Mental Health and Homelessness

Mental Health & Homelessness

People are afraid of the homeless in part because they fear that homeless individuals suffer from mental health disorders. This means they cannot be trusted, their behaviors cannot be predicted, and they could lash out irrationally at people passing by. This perception of mental health disorders is fueled by real observations, such as depressed homeless individuals, homeless people talking to themselves, or homeless people acting and behaving in strange ways. It is also used as an excuse to explain why people are homeless, how useless it is to try to help them, and why we don’t really need to help them (because they have mental problems and we can’t help them even if we wanted).
However, Elliot Liebow’s book Tell Them Who I Am suggests that this perception is at least partially wrong. According to Liebow, some of the homeless women he met did have real mental health issues and concerns, but those concerns and problems did not necessarily cause their homelessness. For many of the women he met, the causal arrow flowed in the opposite direction. He writes, “some women explained that their mental health problems were caused (not merely aggravated) by homelessness and shelter living, and there was nothing to do about them so long as one remained homeless. For these women, the remedy lay in housing rather than treatment.”
Homelessness and the loss of autonomy that comes from living within shelters was the cause of mental health issues for many women. The stress of homelessness, the unpredictability of shelter living, and insufficient nutrition created mental health crises for some of the women. Social isolation and the feeling of failure and worthlessness further contributed to mental health problems. Mental health problems didn’t always drive women into homelessness and poverty, but often homelessness and poverty did drive women into mental health problems.
One solution would be to try to treat the homeless with medications or therapy to solve their mental health challenges and open a pathway to a job and stable housing. Liebow suggests that this would not work for many of the homeless. Their mental health challenges in part stem from being homeless (something Matthew Desmond wrote about in Evicted) and what they need more than treatment is a stable place to live. A stable place to live can open a pathway to improved mental health, reintegration with society, and ultimately a job and all the things we want for homeless men and women. For mental health concerns, Liebow argues, housing must come first, not as a reward for getting things back on track.
Without Stable Shelter, Everything Else Falls Apart

Without Stable Shelter, Everything Else Falls Apart

“Without stable shelter, everything else falls apart,” writes Matthew Desmond in his book Evicted. Throughout the book Desmond shows how eviction, and sometimes just the threat of eviction, has the power to ruin people’s lives. People who are living in poverty and just barely holding on can be pushed over the edge by an eviction, and can find it impossible to get their lives back on track. Far from being a consequence of poor decision-making and poverty, eviction can often drive people to make poor decisions, cause people to lose jobs, and can drive people into grinding and inescapable poverty.
“The pursuit of happiness undeniable includes the pursuit of material well-being,” Desmond writes, “minimally, being able to secure basic necessities.” People who have faced eviction don’t have the ability to secure basic necessities, they are excluded from the pursuit of happiness that Jefferson enshrined in the Declaration of Independence. Homeless shelters limit people’s ability to own items and bring them into a shelter. Storage facilities, where people may hope to keep things safe during an eviction, often become a black hole from which people’s possessions never return. Eviction leaves people with only the things they can carry with them, or perhaps with the things they can stuff in a car.
When people lose basic necessities they are effectively shut out of society. Sure, someone doesn’t need a TV, doesn’t need 5 pairs of shoes, and doesn’t need a coffee maker (that last one is arguable), but people do need things to brush their hair and teeth, enough changes of clothes to keep garments clean, and other basic necessities to avoid being shunned in public. We need small comforts from time to time to enjoy some aspect of life and feel human. We need connections, and that means we need some basic level of material possessions and a way to keep them out of the elements. Eviction takes these things away from people and makes lives fall apart. Housing needs to be a basic right, it needs to be something we make sure people have, otherwise we can never expect people to live the stable and responsible lives we want for them.
Housing Vouchers - Joe Abittan - Matthew Desmond - Evicted

