Tuesday, December 28, 2010

Blog on Homelessness: Solutions to Social Problems and Why They Work

"There is this sense in our minds that someone who’s on the streets is almost in their DNA different from someone who has a house
... that is really not the case.”

~~ Becky Kanis, Common Ground, NY

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December 24, 2010, 8:30 pm

The Street-Level Solution

Solutions to Social Problems and Why They Work

When I was growing up, one of my father’s favorite sayings (borrowed from the humorist Will Rogers) was: “It isn’t what we don’t know that causes the trouble; it’s what we think we know that just ain’t so.” One of the main insights to be taken from the 100,000 Homes campaign and its strategy to end chronic homelessness, which I wrote about in Tuesdays’ column, is that, until recently, our society thought it understood the nature of homelessness, but it didn’t.

That led to a cascade of mistaken assumptions about why people become homeless and what they need. Many of the errors in our homelessness policies have stemmed from the conception that the homeless are a homogeneous group. It’s only in the past 15 years that organizations like Common Ground, and others, have taken a more granular, street-level view of the problem — disaggregating the “episodically homeless” from the “chronically homeless” in order to understand their needs at an individual level. This is why we can now envision a different approach — and get better results.

Most readers expressed support for the effort, although a number were skeptical, and a few downright dismissive, about the chances of long-term homeless people adapting well to housing. This is to be expected; it’s hard to imagine what we haven’t yet seen. As Niccolò Machiavelli wrote in “The Prince,” one of the major obstacles in any effort to advance systemic change is the “incredulity of men,” which is to say that people “do not readily believe in new things until they have had a long experience of them.” Most of us have witnessed homeless people on the streets for decades. Few have seen formerly homeless people after they have been housed successfully. We don’t have reference points for that story. So we extrapolate from what we know — or think we know.

But that can be misleading, even to experts. When I asked Rosanne Haggerty, the founder of Common Ground, which currently operates 2,310 units of supportive housing (with 552 more under construction), what had been her biggest surprise in this work, she replied: “Fifteen years ago, I would not have believed that people who had been so broken and entrenched in homelessness could thrive to the degree that they do in our buildings.”

And Becky Kanis, the campaign’s director, commented: “There is this sense in our minds that someone who’s on the streets is almost in their DNA different from someone who has a house. The campaign is creating a first hand experience for many people that that is really not the case.”

Once homeless people return to housing, they’re in a much better position to rebuild their lives.

One of the jolting realizations that I had while researching this column is that anybody could become like a homeless person — all it takes is a traumatic brain injury. A bicycle fall, a car accident, a slip on the ice, or if you’re a soldier, a head wound — and your life could become unrecognizable. James O’Connell, a doctor who has been treating the most vulnerable homeless people on the streets of Boston for 25 years, estimates that 40 percent of the long-term homeless people he’s met had such a brain injury. “For many it was a head injury prior to the time they became homeless,” he said. “They became erratic. They’d have mood swings, bouts of explosive behavior. They couldn’t hold onto their jobs. Drinking made them feel better. They’d end up on the streets.”

Once homeless people return to housing, they’re in a much better position to rebuild their lives. But it’s important to note that housing, alone, is not enough. As with many complex social problems, when you get through the initial crisis, you have another problem to solve which is no less challenging. But it is a better problem.

Over the past decade, O’Connell has seen this happen. “I spend half my time on the streets or in the hospital and the other half making house calls to people who lived for years on the streets,” he said. “So from a doctor’s point of view it’s a delightful switch, but it’s not as if putting someone in housing is the answer to addressing all of their problems. It’s the first step.”

Once in housing, formerly homeless people can become isolated and lonely. If they’ve lived on the streets for years, they may have acquired a certain stature as well as a sense of pride in their survival skills. Now indoors, those aspects of their identity may be stripped away. Many also experience a profound disorientation at the outset. “If you’re homeless for more than six months, you kind of lose your bearings,” says Haggerty. “Existence becomes not about overcoming homelessness but about finding food, panhandling, looking for a job to survive another day. The whole process of how you define stability gets reordered.”

Many need regular, if not continuous, support with mental health problems, addictions and illnesses — and, equally important, assistance in the day to day challenges of life, reacquainting with family, building relationships with neighbors, finding enjoyable activities or work, managing finances, and learning how to eat healthy food.

-- More From Fixes -- Read previous contributions to this series}

For some people, the best solution is to live in a communal residence, with special services. This isn’t available everywhere, however. In Boston, for example, homeless people tend to be scattered in apartments throughout the city.

