Should Homeless Addicts Be Removed From Cities?

[zapatos]

59 minutes ago, dimreepr said:

That 'maybe' true for the severely mentally ill, but for the addicted, how can it be true?

An addict is trying to make their life more comfortable and a tiny house is way more comfortable than the street, to have a drink.

I agree. I'm surprised to learn that anyone has even done a study showing that giving a tiny house to an addict won't work.

[Peterkin]

14 hours ago, Alex_Krycek said:

The Tiny House solution works great for those who aren't severely mentally ill or addicted to drugs.  For the homeless in these two categories, simply giving them a tiny house isn't going to work.  

It will for addicts who want to recover and people with mild emotional impairments, if an appropriate medical regimen comes with the tiny village placement. A support group is readily available on site, but without the intimidating, relapse-inducing barbed wire and guard towers. 

People with severe mental illness should be hospitalized and treated, not imprisoned.

[Genady]

1 minute ago, Peterkin said:

People with severe mental illness should be hospitalized and treated

Unfortunately, this happens only for short term during psychotic episodes.

[Peterkin]

Yes.... they're just too expensive. After a gall-bladder operation you're expected to recover and go home in 3-5 days. After a schizophrenic break, you might need a month or longer. So, back on the street you go.

Quote

There is clearly a link between psychiatric disorders and homelessness; disentangling the nature of this relationship is complicated.

https://www.psychiatrictimes.com/view/never-ending-loop-homelessness-psychiatric-disorder-and-mortality

...Briefly, solutions to the problem of homelessness include finding and implementing innovative models of care such as street psychiatry, integrated primary care, and mental health care models; Veterans Administration Homeless Models (Homeless Patient Aligned Care Teams H-PACT); and utilizing allies in the housing and rehabilitation services domains to find specialized housing opportunities.

Whatever treatment option is offered, secure housing is key to its success.  

[zapatos]

24 minutes ago, Peterkin said:

It will for addicts who want to recover...

Depending on what is meant by "...isn't going to work...", it will also work for those who don't want to recover.

If the goal is to get a roof over the head of an addict and keep them off the main thoroughfare, then having them in a tiny home may work just fine.

[CharonY]

4 hours ago, zapatos said:

I agree. I'm surprised to learn that anyone has even done a study showing that giving a tiny house to an addict won't work.

Interestingly, there is a fairly large body of literature at this point to figure out effectivenesss of Housing First, specifically for cases of mental illness and addiction. Of course the outcomes are vary widely, as the initiatives are very different in scope and set up. For example, some initiatives have centralized dwellings with access to counselling, others are just dwellings but may have stipulations that forbid use of illicit drugs. These initiatives also cover a wide range of ground, like focusing on transient homeless vs long-term homeless folks. Young vs elderly, etc.

A Canadian study on mental illness and drug abuse for example, has shown that HF intervention in conjunction with intervention showed significant reduction of alcohol-related problems compared to interventions alone, but did not reduce illicit drug use, suggesting that other interventions are needed to address those. https://doi.org/10.1016/j.drugalcdep.2014.10.019

That being said, a follow-up showed that even in folks with substance abuse, overall outcomes improved with HF (just less than folks without).

 https://doi.org/10.1111/add.13928

 

 

 

[Peterkin]

1 hour ago, zapatos said:

If the goal is to get a roof over the head of an addict and keep them off the main thoroughfare, then having them in a tiny home may work just fine.

OK, I agree. I had assumed the objective of the OP was to solve both problems of homeless addicts.

However, if you put people who intend to keep using in an urban setting, there could be trouble from/with the neighbours, among other possible setbacks. Neither would I hardened users together with those who are trying to get clean (and/or sober); that probably wouldn't turn out well. So the villages would have to zoned as 'safe sites' or 'drug-free' or 'dry', and I certainly wouldn't put children in non-recovery communities.    

[Alex_Krycek]

6 hours ago, Peterkin said:

It will for addicts who want to recover and people with mild emotional impairments, if an appropriate medical regimen comes with the tiny village placement.