Housing Vouchers

Housing vouchers have been a major political win for landlords and realtors. Matthew Desmond’s book Evicted is about the real negative consequences of America’s high cost of housing, and he addresses housing vouchers which have been one of the main forms of public assistance for low-income renters. Our country likes market, or near-market, mechanisms to provide aid and assistance. Housing vouchers represent that preferred market mechanism, especially when compared to government provided, low cost housing. However, housing vouchers are not necessarily the most efficient way to provide assistance to those who cannot afford a place to live.
Desmond writes, “In Milwaukee, renters with housing vouchers were charged an average of $55 more each month, compared to unassisted renters who lived in similar apartments in similar neighborhoods. Overcharging voucher holders cost taxpayers an additional $3.6 million each year in Milwaukee alone – the equivalent of supplying 588 more needy families with housing assistance.”
Housing vouchers are taken advantage of and abused by landlords and the companies managing apartment complexes. If an individual with a voucher is not facing the full cost of the housing unit, then they don’t have the same market pressures to find alternative housing options. The result is that higher rent can be charged, with that higher rent absorbed by the voucher. Money and aid is ultimately wasted, and families who could receive help do not receive it.
The extra money that can be made by overcharging voucher holders is a windfall for landlords and realtors, and unsurprisingly, both groups lobbied for voucher systems rather than government provided housing. Desmond writes, “Landlords and realtors saw government-built and -managed buildings offered at cut-rate rents as a direct threat to their legitimacy and bottom line.” If the government could provide housing at reasonable rates, then renters wouldn’t have to put up with high rent and lousy living conditions in slums. Contrasting a voucher program that encourage rent seeking behavior, those who profit from vouchers would lose money under a system bolstered by public housing and would have to lower rents or improve property to compete against government housing that didn’t have a profit motive.
It is easy to say that government-built and -managed housing has failed in the United States and that vouchers are clearly the superior way to provide housing assistance, even if they are inefficient. But I don’t think that is a truly valid argument, and I don’t think Desmond would find it a compelling argument either. Massive housing projects in the United States were built in a way that clustered poverty, creating dense units of low-income individuals. Research from Raj Chetty has shown that economic integration and mixing is important for social and economic success, and the experience of those living in dense housing projects supports Chetty’s research. Housing projects were also constructed at a time when cities and local governments were disinvesting in inner cities, before lead abatement programs had taken hold, and when the nation had not yet begun to reckon with its racist past. In some ways it seems as if these approaches to government housing projects were intentionally designed to fail.
I don’t see any reason why government-built and -managed housing could not be successful today if built in a more dispersed manner, if designed to integrate poor, and constructed to be responsive to the racists history of housing, drug, and incarceration policy of our nation. Of course this would require real investment from the government, contrasting the disinvestment that mass housing projects once witnessed. Political considerations are the real barrier, as realtors and landlords would surely seize upon the history of failed housing projects, and stoke fear of crime and dereliction that many American’s likely harbor around public housing. Unfortunately, our unwillingness to imagine a new form of government housing means that we are stuck with inefficient housing vouchers, lobbied by (and potentially doing more to benefit) landlords and realtors than the people who are the intended recipients.
The Incentives Around Low-Market Housing

The Incentives Around Low-Market Housing

Low income renters face a lot of challenges in terms of maintaining stable housing. For those with low incomes, affordable rental units are hard to find, and the competition for such units means that any error or slip-up on the part of the renter could land them on the streets with no where else to go.
In Evicted Matthew Desmond writes, “the high demand for the cheapest housing told landlords that for every family in a unit there were scores behind them ready to take their place. In such an environment, the incentive to lower the rent, forgive a late payment, or spruce up your property was extremely low.” A lack of affordable housing and high competition among low income renters means the incentives for landlords are not in favor of the renters. Landlords know they can boot out a tenant who has young children that cause problems, or a tenant who misses a couple of rent payments, or a tenant who complains too much about problems with the property and quickly find a replacement. There are no incentives to have a nicer property to attract new tenants. There is no incentive to work with a tenant who was just laid off or had unexpected medical bills to repay late rent.
This puts low income renters in dangerous places. They cannot pass up low rent opportunities at units that are in bad condition, because if they pass, someone else will take it and they will be without a place to live. Low income renters cannot afford to have a child break a window, because they may be more likely to be kicked out of the unit than to have the window repaired timely. Additionally, they are unlikely to get a break if they hit an unlucky spell with work or health that prevents them from making rent. In many ways, the incentives around low-income housing lead to unhealthy and exploitative relationships between the poor and their landlords. Throughout Evicted Desmond explores these relationships and the real psychological costs that this reality creates for low income renters.
The Incredible Cost of Housing in the United States

