. Tent cities don't have bedbugs (unlike the indoor shelters, which have them in profusion).  Yes, they are minimalist in terms of shelter. But there are reasons why many people use them. See my post on why people refuse shelter.

Tent cities are very visible reminders of homelessness.

And then there's this: if SHARE disappears by going bankrupt, will the Tent Cities disappear?

NO, they will NOT disappear. The tent cities of SHARE can operate without SHARE, and will if they need to.

Saturday, March 19, 2016

What do the homeless need most of all?

What's the Number One need of the homeless?

At a conference on March 11 in Tukwila, a number of leaders from cities around King County asked that question of three formerly homeless people.

And it's true that the homeless need Housing, and Jobs, and Shelter. Yes, they need those things. They need Showers, and they need Food.

But there are some things missing in that list.

Treat them with Dignity.

This is perhaps the single most important thing you can do. When you recognize that the homeless person you're looking at, the person you're trying to help, is a human being, and you treat them with the Dignity due every human being, something changes in your attitude, and something will change in theirs, too. Treat them with Dignity.

Include them in Community.

The homeless are citizens too. Include their opinions and respect their opinions when creating policy surrounding homelessness. They really are experts on their personal situation and why they're still stuck there. Include them in community.

Let them Participate.

Given the opportunity, most homeless people will seize it and make their own way out of homelessness. Seriously, this is the message that we see in all the data. For example, in Seattle, between a sixth and a quarter (the number depends on who you ask) of the homeless are chronic -- what man providers term "long-term stayers." But think about that. That means that three-quarters to five-sixths are getting themselves out of homelessness before they become long-term stayers! And, to be honest, the long-term stayers, given a reasonable opportunity to get off the streets... will seize it with both hands. So give them the opportunities, and let them participate in their own rehabilitation from homelessness.

Friday, March 18, 2016

What happened at Nickelsville?

News of "Occupy Camp Dearborn"

We knew what was going to happen as soon as we heard the news. The Dearborn location of Nickelsville decided to fire Scott Morrow (he was their staff person) and go their own way.

I should probably begin last year in 2015, when about the same thing happened. This is documented in the SLOG, the Stranger's blog. In early 2015, Nickelsville fired Scott. Steve Olsen, the pastor of Good Shepherd Lutheran Church, warned them that if they did not reinstate Scott Morrow, they would face eviction. In 2015, they did so. Within a few weeks, the people who ramrodded that eviction were barred from Nickelsville.

So when the Dearborn site of Nickelsville did the same thing again, we expected it to go about the same way it did last time. There was a difference this time, though. The residents stuck to their decision. So, on February 20, when they were supposed to leave, and they hadn't found a spot, they didn't leave.

Olsen told the Nickelsville residents that he has "great confidence in the Nickelsville model of self-government." However, the church had understood that "when we contracted with Nickelsville was that Mr. Morrow, as staff, would be our chief liaison and communication link. ... If that is not to be the case, we will no longer be able to serve as church host for the Dearborn site."

Now, I have to question this decision. Was the Nickelsville model of self-government only okay as long as Scott Morrow was in charge of it? But be that as it may (and I only ask the question because there are accusations that Scott Morrow manipulates pastors into doing things like this), Nickelsville did not reinstate Scott, even after being threatened with eviction.

So, on March 11, 2016, Nickelsville was swept by the police. We cannot deny that the residents had plenty of notice.

Real Change News carried the story: (quotes from their website; please go read the whole story)
Polly Trout, founder of the social services nonprofit Patacara, stepped into the fray in February with the intention of becoming the new sponsor.
....
Sixteen former Dearborn residents were spread between hotel rooms and activists’ homes until afternoon on March 14 when they moved into the open lot in Africatown. It’s unclear how long they can stay there, and Patacara is actively looking for a more permanent location, Trout said. 
 But there's a problem.