See the Safe Rest Village project I linked to earlier:  https://www.portland.gov/united/saferestvillages

6 hours ago, Peterkin said:

A support group is readily available on site, but without the intimidating, relapse-inducing barbed wire and guard towers. People with severe mental illness should be hospitalized and treated, not imprisoned.

This is your self serving caricature / straw man, not mine.  I never mentioned anything about barbed wire or guard towers.

[TheVat]

On 2/23/2023 at 5:06 PM, Alex_Krycek said:

An addict would not be able to leave the camp until they get clean. 

I respect that you modified your ideas in the course of this chat, and it speaks to your openness to trying different things.  I would guess that the above quote in the OP has, unfortunately, led to the recurrent references to guard towers, barb wire, and other validations of Godwin's Law of Net forums.  

As you realize by this point, the OP restriction above would necessitate guards of some kind, and physical barriers, given that some would opt to leave for whatever reason.  

I like the HF approaches, in that they recognize that any person, once they have a secure sheltering space over which they have some control, is better situated to consider how/if they might work on goals of betterment.  

[Alex_Krycek]

29 minutes ago, TheVat said:

I respect that you modified your ideas in the course of this chat, and it speaks to your openness to trying different things.  I would guess that the above quote in the OP has, unfortunately, led to the recurrent references to guard towers, barb wire, and other validations of Godwin's Law of Net forums.  

Correct.  I have since amended that point as the discussion unfolded, the Sun Break Ranch proposal being more closely aligned with what I think would actually work.

[Peterkin]

1 hour ago, Alex_Krycek said:

This is your self serving caricature / straw man, not mine.  I never mentioned anything about barbed wire or guard towers.

That's true. I did caricature the OP suggestion, since I found the approach objectionable and have some idea where such approaches lead in real world situations. Donald Trump showed us an example of how detaining illegal immigrants can go very badly wrong. Any mass detention can - and they usually do. We know too many instances to leave our guard down when any facile blanket 'solution' to a societal problem is proposed, especially if that solution involves people indiscriminately rounded up by police.  

[Alex_Krycek]

13 minutes ago, Peterkin said:

That's true. I did caricature the OP suggestion, since I found the approach objectionable and have some idea where such approaches lead in real world situations. Donald Trump showed us an example of how detaining illegal immigrants can go very badly wrong. Any mass detention can - and they usually do. We know too many instances to leave our guard down when any facile blanket 'solution' to a societal problem is proposed, especially if that solution involves people indiscriminately rounded up by police.  

Do you really think it was all Donald Trump?  Hate to break it to you, but Trump's policies were largely a continuation of Obama's, and were continued without major changes by Biden.  Yes, Trump pushed the envelope to appease his base,  but his policies were by no means a drastic departure of what was previously, and has since been, US immigration policy with respect to civilian, non-criminal, non citizen detainees.

Here's a list of all the ICE detention facilities currently in operation for non-citizens:  https://www.ice.gov/detention-facilities?state=All&office=&name=&page=0

It's five pages long with over 100 facilities.  

So we should recognize the reality that such facilities are already in operation for millions of human beings in the US.  What I'm proposing here in alignment with the Sun Break Ranch proposal really pales in comparison to what is already occurring.  Such a facility would also be far more humane than leaving homeless addicts out on the street to live in squalid and dangerous conditions.

Edited March 8, 2023 by Alex_Krycek

[Peterkin]

1 hour ago, Alex_Krycek said:

Do you really think it was all Donald Trump? 

No. That was a facile example.

It was Americans believing that complex problems have simple solutions that do not involve them having to examine their past actions, or give up anything of their comfort and convenience. Closing their eyes to consequences and sweeping past injustice and present disparity under rugs.

1 hour ago, Alex_Krycek said:

What I'm proposing here in alignment with the Sun Break Ranch proposal really pales in comparison to what is already occurring.  Such a facility would also be far more humane than leaving homeless addicts out on the street to live in squalid and dangerous conditions.