The Incredible Cost of Housing in the United States

I live in a town that has experienced a major housing boom in the last 5 years. By car, we are only four hours away from San Francisco and by plane it is only an hour hop to the bay. Reno, Nevada is also located next to Lake Tahoe, one of the most beautiful alpine lakes in the world (if you don’t mind my little brag), and offers a lot of great hiking, skiing, and other outdoor activities. The city has become an attractive place for people in San Francisco, Oakland, or Sacramento who want to buy a more affordable home and have more space for families and outdoor living.
Unfortunately for many people in Reno, what is considered an affordable home to someone who has lived in the Bay Area or Sacramento is not what has traditionally been considered an affordable home to long-time locals and their families. The median price of homes in Reno has soared to over $500,000, placing homes out of reach for many long-time residents. However, with median prices for homes in the Bay Area being over $950,000, homes in Reno are somewhat of a steal.  The end result in Reno is a growing population, a housing supply that hasn’t kept up, and increasing housing costs.
I personally know people who have been renting apartments for roughly the same monthly rate as what I have paid for mortgages on houses. This soaring cost of rents is pushing people in the city into unstable housing situations, and for many, into homelessness. Reno is a great example of the challenges of sudden housing cost increases, but it certainly isn’t the only place where this is happening.
In his 2016 book Evicted, Matthew Desmond writes, “Families have watched their incomes stagnate, or even fall, while their housing costs have soared. Today, the majority of poor renting families in America spend over half of their income on housing, and at least one in four dedicates over 70 percent to paying the rent and keeping the lights on.” For close to a decade the cost of housing in many cities and regions of the country has been soaring at a time when many people were not seeing wages increase. This pushed people to have to decide between working more, moving, going into debt, risking homelessness, or sacrificing time with family, comforts, and necessities.
It is not possible to tell everyone living in a place where rent and housing costs are soaring to move to South Bend, Indiana where homes are more affordable. It is not reasonable to tell everyone to take on a second job, to get more roommates, and to simply downsize into smaller and more affordable places. The problem has to do with the amount of housing being constructed, limits placed on housing construction, and the increasing concentration of economic opportunities to large coastal cities. There are many factors and trade-offs that influence the decisions that are made with regard to new housing construction and zoning regulations, but we should remember that one outcome from failing to provide enough quality housing is homelessness. Homelessness can be temporary, cyclical, and chronic, and it has tremendous costs on society and the environment, and if housing costs can’t be brought down to a level where people are not spending half their income on rent, then it will persist and worsen.
A Double Housing Squeeze

A Double Housing Squeeze

A big focus on unaffordable housing is on the price of homes and the cost of rent. However, wage stagnation is another important factor that contributes to unaffordable housing. In $2.00 A Day, Kathryn Edin and H. Luke Shaefer write, “rising rents are certainly a big part of the problem, but the concurrent fall in renters’ incomes has outstripped the rise in prices by a factor of more than two to one.” There is a double housing squeeze being felt across the nation as the price of housing increases while wages either stagnate or decrease, especially when considered relative to general inflation indexes.
Rising home costs are often attributed to zoning regulations the prevent building sufficient housing to meet the needs of a city or population. Zoning laws restrict the building of duplexes and apartment complexes. Some zoning laws require ample parking space, cutting down on potential living space. And some zoning prevents infilling with more high density housing that would allow more people to move to the area. The results are limited housing options and higher prices for sought after units.
As wages stagnate, this becomes a serious problem. People search for sectors with higher wages and more opportunities for advancement. Such opportunities are often found in cities, however that is where the highest competition for housing exists. So individuals seeking higher wages have to contend with higher housing prices. The alternative is often accepting a stagnant wage and living further away from work than one would like, because that is the only place affordable housing can be found.
This double squeeze creates a lose-lose situation for low income individuals. If they  move to a city they may find better work opportunities, but they will pay more for less space. But if they don’t move, they will either face a very long commute or a job closer to their home that pays less and has no opportunities for advancement. Housing is a major issue, and unaffordable housing has a whole cascading series of negative consequences.
A True Democracy

A True Democracy

A while back I wrote about Cory Booker’s autobiography, and a quote he included from a housing advocate in Newark. Booker, learning from this advocate, talked about how important it is that everyone have access to housing. Both men believed that housing was a human right, just as we have rights to property, we have rights to stable, affordable, healthy housing. The reason housing must be a human right is because we cannot survive without it. We cannot flourish, we cannot store necessary medications, and we cannot live out our democratic responsibilities without a home. A true democracy helps its people do more than survive – it helps them participate, grow, and be valued members of society. A home is a necessary component of a true democracy.

 

A quote in Johann Hari’s book Chasing The Scream brought these ideas of a true democracy to my mind this morning. Housing is a first step toward solving many of the problems we see in society, but it also depends on how we think about our society and see our responsibilities within society. Right now we are too quick to cast out others and to see their lives as valueless.

 

Writing about drug users and people addicted to drugs, Hari writes, “In a true democracy, nobody gets written off. Nobody gets abandoned. Nobody’s life is declared to be not worth living.” We write off the lives of the homeless, of drug addicts, and of our nation’s poorest people all the time. If we were to be a true democracy, however, we would have to think more critically of our shared stories, futures, and connections, and work to lift up those who we have pushed down. A true democracy doesn’t limit you to your worst quality or mistake, it helps pull you up beyond your lowest point.

