Homelessness and Health

The biggest contradiction is when they say “everyone matters”
-Blake Simons

Is mental health the new buzzword? Perhaps. Celebrities are becoming more outspoken, mental health programming is more rampant, and mental health online communities have gathered a significant following. Bullet journals, stress balls, and photo-ops are a few of the ways social media has capitalized on mental health content creation. So no sweat, right?

The mainstream discussion of mental health has become a double-edged sword. While it potentially has resulted in individuals seeking care and developing healthy coping mechanisms, these conversations are far from inclusive. Housing security has statistically proven to have a strong association with mental health. Yet when it comes to discussions regarding housing security as a significant  social determinant, the silence is frustrating.

When I refer to silence, I’m referring to California specifically. Yes, blue, liberal, loving California. California state legislators characterize the Golden State as tolerant, releasing a statement following the 2016 presidential election that stated the following:

California is – and must always be – a refuge of justice and opportunity for people of all walks, talks, ages and aspirations – regardless of how you look, where you live, what language you speak, or who you love. 

Politicians discuss inclusiveness with respect to foreign policy, but rarely do we stop and think about the displacement of populations happening in front of our eyes. The Bay Area is a perfect example of this: 71% percent of San Francisco’s homeless population used to have homes. Yet where is the outrage, the protest, and the legislative action?

Homelessness occurs in every nation, so the question is which governments are willing to step in: Which governments are willing to guarantee food, shelter, and health as fundamental human rights?

Homelessness–a mental health issue?

For this piece, I poured over academic publications and reviews. Yet, the most insightful sources of information came not from academics, but individuals who had either experienced homelessness or worked to combat intersecting issues. I interviewed Blake Simons, a recent UC Berkeley Alumni with extensive work in the Black Student Union, and Delphine Brody, a formerly-homeless individual who currently works on mental health initiatives.

I started writing, thinking that the streets were merely a different tool used to isolate the mentally ill, hence how homelessness arises. However, as both Blake and Delphine pointed out, it is important not to equate homelessness as a mental health issue and vice versa.

“The situation is more nuanced than that,” says Blake, “It relates to capitalism and what we see as valuable. It’s what enabled slavery to thrive, by essentially dehumanizing people and considering them disposable.”

Background

The United States (and California specifically) has a history of failing the homeless population. Both Blake and Delphine agreed that the problem is long rooted in a history of dynamics ranging from systemic racism to neoliberalism. The seeds for homelessness were laid far prior to the Tech Boom. During the 1980s, President Reagan’s administration escalated the War on Drugs by both incarcerating drug users, especially people of color, and commencing a series of massive public spending cuts, leading to psychiatric hospitals, housing programs, and community mental health services being shut down. The result was a spike in the homeless population, increased incarceration rates, and a higher incidence of mental illnesses, especially among incarcerated and homeless populations. Even more alarming were the disproportionate numbers of Black populations displaced and arrested, many of whom suffer from the consequences today. Now approximately one-third of homeless individuals have had a serious mental disorder; additionally, many with a mental illness history end up in unsafe, segregated areas. Furthermore, individuals who disclose existence of a mental illness have higher chances of being refused housing by landlords [1].

But what specifically in the Bay Area is leading to the problem? The recent demographic shift due to the proximity of tech jobs, coupled with skyrocketing rent, has extenuated the issue. Landlords currently have limitations with regards to raising rent or evicting individuals. However, these policies include plenty of loopholes that enable landlords to evict low-income individuals, especially people of color.  The number of evictions due to the Ellis Act is growing and is rooted in human greed. Remodeling results in an increased property value, and landlords have gone to extreme measures to evict tenants. Some have been known to hire arsonists to damage property and evict individuals while they repair the damage, enabling them to increase rent once again.

“In San Francisco, mayoral candidates spend massive money on campaigns attacking poor and homeless people as dangerous criminals on behalf of their corporate donors. Poverty is not just an unfortunate situation, it’s violence. It’s a result of greed in public policy.”
– Delphine Brody

The Bay Area contains numerous abandoned, habitable houses, yet refuses to pass measures to grant these spaces for homeless individuals, citing financial concerns. Communities, especially of color, are currently being displaced in Oakland. To not see race in the equation would be ignorant; a politically-conservative state, Utah has addressed homelessness through progressive policies, yet its racial demographics are homogeneous compared to the Bay Area. Racism may be absent in conversations regarding housing security, but it is a core cause of the issue.

Interventions

So how do we address this? Suggesting we redirect individuals toward treatment is not enough, not when abuse is so prevalent in treatment facilities. We need harm-reduction policies, allowing for safe and sanitary conditions for individuals to use needles. We need to actively fight stigmas tangential to homelessness, including stigma against drug users and stigma against the trans community who experience higher rates of violence. We need to decriminalize being homeless to begin with i.e. stop evicting individuals for not being able to pay rent and stop citing and fining people for sleeping on park benches. And we need to reverse the War on Drugs, which has punished too many by withholding necessary treatment.

But perhaps, most of all, we need to recognize the multifaceted nature of the issue. The lack of academic material acknowledging the multitude of narratives and identities is disingenuous and dangerously misleading. Homelessness isn’t just a mental health issue, it’s a result of systemic racism, institutional failure, transphobia, and state-mediated violence. It’s the consequence of seeing individuals as disposable and blaming them for their “personal problems”.

Yet, it can be combated. But everyone has to do their part.

External Links:
http://www.endhomelessness.org/pages/policy
https://sites.google.com/site/strategiesforchange/home

Footnotes:
[1]  The Mark of Shame by Stephen Hinshaw


This post was written by Deepika Dilip. Please send any questions or concerns to content@subconscious.org.

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