That might even be true. For about five minutes. But you have not detailed the costing and funding, let alone the legislations required to make your solution available to all c600,000 homeless Americans, and who knows how many world-wide. Who's going to sort out the drug addicts from the alcoholics from the mildly or severely mentally ill from the people who just got evicted because their landlord wanted to flip a tenement into an upscale condo and give each of those people the help appropriate to their need?

There are plenty of good ideas, but not enough support or resources. When you resort to force, a whole lot of people fall through, or get stuck in, a whole lot of cracks.  

[Moontanman]

Has the number of homeless who are addicts been established? Are we assuming most are? Or is addiction relatively rare among the homeless? I think it would help if we had some idea of what portion of homeless are addicts or mentally ill, or just people who are down and out financially.  

[CharonY]

2 hours ago, Moontanman said:

Has the number of homeless who are addicts been established? Are we assuming most are? Or is addiction relatively rare among the homeless? I think it would help if we had some idea of what portion of homeless are addicts or mentally ill, or just people who are down and out financially.  

I have seen some data and I can probably dig out papers for more detail. But from what I recall issues regarding substance abuse is fairly high, roughly in the 70% range. The most prominent one being alcohol. Mental illness depends a lot on classification, as substance abuse can also be classified as a disorder, for example. But diagnoses like schizophrenia, anxiety disorders and so on are fairly high and most long-term homeless folks suffer from something. Which is not surprising, as such. If not already suffering from these disorders, being homeless is certainly making things worse.

But you are of course correct, one should really establish facts (rather than anecdotes) before thinking about doing something that can significantly affect other folks.

Especially if the thing is convenient for you but with unclear consequences for others. The mere thought that it does not affect oneself, makes it easier to go way overboard, resulting in unintended atrocities.

[Moontanman]

I know that homelessness has always been one of my own personal fears to the extent I have nightmares about it even today. 

[CharonY]

4 hours ago, Moontanman said:

I know that homelessness has always been one of my own personal fears to the extent I have nightmares about it even today. 

To me it is interesting to me how different the impact is when you are a kid vs being an adult.

Even transient loss of a home as an adult is a huge thing. However, as a kid you might not even question (too much) why you are sleeping temporarily in a garage, for example. I think part of it is because as an adult you see or imagine potential futures ahead (or lack thereof).

[Peterkin]

32 minutes ago, CharonY said:

However, as a kid you might not even question (too much) why you are sleeping temporarily in a garage, for example.

How old a kid? When I was 10, we packed a minimum of belongings and left our home. I was very much aware that we would never go back, never see that apartment, or that city, ever again. It was terrifying, even though I was with both my parents. My brother was 5, and pretty much took things as they came. Later, he had only scrappy memories of the next eight months, while I retain every landscape, voyage and temporary shelter to this day.

I do understand why some old people, on losing their home, lose the will to live. And why people with mental health issues can't possibly get better until they have a safe place of their own. Not an institution, not a hostel, not a rehabilitation camp with bunk beds - a room with a door they can lock and a light they can turn out or leave on and a bed where nobody else is allowed to crash, except by their invitation.   

Edited March 9, 2023 by Peterkin

[CharonY]

29 minutes ago, Peterkin said:

How old a kid? When I was 10, we packed a minimum of belongings and left our home. I was very much aware that we would never go back, never see that apartment, or that city, ever again. It was terrifying, even though I was with both my parents. My brother was 5, and pretty much took things as they came. Later, he had only scrappy memories of the next eight months, while I retain every landscape, voyage and temporary shelter to this day.

I would think that it depends a lot on the individual. We moved a lot when I was young, so for a while there was no real sense of a real home. My memory is quite detailed, though, mostly because it was fairly cold.

30 minutes ago, Peterkin said:

I do understand why some old people, on losing their home, lose the will to live. And why people with mental health issues can't possibly get better until they have a safe place of their own.

I think studies suggest that elderly folks who become homeless often suffered from some event that makes them spiral into homelessness. I think some of the frequent factors include loss of partner or job.

