Ever since that deinstitutionalization, the number of homeless (both the mentally ill and others) has continued to increase. Approximately two million persons are now homeless at some time during the year, according to the National Law Center on Homelessness and Poverty. New York City alone spends $850 million a year to house and counsel homeless people. Currently, the U.S. Department of Housing and Urban Development provides more than $1 billion yearly to fund programs for them.
Despite today’s unprecedented prosperity, homelessness is unlikely to lessen and may even increase. Corroborating such a prediction are two comprehensive surveys released in December 1999 by the U.S. Conference of Mayors and the U.S. Department of Housing and Urban Development. The Conference of Mayors, for example, reported that most of the cities surveyed had reported more requests for emergency shelter.
In many cases, homelessness signals deeper problems. All may qualify as homeless, but many desperately need more than a roof over their heads. Their basic need may not be housing at all. Paradoxically, current public policy at the city and state levels actually generates homelessness. Unless this predicament changes dramatically, no decline in the number of shelterless can be expected.
How then do governmental policy and expenditures shortchange the homeless? Nationwide in the 1960’s, there were 500,000 state beds for the mentally ill. Today, there are fewer than 70,000. In the 1950’s New York State’s mental hospitals housed 93,000 patients; now there are 6,000. Consequently, thousands of mentally ill men and women now stumble along the streets without a home and without the medication they need. What they deserve is a caring residential facility with constructive things to do, help in developing their abilities and assistance with their prescribed medications.
The count of the mentally-ill homeless would be even higher were not large numbers in jails or prisons. In many cities, the local jail has become the community’s largest institution for them. Schizophrenics or manic-depressives are more likely to be arrested for conduct related to their ailments than to be granted refuge in mental health facilities. In New York City, for example, nearly 3,000 mentally ill people are behind bars.
Sixteen percent of the nation’s mentally ill are likely to be imprisoned, according to a U.S. Department of Justice study released in 1999. Only a minority of those imprisoned are given treatment. Furthermore, upon release, they are seldom referred to local institutions for medical attention. Many become homeless, deteriorate, are re-arrested and then return to jail.
Another large group of homelesshard-core drug or alcohol abusersare also shortchanged. Despite a hard-fought war against drugs, the nation’s epidemic of substance abuse thrives. Many users eventually become penniless, helpless and then homelessespecially those with lower incomes. (The Federal Centers for Disease Control and Prevention in Atlanta recently reminded us that cocaine and marijuana use among high schoolers grew steadily during the 1990’s before finally tapering off.) Hard-core users willing to kick their drug or alcohol habit by undergoing treatment find their options limited. In most large cities, detoxification centers and halfway houses are understaffed, overcrowded and too few in number.
Also among the homeless are urban vagabonds, drug-addicted down-and-outers, many of whom rebel against a shelter’s hospitality requirements for cleanliness and sobriety. These include the Chicagoans removed last year from the sidewalks of Lower Wacker Drive, where they lived in cardboard boxes or other makeshift shelters. Still others are periodically homeless because of domestic violence, the loss of jobs, death of a breadwinner or lack of affordable housing. Among them are runaways and unwed mothers with young children. Many are employed or employable.
In the meantime, a significant shift is taking place in the public’s attitude toward the homeless. Ten years ago the dominating question was: are there enough beds, especially in the winter? New questions are now being advanced. Why have we not succeeded in breaking the cycles of homelessness? A shelter tonight, but what about the rest of the year? Public and private funders want to know whether their dollars make a difference. How many of the homeless are now in more or less permanent housing? How many have jobs? And how many have kicked the habit of substance abuse?
As a result, many city officials now understand that most homeless people require more than a shelter to abandon the city streets. They need not only a bed but also a reason to get out of it. Governments increasingly demand that the shelters they fund do more than supply overnight beds, so that through hands-on counseling and individualized attention, more homeless people will be able to rejoin the urban mainstream. On the other hand, public officials also realize that turning around the lives of the homeless is no cinch and that it takes time.
What initiatives are now being taken to prevent homelessness? In some cities, nonviolent drug offenders who are arrested are given treatment instead of jail sentences. Addicted welfare recipients are required to undergo treatment. More jail wardens, when releasing mentally ill prisoners, now steer them to social agencies for follow-up psychiatric care. Greater efforts are being made to ensure that deadbeat dads (and moms) make their child support payments. Some city employees have become pro-active by going out on the streets trying to persuade the homeless to take advantage of counseling and social services. And nationally and locally, new steps, including rent subsidies, are underway to increase the supply of affordable housing for low-income homeless.
More and more citizens understand that the billions of dollars now being spent annually to imprison the mentally ill and drug addicts could better be used for programs of prevention and treatment. Yet too little is being done to set up additional halfway homes and detoxification centers or to multiply residences for the troubled mentally ill.
While individuals, social institutions and local governments have slowly begun to take steps that could eventually alleviate the nation’s homelessness, the problem remains. Current efforts are still too few and too small in scope. Wider and broader initiatives must be mounted to aid the destitute on our streets. We now know what steps should be taken to decrease homelessness in the United States. The question is whether we will take those steps.