Common Ground’s large residences in New York offer insight into the possibilities for change when homeless people have a rich array of supports. In additional to more traditional social services, residents also make use of communal gardens, classes in things like cooking, yoga, theatre and photography, and job placement. Last year, 188 formerly homeless tenants in four of Common Ground’s residences, found jobs.

Because the properties have many services and are well-managed, Haggerty has found post-housing problems to be surprisingly rare. In the past 10 years, there have been only a handful of incidents of altercations between tenants. There is very little graffiti or vandalism. And the turnover is almost negligible. In the Prince George Hotel in New York, which is home to 208 formerly homeless people and 208 low income tenants, the average length of tenancy is close to seven years. (All residents pay 30 percent of their income for rent; for the formerly homeless, this comes out of their government benefits.) When people move on, it is usually because they’ve found a preferable apartment.

“Tenants also want to participate in shaping the public areas of the buildings,” said Haggerty. “They formed a gardening committee. They want a terrace on the roof. Those are things I didn’t count on.” The most common tenant demand? “People always want more storage space — but that’s true of every New Yorker,” she adds. “In many ways, we’re a lot like a normal apartment building. Our tenants look like anyone else.”

As I mentioned, homelessness is a catch-all for a variety of problems. A number of readers asked whether the campaign will address family homelessness, which has different causes and requires a different solution. I’ve been following some of the promising ideas emerging to address and prevent family homelessness.

Later in 2011, I’ll explore these ideas in a column. For now, I’ll conclude with an update on the 100,000 Homes Campaign. Since Tuesday, New Orleans and a few other communities have reported new results. The current tally of people housed is 7,043.

David Bornstein is the author of “How to Change the World,” which has been published in 20 languages, and “The Price of a Dream: The Story of the Grameen Bank,” and is co-author of “Social Entrepreneurship: What Everyone Needs to Know.” He is the founder of dowser.org, a media site that reports on social innovation.

Linda's Hearth note: Maybe I can create a responsive essay to this? It may help me get out my own perspective: local manifestations of those policies Bornstein describes? I like the writer's "balance" between spheres of influence: between street heat, creative nonprofit and religious service providers, and "the public sector." Voices of local citizens, and of merchants, developers, education and private enterprise seems missing, in any ongoing sense, to me, where decision and policy happens.

I personally believe that in congregate housing, an ideal set-up for most homeless people going thru' yet another **collosal psychic change** once they get a room or place with indoor privacy: wrap-around supportive services directed by client, balanced with real-world property management/advocate support (people gain new skills when it works). I would want to help create a collaborative household which includes BOTH the wrap-around client supports with building-based, voluntary, tenant-advised "social activities". For ex: AA meetings, art therapy workshops, "yoga nite", root beer floats together (maybe not the sugar?), or whatever social supports clients together deem helpful to many.

When I was a homeless mom, I remember needing somebody to help me make some timely phonecalls, but any such help was a huge gulf away (wait lists everywhere then)because "helping programs" deign to make personal and family decisions for me before they decide for themselves how they may help out. It is such a waste of resources at the least; for me it created insurmountable debts, delays in ongoing bureaucratic and legal tasks borne of poverty, which I wasn't able to complete because I had to perform somebody else's schedule.

My young son's school progress was injured drastically because a shelter had a standing rule that kids under 12 had to be enrolled nearby. This is a form of blackmail that my son and my family will always be compensating for. I cannot blame the "counselor" orthe shelter, I cannot blame myself for going against my instincts because OTHER instincts drove me to stable food situation, beds instead of car seats, etc. NO FAULT, and MUCH gratitude. Makes me sad that there is not feedback loop to the funders and caregivers because clients are homogenized by staffers. I learned that without our clients' voices, support systems will not work very well and can do great harms which nobody can forsee. WITH clients' voices, if they are fresh from homelessness or any other serial shocks (Vietnam, sudden weaning, losing one's parents even for a short time, hunger, facing others' predations without the support and rearing required...

Along these lines, I would also caution those who help with intake and developing an action plan for homeless clients, and who would be case managers or support people during such reentry into "mainstream" life -- KNOW that even the homeless person who is articulate and at ease with interviewing is not going to be able to share all the horror and shock of being on the streets or hidden in a forest for too long. Don't press for a new client's whole story -- instead, make it easy for the person to "share" (and feel heard, and feel their own voices validated) when she or he is ready.

The worse one's shocks have been, whether distant or recent, the harder it will be to "bring up" everything at once. I believe there's a necessary sequencing required for such work to be healing. It takes months or a year; longer wihtout the right, tender, social contacts and support, for one's injuries to be fully revealed, once a continuum of safety is established.

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