[Peterkin]

9 hours ago, CharonY said:

I think studies suggest that elderly folks who become homeless often suffered from some event that makes them spiral into homelessness. I think some of the frequent factors include loss of partner or job.

That's not just old people; that applies to most homeless people. Something bad happened, then another bad thing and another, they lost control of their life, had a breakdown or self-medicated to excess, until finally, they couldn't afford the mortgage or the rent and utilities.... The cracks keep getting wider and more people fall through.

[TheVat]

Elder homelessness seems to me criminal, when the person losing a dwelling does not have another shelter provided.  Evictions, where the evictee is 65+ and has no place to go, should be banned by federal law.  

[Phi for All]

11 hours ago, CharonY said:

I think studies suggest that elderly folks who become homeless often suffered from some event that makes them spiral into homelessness. I think some of the frequent factors include loss of partner or job.

I wonder if those studies include the impact of capitalism on the elderly. In the US, we spend our whole lives saving for retirement, paying into Social Security, only to find several well-oiled, privately owned industries are just waiting to sink their hooks into your savings. Medicare is rife with all these private schemes that suck the effectiveness out of your retirement savings (I get invited to steak dinners so they can sell me on my government's medical coverage). Even if you can avoid scammers, there are too many legal ways to fleece the elderly. 

[CharonY]

4 hours ago, Peterkin said:

That's not just old people; that applies to most homeless people. Something bad happened, then another bad thing and another, they lost control of their life, had a breakdown or self-medicated to excess, until finally, they couldn't afford the mortgage or the rent and utilities.... The cracks keep getting wider and more people fall through.

Actually studies show a marked difference in the causes of homelessness based on age. Those that became homeless at an older age (suggesting that they had security before), cataclysmic events seem to be most associated with homelessness. In younger folks, enduring household and other systemic issues (abuse, conflict with parents, neglect, being placed out of home etc) are more common.

common. https://doi.org/10.1176/ps.2009.60.4.465

That is to say, the pattern of elderly homelessness seems to be more heterogenous. 

 

2 hours ago, Phi for All said:

I wonder if those studies include the impact of capitalism on the elderly. In the US, we spend our whole lives saving for retirement, paying into Social Security, only to find several well-oiled, privately owned industries are just waiting to sink their hooks into your savings. Medicare is rife with all these private schemes that suck the effectiveness out of your retirement savings (I get invited to steak dinners so they can sell me on my government's medical coverage). Even if you can avoid scammers, there are too many legal ways to fleece the elderly. 

I think the question is probably a bit vague, but there are likely studies looking at financial issues and the impact of social security systems in preventing homelessness. 

Edit: but I think there some level distinction that need to be made. There is evidence that buffer programs, where safety net provide fast financial relief have a big impact on likelihood of homelessness https://doi.org/10.1126/science.aag0833

However, some elderly have trouble adjusting to significant changes in their life that may not be financial in nature. In these cases, a supportive social environment or e.g. counselling might have a stronger impact to prevent further spiraling.

[mistermack]

2 hours ago, TheVat said:

Elder homelessness seems to me criminal, when the person losing a dwelling does not have another shelter provided.  Evictions, where the evictee is 65+ and has no place to go, should be banned by federal law.  

If you ban eviction, you basically remove the option to rent for older people. If I had a house and was thinking of letting it, why would I accept a tenant aged over sixty, if I was just giving them licence to not pay the rent? 

I would rather take less rent off a younger applicant than rent to someone I can't evict if it all goes wrong. And morally, you are putting the burden of homelessness on people who have done nothing to deserve it. People are not stupid, they want some sort of security when they rent out a property, or they will simply not bother. 

[TheVat]

14 minutes ago, mistermack said:

If you ban eviction, you basically remove the option to rent for older people. If I had a house and was thinking of letting it, why would I accept a tenant aged over sixty, if I was just giving them licence to not pay the rent? 

Due to brevity of my post i did not include the obvious, which is that such bans be paired with compensation programs for landlords.  I didn't flesh out that post because of time constraints this a.m.

Hope that clarifies.