What the Armchair Experts get Wrong about Homelessness

Rachel Sheffield’s widely published OP/ED piece on homelessness earlier this month offers a prime example of misunderstanding the problem. A research fellow for Heritage Foundation, Sheffield recycles the old “treatment first” tactic that has impeded efforts to manage homelessness for decades.

Sheffield is correct when she argues that current versions of  “housing first” tactics have failed to reduce homelessness in California; however, her explanation of why it has failed is absurd. She writes,

“between 2010 and 2019 California increased its number of permanent supportive housing units by 25,000, but the number of unsheltered homeless people in the state rose by 50%. How can this be?”

The number of homeless people increases when the number of new housing units is insufficient to keep pace with the demand for housing, that’s how “this can be.”

For example, in Ventura County alone,

“Home construction has run 12.5% short of local needs (a gap that ranks No. 1 in the US). The deficit translates to the underproduction of 36,161 residential units.”

Statewide, California’s housing shortage amounts to hundreds of thousands of units each year. Even with recent population declines, state officials have estimated a need of 148,000 units per year as a baseline need if we’re to ameliorate out severe housing crisis.

Housing shortages tend to have a cascading effect that begins slowly, then escalates. For example, gentrification in cities like San Francisco has led to severe shortages of affordable housing, including and especially the rooms in cheap hotels that once sheltered hundreds of low-income people with nowhere else to go.

Disabled woman Modesto Ca, fall of 2023
Disabled on the streets of Modesto

In Chinatown, when 1700 residential units were converted to office space, the loss of housing wasn’t mitigated, nor were the losses in the Mission District when the dotcom boom attracted highly educated workers whose needs for housing drove rental prices up.

Rising housing costs in the Bay Area led to an exodus of workers to Valley towns like Stockton, Manteca, and Modesto, where housing prices have risen far beyond the means of many local residents, whose incomes average much lower than those of Bay Area commuters. The demand created by these commuters resulted in the construction of large family homes, which have higher profit margins than apartment buildings or affordable housing of any kind. Rising prices exerted downward pressure on housing of all kinds, including hotel and motel rooms.

When the City of Modesto condemned an apartment building at 624 Ninth Street in 2017, the city and Stanislaus County made a valiant effort to secure housing for displaced residents. Nonetheless, some of those residents have experienced periodic homelessness ever since. Volunteer outreach worker Frank Ploof tracked one such resident for almost six years; he found her living under a tarp attached to a chain link fence earlier this month, disabled and wheelchair-bound.

Like most everyone who argues in favor of treatment first tactics for managing homelessness, Rachel Sheffield stubbornly refuses to acknowledge the obvious consequences of severe housing shortages. Consider the following:

“The federal government should stop prioritizing the costly and inefficient housing first approach. Instead, funding for programs addressing homelessness should be tied to improved outcomes, such as reduced substance abuse, better mental health, moving people into self-supported housing, and reducing overall rates of homelessness.”

Tent on Janopaul, Modesto, CA, Feb 2024
Assisted living?

Most anyone who has worked with homeless people over time knows that “reduced substance abuse” doesn’t necessarily lead to “reducing overall rates of homelessness” for many reasons.  Sixty or ninety days in a drug treatment program may help end addiction, but it doesn’t miraculously end housing shortages, nor does “better mental health.” People often emerge from treatment only to find they have nowhere to go but back to the streets.

Moreover, California doesn’t just have a catastrophic housing shortage, it also has severe shortages of staff and infrastructure for drug and mental health treatments, not to mention shortages of assisted living facilities.

Sheffield is right when she argues that housing first policies alone won’t end homelessness. For the many homeless people who are disabled, mentally ill and severely traumatized, assisted living will be a necessary component for getting off the streets.

As for, “moving people into self-supported housing,” Sheffield again ignores reality. Of the thousands of Bay Area people living in cars, trucks and motor homes, many are employed. Most don’t earn enough to afford local rents, and even when they do earn enough, there aren’t enough rooms and apartments to serve everyone’s needs.

The fundamental problem with treatment-first remedies for homelessness is the inconvenient truth: We don’t have enough housing. We also don’t have enough service providers for the ill and disabled, nor do we have sufficient staff and infrastructure to treat the mentally ill.

Until public officials throughout the state learn to accept the hard facts about homelessness, homelessness will only get worse. Drug use and mental illness didn’t create California’s dire need for treatment centers and assisted living facilities, nor did unemployment cause housing shortages. Self-supported housing can’t happen without housing, and we don’t have enough housing.

No one blames the passengers for sinking the Titanic, but too many people are willing to blame homelessness on the homeless, which is just as absurd an argument. Homeless people need temporary shelter and basic services now; “treatment first” tactics and arguments ignore those needs and contribute to ongoing suffering and harm for people on the streets.

Eric Caine
Eric Caine
Eric Caine formerly taught in the Humanities Department at Merced College. He was an original Community Columnist at the Modesto Bee, and wrote for The Bee for over twelve years.
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7 COMMENTS

  1. Good article Eric…2 key points: housing and services. Seems like it would be straight forward to solve: build units and staff up. Problem of course is money. There is not much if any profit to be made in non-market based units so very few get built.

