Frequently Asked Questions
Definitions & Scope
Family Homelessness
Youth & Young Adult Homelessness
Mental Illness & Homelessness
Substance Abuse & Homelessness
Giving Money to Homeless Individuals
Definitions & Scope
What is homelessness?
According to the federal government and cited by the National Coalition for the Homelessness [1], a person who is homeless is someone without a fixed, regular and adequate nighttime residence, or one whose primary residence is:
- A temporary place for people about to be institutionalized,
- Any place not meant for regular sleeping accommodation by humans, or
- A supervised temporary shelter.
[definition & scope questions | top]
Why are people homeless?
The complex problem of homelessness is linked to the rising cost of housing and increases in single-parent households with low earnings. Three aspects of the cause of homelessness are:
- Structural issues such as high housing cost, low household income;
- Personal issues such as mental illness, substance abuse, and other physical and mental disabilities; and
- Social policies, i.e. the inadequacy of assisted housing programs, mental health programs, substance abuse programs and other service interventions.
Personal issues and social policies vary among those who are homeless, but the structural issues are common to all people who are homeless. Hence, the development of decent, safe, affordable housing is a critical first step to ending homelessness. [2]
[definition & scope questions | top]
Who is homeless?
Persons who are homeless vary from war veterans, families and children, to battered women, and other victims of domestic violence. According to a 2003 survey of 25 American cities, families compose 40% of the homeless population. This survey also found that the homeless population is 49% African American, 35% Caucasian, 13% Latino, 2% Native American, and 1% Asian. It estimates that 23% of the single adult homeless population suffers from some form of severe or persistent mental illness and 30% could be diagnosed with an addiction disorder. [1]
[definition & scope questions | top]
How many people experience homelessness?
Due to the high turnover rate in the homeless population, it is difficult to count the number of people who have experienced homelessness at a given time and who are currently experiencing homelessness. No survey will be able to give a truly accurate picture since they cannot take into account those living with family members, or who experience only short episodes of homelessness.
Therefore, most studies of homelessness are limited to counting the number of people in shelters or on the streets. A 50-city study showed that official estimates of people who are homeless greatly surpassed that of available emergency shelter and transitional housing in every city. The best approximation says that about 3.5 million people, 1.35 million of them children, are likely to experience homelessness in a given year. [3]
[definition & scope question | top]
Family Homelessness
Facts
- Homeless families are the fastest growing segment of the homeless population, comprising nearly 40% of the total homeless population. [4]
- Today, over 1,000 Massachusetts families are in shelter on any given night, filling every bed in 80 state-funded shelters, and 300 families are living at state expense in motels — many without kitchen facilities or access to transportation or services.[5]
- 10,500 more families lack permanent housing and are doubled up with relatives, friends, or living in cars. 65% of families seeking shelter are turned away because they earn too much to qualify. 25% of families in shelters are working. [5]
[family questions | top]
Who are these families?
The face of homelessness is described by One Family Campaign as follows: “Of those in shelters, 90% are women with children. One in five are working. Nearly two-thirds do not have a high school diploma. More than half have experienced domestic or sexual abuse, and many are products of our foster care system. Children who grew up in foster care—without a permanent loving family—are particularly likely to become homeless as adults. Women who have experienced domestic violence are often cut off from a network of family and friends who could have helped them when they need a home.” [5]
[family questions | top]
Why are families homeless?
While most people assume that family homelessness is due to mental illness, substance abuse, or criminal behavior, research shows that though these may be contributing factors, homeless families are no more susceptible to these incidences than housed poor families. The primary cause of family homelessness today is poverty. In Boston, for example, studies show that a woman with one pre-school and one school-age child would need to earn over $39,000 to pay market rate for an apartment, child care, health care and other expenses; however, the average income of a woman living on welfare is $17,000. [6]
[family questions | top]
What is needed to end family homelessness?
Realistic changes in policy are vital to ending family homelessness. Unrealistic policies and assumptions about the actual cost of raising a family undercut the current system. There’s a discrepancy between current methods of prevention and intervention and the research recommendations on the problem. From budget changes to structural changes in the system, i.e. working to establish long-term support and stability, policymakers must address the core issues of homeless families such as housing and job stability. [7]
[family questions | top]
Youth & Young Adult Homelessness
Fact: The National Runaway Switchboard cites that one in seven youth will run away from home before age 18 and that between 1.3 and 2.8 million youth are on the streets every day because they’ve either run away or been forced out of their homes. [8]
[youth questions | top]
What is youth and young adult homelessness?