Ms. Trout and Camp Dearborn have chosen a lower-barrier encampment model.
“Our mission is to offer compassionate, respectful services that meet people where they’re at,” Trout said. “We’re making sure everyone at the camp has case management and is getting on the coordinated entry waitlist for housing and connecting them to other services if they need it.”
Nickelsville cofounder Peggy Hotes says the low-barrier approach is not sustainable. In her words,  “when you’re drunk or high it’s impossible to make rational decisions, including decisions on moderating the intake of substances.”

Nickelsville has never had a really good reputation for making sure residents stayed clean and sober. When they were founded, they ran themselves as "anti-SHARE," and allowed open drinking and open drug use. When that didn't work out (it took them a week to figure that out), they decided that drinking and using in camp was not okay, but being drunk or intoxicated in camp was okay as long as they person stayed in their tent (or went right to bed) and didn't bother anybody.

The camp still has this attitude, sorry to say. Nickelsville has had a reputation as a camp for druggies for quite some time, and nothing that has happened in the last few years has done much to change that reputation.

Occupy Camp Dearborn has set up a facebook page.

According to the Stranger's SLOG, some Camp Dearborn residents have found a temporary campsite at the Umoja P.E.A.C.E. Center in the Central District. The writer of that article says, "the city faces constant neighborhood freakouts over opening even highly regulated tent encampments." This is very true. Imagine the freakout that will happen over a low-barrier "compassionate" encampment.

That's not to say that something doesn't need to be done for them, but a self-managed encampment is probably not the right answer. As Ms. Hotes says, it's really hard for someone under the influence to make good decisions.

Monday, March 14, 2016

Why Housing First?

Why Housing First?

Why do the supporters of Housing First believe that substance abuse should not be a bar to housing?
The Housing First model originated with a psychologist who discovered that people in housing stabilize more often than people not in housing. He discovered this before 1992, and his name is Sam Tsemberis1.

The Housing First model is really pretty simple:

...provide housing first, and then combine that housing with supportive treatment services in the areas of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This "scattered site" model fosters a sense of home and self-determination, and it helps speed the reintegration of Pathways clients into the community.2

Pathways to Housing (Tsemberis’ organization) claims a housing retention rate of 85-90%.
Mentally ill and substance-abusing patients adhere to therapy better; tolerate housing better; and are less likely to commit crimes when housed.

Why?

Traditionally, the chronically homeless live in a cycle of surviving on the street, being admitted to hospitals, shelters, or jails and then going back to the street. The stress of surviving each day in this cycle puts a tremendous amount of pressure on the individual’s psychiatric and physical health. “Living in the street,” one Pathways to Housing client said, “It makes you crazy.”3

What’s different about the model, other than “put them in homes”?

The client participates in support services as long as they need them, but participation in a structured program is not a requirement for clients to keep their housing. Clients must only agree to meet with a member of their ACT team five times a month. Multi-disciplinary Assertive Community Treatment teams (ACT) provide clinical, vocational, and health services that are client-driven. These teams are available on-call 24 hours a day, seven days a week.4

Not every program that claims to be using “Housing First” really is using “Housing First.” This is a critical distinction. You can see from the above that the Housing First model means having support staff on-call 24/7. It means support is client-driven, not provider-driven.

We know that 88% of those who have housing in the “Housing First” model are likely to keep it. Only 47% of those not in that model are likely to keep it.

We know that the recidivism rate of former criminals is lower (by 71%) among those who are housed5. The study was conducted in Vancouver, B.C. Our own data over the last few years show this trend is real; the number of days spent in jail is reduced by 66%6 (6 months housed vs 6 months prior to housing).

The South King County pilot project7,8 showed a reduction in jail bookings (not the same as jail time), and drug and alcohol use was reduced.

Further, we know that Housing First, applied to the mentally ill and substance abusers, is cheaper than leaving them to live on the streets. This is seen in Utah, Florida, Seattle, Vancouver, Los Angeles. The amount saved per person housed depends on many variables, however. A Vancouver study, published in JAMA in 20159, found no difference in quality of life at 2 years, but substantial cost savings ($14k vs $22k, per person).