    Money for services is hard to come by because it’s usually tax dollars and locals sure don’t want to pay for services and they don’t! As an example our county BHRS budget is mostly funded by the states millionaire tax and Medi-Cal reimbursements!! Local tax dollars only contribute 3-4 million annually of an over 100 million dollar budget.

    We all know the struggle its been to get decent and affordable health care, which is the basic service most homeless folks need, especially when you consider substance abuse as a health issue.

    You always hear about services but the ones most critical are in very short supply and have long wait periods. The other services factor of course is pay scales that are way out alignment with the work; thus, not many folks are interested in this type of work! Wouldn’t be surprised if even more quit and go to work for $20 an hour at fast food places.

    So what can we do?
    – Governor should declare a state of emergency to address the two issues.
    – For housing, buy large acreage in key areas of the state to create new communities, like we do for parks.
    – Review building codes and put into A (keep), B(may keep), and C(suspend) categories. Suspend all building codes that are in category C.
    – Design these new communities to optimize the needs of the homeless populations assigned to live there.
    – Relocate people from the cities to these new communities.
    – Close/downsize traditional shelters as well as many of the non-medical support services
    ————-
    – For services. Create new training programs to develop staff to work directly within the communities
    – Develop new business practices that are highly automated and information rich such that data for the management of the system is available as needed.

    Sorry, I was dreaming….waking up now….

  2. Good article this time around. However, Government can’t really solve this problem alone. the solution will be long term. this problem is being worked in other states and countries- maybe it might be best to search for programs that work elsewhere and bring it here. Combining government grants with organizations that have success in this venue would be the best approach. I wonder, how much has the State of California plus all the counties of California spent over the past 20 years to ‘solve this problem? I suspect the $$$ spent exceeds $20 Billion- and the problem is worse than it was 20 years ago.

  3. Some
    make it sound so simple…it’s not so complicated. Get it? I am with Frank Ploof, only, don’t wake me, I’m dreaming…

    As I understand it, 90% of the addicted, suffer from Complex Post Traumatic Stress Disorder (CPTSD). Treatment for such can be done on an outpatient basis, similar to AA and/or NA, but with an entire knowledge base taught in group settings. Only need rooms large enough to gather. All volunteer peer staff and free admission.

    This certainly would allow people afflicted with CPTSD, to learn what it is, how it got started, what characteristics exist, the difference between healthy coping and unhealthy coping, logical thinking vs. illogical thinking, and much more, to form a safe, inclusive, loving counter culture of like-minded people on the mend.

    I, for one, am tired of letting talk, or want of money for necessities get in the way of emotional and psychological health. Addiction is not a pre-requisite. CPTSD afflicts many who do not recognize it for what it is. People afflicted with CPTSD can experience harm to the point that they suffer illness, psychiatrists label as borderline personality disorder, manic-depression, schizophrenia, anxiety, dissociative disorder, etcetera, that Big Pharma has no real cure for.

    I am extremely concerned California and the city of Modesto are eager to push court ordered treatment, including: dangerous drugs, proven, to NOT cure, on those with mental, emotional, psychological health concerns, PRIOR to seeking out a much more practical and educational remedy.
    Besides mandating treatment, known to have a dismal track record, what I recommend is a way to build trusting relationships within the community. NO experts need apply for a job.

    I agree with the disability lawyers, and, other outspoken groups, opposed to this particular forced imposition on the ill, when there are other ways which can assist the hurting to heal from trauma. Being homeless without a caring community reaching out, worsens, and extends the length of suffering from complex trauma.

    The subject of psychiatrists and the use of pharmaceuticals has become a regular issue, up for discussion 24/7 on YouTube. Even psychiatrists are admitting the harm that has been done to those unable to help themselves. Take a listen for yourselves.

    John F. Kennedy, while President, dreamed of a better way to house and care for our helpless. Over 50 years ago housing was a problem to be reckoned with. Nothing new. cities, like Modesto, CA, are still cowing to the self-centered defenders of private property and selfish interests.

    What I suggest, wholeheartedly, is FREE, other than spending some time, in earnest effort, to prove our love for neighbors and tight knit community.

  4. Nice article. This is such a tough multifaceted issue.

    In Toronto, they have created a halfway house between homeless and the streets. People can go into the housing and continue using drugs. There are always strings attached. They must meet with a social worker once a week who comes to the apt building. They can do drugs in their room alone, no friends. They added a community kitchen with one meal a day. The residents felt lonely in their aparttments, so this created a sense of community. If people don’t follow the rules, they are kicked out. There is a person who checks in with them and monitors. In his free time he talks to homeless on the street to encourage them to come in. He himself, was on the streets, and came in through this program.

    This is working pretty well. There is a hierarchy of needs in psychology which starts with food, shelter, and safety. Once people feel safe, they start to hope for more and move on to treatment programs and housing.

    It sounded really interesting but I think it might be a hard sell. I can just hear the rebuttal, “I don’t want my tax money going for people to use drugs.”

    • The initiative promises to add more beds for mental health patients. This is not necessarily “treatment first.” Staff shortages in health care in general make treatment first a complex problem.

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