The National Coalition for the Homeless defines homeless youth as “individuals under the age of 18 who lack parental, foster, or institutional care.” Studies estimate that the homeless youth population is approximately 300,000 young people each year. According to the U.S. Conference of Mayors, youth account for 3% of the urban homeless population. “Homeless young adults” refers to individuals between 18-24 years old. [9]
[youth questions | top]
What are the causes of youth homelessness?
Research has shown that the causes of youth homelessness generally fall into three inter-related categories: family problems, economic problems, and residential instability.
Often it is after years of physical and sexual abuse, addictions within the family, and parental neglect that youth leave their home, becoming homeless.
Economic problems contribute to youth homelessness when youth become homeless with their families due to a lack of affordable housing, limited employment opportunities, insufficient wages, a lack of medical insurance, or inadequate welfare benefits for the family. Following homelessness, these youth are often separated from their families due to social policies regarding shelter, transitional housing, and child welfare.
Residential instability, particularly through a history of foster care, correlates with youth becoming homeless at an earlier age and remaining homeless for a longer period of time. Youth living in residential or institutional placements become homeless when they are discharged with no housing or financial support. Studies have shown that one in five youth who arrive at shelters come directly from foster care, and one in four have been in foster care in the previous year. [9]
[youth questions | top]
What are the challenges facing homeless youth?
Homeless youth face a variety of challenges while living on the streets because of a lack of shelter beds for youth, shelter admission policies, and youth preference for autonomy. Their age also limits their ability to earn enough money legally to meet their basic needs.
As a result, many youth turn to exchanging sex for food, clothing, and shelter in order to survive on the streets. Survival behaviors place homeless youth at a greater risk of contracting AIDS or HIV-related illnesses, which has been verified by HIV prevalence studies that suggest the likelihood of HIV contraction for homeless youth is 6 times higher than for other adolescents in the U.S.
It is also common for homeless adolescents to suffer from severe anxiety and depression, poor health and nutrition, and low self-esteem. Studies show that the rates of major depression, conduct disorder, and post-traumatic stress disorder tend to be 3 times higher among runaway youth than youth who have not run away. In addition, they face difficulties attending school due to legal guardianship requirements, residency requirements, lack of proper records, and lack of transportation. Each of these challenges hinders their ability to obtain an education and support themselves emotionally and financially. [9]
[youth questions | top]
Mental Illness & Homelessness
What is mental illness?
Mental illnesses are biologically based brain disorders. These disorders include schizophrenia, bipolar disorder, major depressive disorder, obsessive-compulsive disorder, panic and other severe anxiety disorders, attention deficit and hyperactivity disorder, borderline personality disorder, and other severe and persistent mental illnesses. These disorders can profoundly disrupt a person's thinking, feeling, moods, ability to relate to others, and capacity for coping with the demands of life. [10]
Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character, or poor upbringing. They cannot be overcome through "will power" and are not related to a person's "character" or intelligence. [11]
[mental illness questions | top]
Why are so many people with serious mental illnesses homeless?
According to the National Resource Center on Homelessness and Mental Illness, “People with serious mental illnesses are over-represented among people who are homeless. While only 4% of the U.S. population have serious mental illness, 5-6 times as many peope who are homeless (20-25%) suffer serious mental illness Their diagnoses include the most personally disruptive and serious mental illnesses, including severe, chronic depression; bipolar disorder; schizophrenia; schizoaffective disorders; and severe personality disorders.”
People with serious mental illnesses have greater difficulty exiting homelessness. They are homeless more frequently and for longer periods of time than other homeless subgroups; many are homeless for years. Up to 50% have co-occurring mental illnesses and substance use disorder (known as dual diagnosis). Their symptoms often go untreated, making it extremely difficult for them to meet basic needs for food, shelter and safety. [12]
[mental illness questions | top]
What do we know about people who are homeless with serious mental illnesses?
The National Resource Center on Homelessness and Mental Illness cites the following characteristics:
- Many of them have had prior contact with the mental health system, either as inpatients or outpatients. Their experiences were not always positive; they may have been hospitalized involuntarily or given treatment services or medications they did not feel were helpful.