It is only common sense that the Housing first model could be appropriately applied to the disabled, the elderly, the infirm, and the chronically ill as well as to the mentally ill and to substance abusers. In a sense, the most vulnerable of the most vulnerable truly need the protection of homes. In addition, all of the homeless are experiencing degradation of their health. This is an inevitable result of living in the weather. And, to be honest, most of the homeless would be happy with substandard housing – it’s better than the streets, the tents, the cardboard boxes. They’d gladly accept a large waterproof box with a locking door, if they and they alone had the keys.

Footnotes:

Friday, March 11, 2016

Drug addiction and homelessness

Are the homeless all drug addicts?


In 1989, 75% of a particular population group reported being addicted to drugs1. In 2003, the studies said 38% of the homeless regularly used drugs2

Of course, that’s 13 years ago, now. In 2007, two-thirds of homeless reported that substance abuse or alcohol abuse contributed to their becoming homeless3. On the street, substances are widely used, and when you’re on the street with them, it’s very hard to not use substances4.

It’s now 2016. Have things changed since 2009, when the National Coalition for the Homeless wrote about homelessness and drug addiction? Well… yes and no. According to the 2010 Annual Homeless Assessment Report to Congress (2010 AHAR), 26.2% of all sheltered persons who were homeless had a severe mental illness, and 34.7% of all sheltered adults who were homeless had chronic substance use issues. So, the answer would be, "No, it hasn't changed that much."

A relatively recent study, published in JAMA5, says that 17% of homeless deaths in Boston were due to drug overdoses. Around the Seattle area last year, the percentage was much higher. You can read the King County medical examiner’s report on homeless deaths here.

It’s not just a problem for the homeless, but for the entire population. 15% of the population uses drugs (or did in 20066).

And here’s the other thing to be aware of: the statistics change as the homeless population changes. In 2008, a veritable flood of homeless hit the streets because of the economic downturn. These were mostly normal people, dispossessed of homes by rampant greed. Most of them were not substance abusers, but some of them became substance abusers to escape the emotional and psychological trauma of having become homeless. Others became homeless because of their substance abuse and alcoholism.

Still, from my point of view, drugs and alcohol are scourges of the homeless population. Any group that addresses homelessness should be addressing drug and alcohol abuse among them.

Not all homeless abuse drugs and alcohol, but many do.

What is being done about the problem? Without stable housing, treatment is hard to seek. However, there are success stories out there. One person I know in the Seattle area has now been clean and sober for two years and counting. This is at least her third try. She is very persistent. But generally, fewer than 25% of homeless receive treatment for their substance abuse7.

That’s plain enough. What are the conditions that aid in recovery from substance abuse? These seem to be critical8:

  • Housing access. A stable living environment is a critical factor in recovery. Conditional housing that demands abstinence can cripple the recovery process.
  • Well-trained staff. Compassionate, flexible and patient care is required, whereas rigidity can break the recovery process.
  • Client-centered services. A tailored treatment plan usually provides a better pathway to recovery than establishing predesigned benchmarks that do not reflect the realities of the client’s circumstances.
  • Integrated services. Since the homeless often have co-occurring disorders, facilities that have multidisciplinary professional staff members can provide centralized treatment, which is preferable to a fragmented services model that has the client traveling between different centers.
  • Comprehensive services. Addressing the many needs of a homeless person, including survival and social needs, treats the problem of homelessness holistically rather than focusing on one part to the exclusion of other vital parts.

This appears to resemble the Housing First model:

Housing First provides access to mental health treatment. The client participates in support services as long as they need them, but participation in a structured program is not a requirement for clients to keep their housing. Clients must only agree to meet with a member of their ACT team five times a month. Multi-disciplinary Assertive Community Treatment teams (ACT) provide clinical, vocational, and health services that are client-driven. These teams are available on-call 24 hours a day, seven days a week. The team provides most services in the client’s “natural environment,” usually that person’s apartment, neighborhood, or workplace. Regardless of the treatment or service, staff members work collaboratively with each client to articulate goals as defined by the client and to help move that individual toward recovery and a full, meaningful life9.

