The United Way of King County has published an ethnographic study of homelessness (PDF) that shatters many of the myths and generalizations about homeless people.

From the introduction:

Fundraising for the Campaign to End Chronic Homelessness is at its halfway point, and the associated resources are now beginning to be deployed in the community. To ensure that we and our partners truly understand the shape and scale of the problem, and use our resources to the best possible effect, we commissioned this Ethnographic Assessment of Homeless Street Populations. It is Washington State’s first-ever effort to take a probing, anthropological look at the people and places of King County homelessness, and capture the diversity of the homeless experience.

Not everyone who is lingering on the street is homeless, and not everyone who is homeless is on the street. Drug and alcohol use is widespread, but hardly universal, and different ages of the homeless have different preferences in substances.

For some homeless people, life will turn around if there is a dependable roof overhead. For others, the challenge is deeper, and success will hinge on supportive services, including mentorship in regaining critical social skills.

All this and more emerges from this rich, textured, and challenging report. As we move forward in United Way of King County’s work to end homelessness, the report will guide our effort to be as comprehensive and effective as possible in our approach. link

Story in the Seattle P-I

Further down, the report notes:

Now, there are evidence-based practices for serving the chronic homeless population. Positive results have been found for models that incorporate Housing First principles, recovery first models, generic outreach, employment options, day centers, harm reduction, and motivational interviewing approaches to chemical dependency. Seattle has yet to develop a coordinated effort incorporating all of these components. However, as reported earlier, MID workers noted a clear difference on the street with the opening of the 1811 Eastlake Project (DESC) for chronic alcoholics and Real Change, which provides the opportunity to earn cash by selling papers. The innovations of Housing First principles have transformed the service philosophy toward this group in recent years. Equally transformative approaches are needed for other homeless streetbased
populations.

In other words, we may need to suspend some of our assumptions about what we should do and look at the research. Many people objected when 1811 was opened, as it lets alcoholics drink in their rooms, but it does get them off the street, giving them a greater chance of achieving sobriety and employment.

The “Chronic Homeless” category used in this report is a bit broad; it’s designed to encompass groups that aren’t adequately described by the other categories “Chronic Public Alcoholic,” “Mentally Ill and Mentally Ill Offender,” “Drug Addicted Offender.” I think the simply down-and-out are a bit overlooked, though I haven’t read the report in its entirety. What about those who have chronic, untreated health issues? Getting such issues fully treated is not easy for the homeless, and such issues can quickly lead to homelessness for those without insurance.

For those of you who know our homeless friend Paul, I’m saddened to report that he passed away about two weeks ago, after spending several weeks in a coma. While he did have some drug issues in his past, most of his issues were related to chronic health problems. We saw over and over that he’d get short-term treatment for his MRSA infections and then be released, so the infections would never go away. They eventually destroyed his kidneys, forcing him to go to dialysis four times a week. A number of other complications made the kidney failure worse, and ultimately contributed to his untimely death.

These are serious issues, and United Way’s $25 million campaign to end homelessness will be a necessary start in addressing them.