Where are the homeless supposed to go?

[u/Garey_Coleman]

Cities have been cracking down on homeless people so they can’t have encampments or stay on sidewalks. At the same time usually the shelters are full. So those who are unable to get into a shelter, where are they supposed to go?

[u/Author_Noelle_A]

I live in a city with Housing First complexes, and others that requires people with addiction issues being treatment. Don’t have to be sober, just in treatment. Treatment’s offered, but you don’t have to and can keep shooting up in private. There are no requirements at all for the Housing First, and it’s gone VERY badly, unless your idea of success is not having to see homeless people and giving them a private place to go OD and not be discovered until three days later. OD in public, and 911 gets called. Worse is the crime rate. One of the complexes, I think Alta Vista, has about 7,000 police calls come in per year. Yes, 7,000. Yes, that’s a ridiculuos number per day, and it’s like, how? The crime is so bad that some people have moved back to the streets to be safer.

The ones requiring being in treatment have been credited with helping people get their lives back together and stable. No crime issues. It’s been great.

The HF really is just a place to get them somewhere we can’t see them. No one wanting to get sober is going to get sober. When a reporter went there to do an article, she was in a woman’s apartment talking interviewing her when someone busted in the door looking for a hiding place because there was a shooting.

HF sounds like a great concept, but the reality is that people so hell-bent on using are personally better off on the streets where 911 can be called. I guess it’s better for society ‘cause one less junkie, right?

And no, decriminalizing didn’t work. It made everything so much worse, more needles in parks, ambulances being so busy that at least one person who had a heart attack is known to have died because it took over half an hour for an ambulance to be available because of how many OD calls. Deciminalization was reversed, and ODs have gone down. I’m on the other side of the river from that, so it’s local. Portland and Vancouver may as well be views as a scientific study.

Having seen how both go, I favor the mandatory-treatment one. Requiring complete sobriety first is extremely unreasonable, but letting it be a free-for-all endangers people, some who really are trying to get their lives together, but can’t because they aren’t safe.

[u/ConfusionsFirstSong → u/Author_Noelle_A]

Ive worked in housing and with people with severe addiction and mental health challenges. In Housing First, getting people housed is only the beginning. After this comprehensive services are offered including mental health and substance use services to insure wellbeing and longevity of the placement.

You seem to overlook that for people who refuse treatment, this approach categorically denies them housing. Which is completely fucked up. Putting someone in housing is not pointless. It is, in fact, quite literally lifesaving.

Maybe if you live in so cal where it never gets cold, then the elements aren’t as life threatening, excepting those heat waves that can melt trash cans to the pavement. Well where I live in Appalachia it regularly gets well below freezing in winter, and we have major snowstorms. People die from the mere fact of being unsheltered. And being unsheltered makes sobriety infinitely more difficult. They take uppers at night to stay awake to avoid being victimized. They drink and take opioids and stimulants to escape the utter misery of homelessness. Their lives are often hell on earth. You’d probably drink or use drugs too if you were unhoused. Most of us probably would.

And despite your city’s apparently awful time rolling out HF, the evidence still points strongly in favor of its use. It is actually MUCH cheaper and results in people being housed (surprise!) much more consistently than programs predicated upon treatment first do.

And besides the evidence and life saving reasons, people just straight up deserve to have some basic level of dignity. Even if they aren’t interested in going to rehab first.

[u/Cocosito → u/ConfusionsFirstSong]

Where is this? I live in AZ and have tried to help a family member and those comprehensive services are incredibly difficult to find and organize even with an address, a phone, insurance, transportation and money.

[u/ConfusionsFirstSong → u/Cocosito]

In my area these comprehensive services are offered by public community mental health agencies. Some, ie ACT for people with psychosis, are not really available to people through private insurance in my state, and so depends on Medicaid or state funding. Substance Abuse Intensive Outpatient (SAIOP), I’m not sure about. But if you look into it, it may be available in your area, or it may not. Generally the best variety of services will be found in larger cities. Rural areas will have fewer such agencies and less resources. Even in places with good services, there’s usually a waiting list. It’s the nature of public mental health and substance use care throughout the country—need greatly outpaces available funding, resources and staffing.