- Their mental illness symptoms as well as the hygiene problems associated with homelessness result in many untreated physical health problems such as respiratory infections, skin problems, and risk of HIV and TB infection.
- Their social support and family networks are usually unraveled. Family members often have lost contact or are no longer equipped to be primary caregivers.
- They are twice as likely as other people who are homeless to be arrested or jailed, mostly for misdemeanors. They are often good candidates for diversion from jail to more appropriate treatment, support, and housing. [12]
[mental illness questions | top]
Are mental illnesses treatable?
Mental illnesses are treatable. Most people with serious mental illness need medication to help control symptoms, but also rely on supportive counseling, self-help groups, housing advocacy, vocational rehabilitation, income assistance and other community services to achieve their highest level of recovery. [13]
[mental illness questions | top]
What can we do to end homelessness among people with serious mental illness?
The National Resource Center on Homelessness and Mental Illness lists the following as effective solutions to ending homelessness among this population:
- Outreach—Consistent outreach and the introduction of services at their pace are key to engaging people in treatment and case management services. A consistent, caring, personal relationship is required to engage people who are homeless in treatment.
- Integrated treatment provided by multidisciplinary treatment teams can improve mental health, residential stability, and overall functioning. Regular assertive outreach, lower caseloads, and the multidisciplinary nature of the services available on these teams lead to positive treatment and housing outcomes.
- Providing supportive services to people in housing helps achieve residential stability, improved mental health, and reduces the costs of homelessness to the community. Many homeless people with serious mental illnesses prefer supported housing. However, this transition is a critical time that needs intensive support and attention.
- Prevention—Homelessness among people with serious mental illnesses can be prevented. Discharge planning to help people leaving institutions access housing, mental health, and other community services can prevent homelessness during transitions. Providing short-term intensive support services immediately after discharge from hospitals, shelters, or jails effectively prevents recurrent homelessness. [14]
[mental illness questions | top]
Substance Abuse & Homelessness
Fact: In 2000, more than 12,000 admissions to substance treatment facilities were homeless at the time of admission. These admissions comprised 10 percent of those admitted. [15]
[substance abuse questions | top]
What is “substance abuse disorder?”
Substance abuse, chemical dependence, addiction disorder and substance abuse disorder all refer to the use of a drug, alcohol or other chemical which causes dependence and other significant health impairment. For many who are homeless, alcohol abuse is the most prevalent form of substance abuse. [16]
[substance abuse questions | top]
What is the relationship between homelessness and substance abuse?
The relationship between substance abuse and homelessness can be controversial, particularly in determining the effect of one on the other. It is important to note that one condition does not necessarily cause the other. Substance abuse can be both a precipitating factor and a consequence of homelessness. So while most drug and alcohol addicts never become homeless, people who are poor and addicted have a greater risk of becoming homeless. For people who are addicted and homeless, alcohol and drug use brings immediate respite from their circumstances, but in turn keeps them from activities that will lead to stability. [17]
[substance abuse questions | top]
What is the nature of the problem?
Historically, there has been a gross over-representation of substance abuse among people who are homeless. More recent research shows substance abuse to be less prevalent, but there is no generally accepted number to measure the prevalence of addiction. [17]
The Substance Abuse and Mental Health Services Administration reports the following:
* Homeless admissions are older than admissions who are not homeless
* Alcohol is the primary substance of choice for a majority of homeless admissions (51%), followed by opiates (18%) and smoked cocaine (17%).
* Homeless admissions are more likely than admissions who are not homeless to refer themselves for treatment (43% vs. 30%). [15]
[substance abuse questions | top]
Are there particular challenges to treatment?
Many people who are homeless with addictive disorders want to overcome their addiction, but the combination of homelessness and barriers in the service system hinders their access to treatment. Engaging and retaining persons who are homeless present great challenges to treatment. The multiple needs often accompanying one who is homeless require more than is available at a given time and facility. Other issues of isolation, distrust of authorities, and transportation require more aggressive outreach than the present system offers.
Another challenge to treatment is connected to retention, namely drop-out rates due to lack of housing. The instability of the homeless condition means these “clients,” having no stable housing, tend to leave programs prematurely. [18]
[substance abuse questions | top]
Giving Money to Homeless Individuals
How do I decide whether to give money or not?
The following are some questions and principles to consider when responding to this question.
- Do you know how the money will be used?
- Is this a short-term, immediate solution to a much larger, long-term, systemic problem?