 

The quote makes me think about how important housing is for a democracy. You can’t participate in local politics without a local home. You can’t engage meaningfully with your society if you don’t have a place within society that you can call your own. You also, I think Hari would agree, can’t triumph over drug addiction without a home where you can be safe and have the necessary protection from the terrors and pressures which may push you back toward drug use. If we want to be a true democracy, we need to think about the ways in which homelessness leaves people behind, and we have to decide that their lives matter, and that they can’t be written off, even if they have used drugs or committed crimes in the past. Writing them off and shutting them out of our democracy doesn’t help them and doesn’t solve any problems, it only further entrenches the problems that already exist.

Budgets Reveal our Priorities

Last summer my class at the University of Nevada, Reno for my Masters in Public Administration was public budgeting. What we discussed in that class was the fact that budgeting in the political process is always political, and never based on completely rational principles. We can do our best to include data and think objectively, but a the end of the day we must make political decisions and judgement calls when we decide where we will allocate funding. How we make those decisions and where we choose to spend money reveal our priorities. This is particularly helpful to understand when we look at our nation’s problem with mass incarceration. A lot of people understand that there are problems with the number of people we arrest and that we underfund a lot of social services, but I don’t think people fully recognize the costs of mass incarceration in purely financial costs, and how those costs relate to other programs or areas where the government could spend money.

Michelle Alexander provides examples of the budget being used to arrest black people in her book The New Jim Crow. Rather than using money for services and programs upstream, before we ever arrest an individual, our resources over the years have shifted toward our police and prisons, making it easier to arrest people and providing funding to keep people incarcerated. Alexander writes, “During Clinton’s tenure, Washington slashed funding for public housing by $17 billion (a reduction of 61 percent) and boosted corrections by $19 billion (an increase of 171 percent)”. She continues by quoting Loic Wacquant, “effectively making the construction of prisons the nation’s main housing program for the urban poor.”

What the funding of public housing and prisons in the United States during the 1990s shows us is where our priorities lied regarding race, incarceration, and public housing. Alexander throughout the book demonstrates how a lack of affordable housing can lead to crime, particularly low level drug dealing charges. By taking away funding for public housing we set up a situation where poor people can barely afford a place to live and turn to illegal forms of earning money. Down stream this leads to more arrests and greater prison costs. Getting ahead of the drug dealing and arrest cycle in some cases is as simple as providing better housing (or any form of housing at all) so that an individual can work a basic job and afford housing.

Ultimately, our nation’s priority has been to punish those who we decide are bad apples rather than help those individuals create a situation where they don’t have to resort to illegal activity in the first place. We have conveniently told ourselves that success, failure, crime, and opportunities are the results of individual actions. The role of the collective and the importance of our position within society are downplayed when we look at success versus criminality, and as a result, we seek punishment for those who mess up and find it unacceptable to help those who are poor, struggling to avoid drug use, have slight mental health issues, and those who lack the education, skills, and abilities to become more successful in the low level jobs that we undervalue. If our priorities were truly aligned around helping people get a step ahead, or if our priorities were on creating a society where one could pull themselves up by their boot straps, our priorities would be reflected in a budget that did not decimate social services and public housing for those who needed some form of stability to help them get on the right path. Our nation has decided that directing ever greater funding toward police, prisons, and incarceration is a better use of our money as opposed to establishing a budget to fund upstream interventions to prevent crime and help build stability in people’s lives.

Hidden Backstories

Last summer I read extensively on race relations in the United States, and Senator Cory Booker’s United was my starting place. One of the things I was struck by in his book is how recently many actively discriminatory policies were in place, and the lingering effect of those policies. I had never experienced or seen outright discrimination or racism in my own life (I am a white male in my 20s, so it is questionable whether I would have recognized it if I had seen it), and I did not think that discrimination still acted as a major force in people’s lives today. Booker’s book along with several others, helped me understand how racial discrimination has persisted in various forms and helped me see how discriminatory practices from the past still impact the lives of people today.

Regarding housing policy in the United States, Booker demonstrates the lingering effect of racial discrimination with the following, “As Kenneth Jackson writes in Crabgrass Frontier: The Suburbanization of the United States, ‘The result, if not the intent, of the public housing program of the United States was to segregate the races, to concentrate the disadvantaged in inner cities, and to reinforce the image of suburbia as a place of refuge [from] the problems of race, crime, and poverty.’”