Given all this, what’s the right thing to do?

Footnotes:
3 Didenko, E. and Pankratz, N. 2007. “Substance Use: Pathways to homelessness? Or a way of adapting to street life?” Visions: BC’s Mental Health and Addictions Journal, 4(1), 9-10. Available from http://www.heretohelp.bc.ca/.
4 Fisher, G.L., ed., and Roget, N.A., ed. Encyclopedia of Substance Abuse Prevention, Treatment, and Recovery. 2009. SAGE Publications, Inc.
6 National Household Survey on Drug Use and Health (NSDUH). “Drugs and Crime Facts: Drug use in the general population.” 2006. http://www.ojp.gov/bjs/dcf/du.htm.
7 “A Comprehensive Approach to Substance Abuse and Homelessness” (http://www.nhchc.org/wp-content/uploads/2012/02/hh-1003.pdf) (Oct. 2003). National Health Care for the Homeless Council. Accessed March 9, 2016.
8 Ibid.

Statistics about the homeless

In 2013, a report about homelessness was presented to the Bill and Melinda Gates Foundation. You can find a copy of it here. There's a pile of data in that report, and it's very interesting reading. I'm going to summarize some of it, because I understood more after reading it.

Understand, first, though, that these statistics don't necessarily show fault or causation.

They were searching for factors associated with homelessness. They often cite other studies for some interesting related statistics. Generally, I’ve limited statistics to whole numbers in the comparisons (they gave them to 1 decimal point).

5.6% are homeless; 6% of veterans are homeless.
2.8% are homeless again; 2.1% of homeless veterans are homeless again.

41% of homeless men and 83% of homeless women are parents.

30% of homeless report binge drinking in the last 30 days, vs. 16% of non-homeless.

20% of homeless scored 13+ on the Kessler Psychological Distress Scale, vs. 2% of non-homeless.

50% of homeless were unemployed, vs. 11% of non-homeless.

20% of homeless have no high school diploma, vs 6% of non-homeless.

41% of homeless have been incarcerated, vs 4% of non-homeless.

31% of homeless have fair or poor health, vs 13% of non-homeless.

Many homeless people have experienced an Adverse Childhood Event (ACE), and they've experienced more of them.

An ACE is defined as one or more of the following:
  1. Mental Illness in Household – Did you live with anyone who was depressed, mentally ill, or suicidal?
  2. Substance Abuse in Household – Did you live with anyone who was a problem drinker or alcoholic? Did you live with anyone who used illegal street drugs or who abused prescription medications?
  3. Incarcerated Household Member – Did you live with anyone who served time or was sentenced to serve time in a prison, jail, or other correctional facility?
  4. Parental Separation or Divorce – Were your parents separated or divorced?
  5. Parents Physically Aggressive Toward Each Other – How often did your parents or adults in your home ever slap, hit, kick, punch or beat each other up? (once or more versus never)
  6. Parents Physically Aggressive Toward You – Before age 18, how often did a parent or adult in your home ever hit, beat, kick, or physically hurt you in any way? Do not include spanking.
  7. Emotional Abuse – How often did a parent or adult in your home ever swear at you, insult you, or put you down? (once or more versus never)
  8. Sexual Abuse – How often did anyone at least 5 years older than you or an adult ever touch you sexually? (once or more versus never) How often did anyone at least 5 years older than you or an adult try to make you touch them sexually? (once or more versus never) How often did anyone at least 5 years older than you or an adult force you to have sex? (once or more versus never)

Indeed, for each of these experienced, a person is 40% more likely to become homeless. The average score for the homeless was 3.97; for non-homeless, 1.58. One-third of those with a score of 8 (the max) are homeless.

Here are some of the statistics (read the paper for the rest of them!):

58% of homeless have divorced/separated parents, vs 27% of non-homeless;
29% of homeless had an incarcerated household member, vs 6% of non-homeless;
52% of homeless have been struck or hit by parents (not counting spanking), vs 18% of non-homeless;
70% of homeless were emotionally abused by parents, vs 31% of non-homeless.