- Handouts can have a disempowering affect as individuals seek handouts, instead of hand-ups.
- Unfortunately, lying is a reality and it is not easy to tell if the person and story being presented to you is based on the truth or a lie. For many, lying becomes a survival technique while living on the streets.
- Does giving money have more to do with relieving guilt than with providing real assistance?
[giving questions | top]
What are some alternatives to giving spare change or handouts?
- Give respect to the individual. Even if you have no intention of giving money to someone, make eye contact, say “hello,” and use terms of respect like “sir.” i.e. “Sorry, sir, I don’t give money.”
- Take the time and learn the person’s name. This is especially helpful if you see the same person frequently. Using his or her name not only give dignity to someone, it also lets someone know that he or she has been remembered.
- Tell/ask the person about local meals for the hungry. If you are in Boston or Cambridge, mention Starlight’s van outreach on Wednesday night on the Boston Common and Thursday night in Harvard Square at 8 pm.
- If you do not want to leave without giving the person something, find an alternative to giving money. Give a gift certificate or the person a meal.
- If you have time and feel comfortable and safe, treat him or her to a meal. Spend time with the person.
- As you get to know someone, ask if he or she is seeking services/help from others concerning long-term solutions; i.e. housing, employment, counseling, and substance abuse services.
[giving questions | top]
Sources:
[1] “Who is Homeless?” National Coalition for the Homeless May 2004, http://www.nationalhomeless.org/who.html (8 July 2004).
[2] “Why are People Homeless?” National Coalition for the Homeless September 2002, http://www.nationalhomeless.org/causes.html (8 July 2004).
[3] “How Many People Experience Homelessness?” National Coalition for the Homeless September 2002, http://www.nationalhomeless.org/numbers.html (8 July 2004).
[4] “Education of Homeless Children and Youth,” National Coalition for the Homeless July 2001, http://www.nationalhomeless.org/edchild.html (8 July 2004).
[5] “Homelessness Today,” One Family Campaign 2001-2003, http://www.onefamilycampaign.org/channels/homelessness_today/homelessness_today.htm (8 July 2004).
[6] “Why our Families are Homeless,” One Family Campaign 2001-2003, http://www.onefamilycampaign.org/channels/homelessness_today/why_homelessness.htm (8 July 2004).
[7] “Homeless Families with Children,” National Coalition for the Homeless July 2001, http://www.nationalhomeless.org/famlies.html (8 July 2004).
[8] “We Can Help,” National Runaway Switchboard 2004, http://www.nrscrisisline.org (8 July 2004).
[9] “Homeless Youth,” National Coalition for the Homeless April 1999, http://www.nationalhomeless.org (8 July 2004).
[10] ”What is mental illness?,” American Psychiatric Association 2004 http://www.psych.org/public_info/mental_illness/what_is_mi.cfm (16 July 2004).
[11] “Mental Illness (An Overview),” American Psychiatric Association 2004 http://www.psych.org/public_info/overview.cfm (16 July 2004).
[12] “Why are so many people with serious mental illnesses homeless?,” National Resource Center on Homelessness and Mental Illness March 2003 http://www.nrchmi.samhsa.gov/facts/facts_question_3.asp (16 July 2004).
[13] “Mental Illness and Homelessness,” National Coalition for the Homeless April 1999 http://www.nationalhomeless.org/mental.html (16 July 2004)
[14] “How can we end homelessness among people with serious mental illnesses?,” National Resource Center on Homelessness and Mental Illness March 2003 http://www.nrchmi.samhsa.gov/facts/facts_question_4.asp (16 July 2004)
[15] “Characteristics of Homeless Admissions to Substance Abuse Treatment,” Substance Abuse and Mental Health Services Administration August 2003 http://oas.samhsa.gov/2k3/homelessTX/homlessTX.html (16 July 2004).
[16] “Understanding Drug Abuse and Addiction,” National Institute on Drug Abuse June 2003 http://165.112.78.61/Infofax/understand.html (16 July 2004).
[17] Addiction Disorders and Homelessness,” National Coalition for the Homeless April 1999 http://www.nationalhomeless.org/addict.html (16 July 2004).
[18] “Treatment for Homeless Persons Program,” National Health Care for the Homeless Council June 2003 2003 http://www.nhch.org/Advocacy/FactSheets/THPFactSheet0903.doc links to MSWord document. (16 July 2004).
[top]
|