In the United States today many large cities are gentrifying, meaning that more wealthy individuals are moving back into the cities, increasing diversity, bringing economic and cultural revival to inner cities, and also driving up the housing costs and cost of living in the cities. This is an opposite trend from what Booker explains by quoting Kenneth Jackson, and if we are not careful it could have the same effect of marginalizing poor groups of society which often tend to be majority racial minorities. In the not too distant past housing policies greatly advantaged white people and disadvantaged black and minority people. White families were shown different neighborhoods when looking for homes and received different treatment in suburban neighborhoods. The result was that it was difficult for black people and minorities in our country to move into newer homes in suburban areas, limiting their ability to build wealth through home investments, creating areas of concentrated poverty, and potentially restricting minority populations to environmentally more hazardous areas. Some of these policies were explicit and some implicit, but many still impact the lives of people today.

Restrictive housing in New Orleans as the city grew and developed in the 1900s created a segregated city with white home owners living and moving into neighborhoods on one side of the city which was higher in terms of altitude altitude, while black people and minorities were restricted to another side of the city with lower lying neighborhoods. When Hurricane Katrina decimated the city, the force of the storm tore up both the higher and lower elevation areas of the city, but the flooding was more pronounced and longer lasting in the lower elevation levels where black people had lived for generations. White people whose families for years had lived in the higher elevation part of the city still needed to rebuild, but with less flooding and quicker drainage, did not have to start over from square one. The housing policies of the not too distant past haunted the city in the early 2000s.

For our society today we must recognize these lingering effects and remember the harm that segregation caused whether intentional or not as we decide how we want to live today. I do not have a clear answer to the problems, but we should recognize when our housing policy as a society and living decisions as individuals lead to greater inequity among racial or economic groups. The gentrification today is not based on overt racial discrimination like the housing policies of the 1950s an 60s, but the economic segregation driving the engine of gentrification could still have the same effects of segregating minority populations into substandard housing and disadvantaging them with greater commute times, and restricted access to services and opportunities.

The Scope of Human Rights

Frank Hutchins, a housing and tenant leader in New Jersey, greatly shaped Cory Booker as he entered politics. Booker recalls several stories of Mr. Hutchins in his book United and offers several quotes from Frank that shaped the way that Booker’s came to understand and approach the world. Regarding human rights, Booker shares the following thoughts, shaped by Hutchins, in United,

 

“Frank asserted that civil rights — indeed, human rights— were not just about equal access to public accommodations and equal employment opportunity. Human dignity, security, freedom from fear, environmental toxins, and physical deprivation were also rights that should be defended and fought for. It was then that he said to me, looking at me with his kind eyes, ‘Cory, housing is a human right.'”

 

We often think of civil rights in the context of the Civil Rights Movement which frames our thoughts through black and white television footage of marches to end segregation. The black and white tv and fuzzy audio recordings make the Civil Rights movement seem so far behind us, but the reality that Frank expressed to Booker is that civil rights issues continue to this day and continue beyond racial categories. Civil rights was never just about segregation as we mistakenly think about it today, but rather it was about everything Frank expressed to Booker, about sharing with everyone on the planet a life that we would find acceptable.

 

When we think about human dignity, security, freedom from fear, toxins, and physical deprivation we are thinking about the things that make us human. We have our differences and we are not born equal in terms of our biological abilities and economic opportunities. We will have different material advantages, different social advantages, and different genetic advantages, but despite our inequities we deserve to all be treated as human and not somehow be treated as less than human because of our differences and starting points. We all understand this, yet it is hard to recognize our inequities, see our advantages, and understand that the reality we experience is not shaped wholly by our own doing, but often by acts and circumstances over which we have no control.

 

The reason we have trouble viewing the expanded idea of human rights that Frank shared is the same reason that road cycling is hard. Even when we are biking with a tailwind, we still feel air against our face, and still feel resistance from the air ahead of us, even though we receive a push from behind. Recognizing our own advantages, accepting that others lack those advantages, and seeing that though we still struggle we are greatly helped by our circumstances is challenging and humbling. But it is necessary if we are to update our views of human rights and share our humanity with those across the world.

 

Tackling human rights issues require that we expand our visions of equality. We must also recognize how much we are impacted by the social world around us and how much our society influences the opportunities we have. It is easier, and often encouraged in the United States, to turn away from the true human rights shortcomings in our country and assume that everyone can overcome any obstacle on their path. It is much harder, but incredibly necessary, to recognize the ways in which environmental hazards or the lack of adequate housing impact the lives of millions of people living in our society and how that reflects back on those of us who have adequate housing and advantages within our system.