The numbers do tend to overwhelm somewhat, but step back and look at the patterns.

Causation?


Well, no. We can't show that with this data.

While it's true that 1/3 of those who scored 8 on the ACE are homeless, it's also true that 2/3 are not.
While it's true that 58% of homeless have divorced/separated parents, 42% do not.

What we do see are risk factors.

Just as smoking one cigarette may cause lung cancer, beating your children once may cause them to be homeless as adults.

Caveats

The report was created for the Bill and Melinda Gates Foundation, which has a long history of working to change some the behaviors this report indicates are associated with homelessness. I doubt the data is biased (after all, it's pure data). The choice of questions and topics may have been. 

And when you read the report, you will understand they did some "weighting" with their statistics, and I'm not sure I understand why. The raw data is not all presented, and does not seem to be easily available. I'm planning on asking for their tabulated survey data, stripped of identifying information.

There are questions they did not ask. Use of drugs, use of tobacco, experience with landlords, number of employers, length of last employment, time of last employment, and a few others. This seems to me to indicate a lack of understanding. However, the data they did acquire seems to be reasonable. I'm not sure I trust some of it, and I suspect a bias in the methodology. But it's a study, and the data is useful.

Wednesday, March 9, 2016

Homeless Student Stability and Opportunity Gap Act, HB-1682, passes.

From the Press Release by Columbia Legal Services:

HB-1682 will make Washington the first state in the nation to implement a new and innovative grant program to promote the creation of state-level school-housing partnerships.

"School is the one place that is likely to catch homeless children and youth early and help prevent chronic homelessness," said Rep. Jake Fey (D-Tacoma), lead sponsor of the bill in the House. "This bill is inspired by the McCarver Elementary School program in Tacoma. When the program works, a housing dollar can be considered an education dollar."

Read more here.

Saturday, March 5, 2016

Why do they refuse shelter?

Seattle reports that 60% of people in “unauthorized homeless camps” refuse shelter. A question many people ask is this: 


“Why don’t they go into shelter? Are they so addicted to drugs they’d rather have the drugs than sleep indoors?

I think that’s a good pair of questions, and they deserve a better answer than most are giving. The City of Seattle department heads, for example, don’t report why shelter is refused. They don't want to admit that their shelter system (or non-system) is inadequate for the needs of the homeless.

Let me ask a different set of questions, though, that may enlighten you as to why some homeless people refuse shelter:


Pets

If you were homeless, and the dog who’s been with you for 13 years was homeless with you, and you were offered shelter but the shelter prohibits pets, would you go into the shelter and abandon your best friend, your dog?
Spouses

If you and your wife were homeless, and the only shelter with beds available was for men only, would you go to the shelter and leave her outside to fend for herself?
PTSD

If you were homeless, and you had PTSD that was triggered by being around lots of people (shelters usually have lots of people), and you felt that you’d probably have a violent episode if you went to the shelter, would you go into the shelter knowing you were going to hurt people?
Bedbugs

If you were homeless, and you’d been in every shelter in the city, and gotten bedbugs at all of them, would you go back to any of them, knowing you’d be bitten again?
"Prohibited" Medications

If you were homeless, suffering from intractable pain for which you needed opiates or marijuana, and were prohibited from using those medications in the shelter, would you go, knowing you wouldn’t be able to sleep without your medication?
LGBTQIA...

If you were lesbian, gay, bisexual, or transgender, and the shelters offered had treated you badly because of your gender preferences, would you return to those shelters to be mistreated and possibly abused?
Children

If you were homeless with your children, successfully caring for them by working like mad, and to go into shelter you had to give them up, would you go into shelter and let your children fend for themselves in another one?
Compassion for others

If you were homeless, and if there were only two beds available, and others nearby on the street needed the beds worse than you, would you go?

I wouldn’t. Not in any of those situations.
Many homeless people I know wouldn't either.
Would you?