Homelessness in America.edited

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Feb 20, 2024

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1 Homelessness in America Briana Nelsen SWK:5008 Macro Social Work Practice with Groups Capella University Dr. Rhonda Waddell

2 Homelessness in America Homelessness in America has always been a significant issue and continues to grow with every passing year. There are many reasons why an individual or a family finds themselves homeless. ”Eviction, fire, job loss, work-related injury, or debilitating illness are among the events that mark the tipping point between being domiciled and being without a roof overhead, especially when resources have been exhausted or are hard to come by in the local community”, (Lee, Shinn, & Culhane, 2021). In recent years, it has become harder to find low-cost living options, decently-paid employment opportunities, access to public assistance programs, and even access to quality mental health services. "Experiences of homelessness depend on a complex interplay between individual, interpersonal, and socioeconomic factors. Research has long identified mental illness and addiction as risk factors for homelessness. Personal struggles also strain interpersonal relationships with family, friends, and romantic partners; in a vicious cycle, conflict undermines well-being and erodes potential housing support. However, socioeconomic factors often dictate the likelihood of displacement" (Fowler, Hovmand, Marcal, & Das, 2019). Homeless individuals are often grouped between individuals with no employment, disabilities or mental illnesses, and domestic violence. Every year in January, the U.S. Department of Housing and Urban Development completes a point-in-time (PIT) of the number of homeless individuals. Both out on the street and in shelters, however, it has been argued that this method is flawed and is inaccurate to the actual number of homeless individuals in the United States (Statista Research Department, 2023). The homeless population continues to grow every year without fail, especially as the cost of living continues to increase. The cost of living, food, and grocery prices increase, and unemployment numbers continue to rise as many jobs do not provide enough hourly wages or

3 salary to keep up with the demands of everyday expenses. Bigger states such as California and New York continue to have the largest population of homeless individuals due to the cost of living in those states and the waitlist for government assistance programs. “…the total number of people who experience some form of homelessness over the course of a year is estimated to be 2.5 to 3.5 million individuals, homelessness is a serious problem" (Balasuriya & Buelt, 2020). Individuals, families with young children, veterans, and young individuals with no parents make up the population of homeless individuals in the United States. Veterans make up a significant portion of the homeless population and struggle to find resources to get them to a stable living environment. Most veterans also struggle with post-traumatic stress disorder after being discharged from active duty. In combination with substance abuse problems as a coping mechanism for post-traumatic stress disorder due to lack of access to affordable mental health care. Another significant portion of the homeless population is young adults; "Homeless youth present another problem in the United States. In 2022, there were an estimated 30,090 unaccompanied homeless people under the age of 25 living on the street in the U.S. 97 percent of the homeless youth in Marin County in California lived outside of homeless shelters" (Statista Research Department, 2023). When young individuals are subjected to homelessness so early in their lives, it increases the chances that the cycle will continue to be repeated should they have families or their own. “At the macro scale of analysis, housing affordability, poverty, social exclusion, public policies, and large-scale shocks influence the number of people living at a disadvantage: the larger that number, the higher the homelessness rate" (Lee, Shinn, & Culhane, 2021). Seeing that many individuals find themselves homeless due to substance abuse or mental illness shines a light on the fact that the programs and resources that are meant to be available to

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4 these individuals are not getting to everyone. Adjustments need to be made so the number of homeless decreases instead of increasing every year. Being in a constant state of homelessness for any individual can have a detrimental effect on their overall health, not just mentally and emotionally. If an individual is unable to seek shelter due to overcrowding and is forced to sleep and survive in the elements, they put themselves at risk for premature morbidity. Health risks also include any disease, many types of physical injury, worsening mental illnesses, suicide ideation, and even completing suicide. Looking at the causes of homelessness is not black and white, as many individuals continue to perceive when looking at the homeless population. Every individual and situation is unique and should be looked at as such to create solutions to alleviate homelessness. With the constant increase in the number of homeless, the solutions that are currently put in place may be to help a small percentage of the population, but they are not keeping up with the overwhelming number. “Homeless services systems continued to expand the availability of both temporary and permanent beds in 2022, but these resources still fall short of reaching everyone in need" (State of Homelessness: 2023 Edition, 2023). Diving into the housing needs so that those who can find shelter are at a decreased risk of becoming homeless again, as this is a sizeable significant chance for individuals and families who have previously been homeless. From the literature found, the need to help decrease the homeless population is to look deeper into the housing options available. With the rise in housing costs, many people are forced to either live with another family in a single household or to avoid homelessness; this is due to the housing costs amounting to more than 50% of an individual’s paycheck throughout the United States, (State of Homelessness: 2023 Edition, 2023).

5 From reading the literature, it appears that Maslow's Law of Hierarchy is significantly observed by an individual needing to meet their basic needs of shelter, food, water, and employment. “Maslow’s hierarchy of needs is a motivational theory in psychology comprising a five-tier model of human needs, often depicted as hierarchical levels within a pyramid" (Mccleod, 2023). Homelessness is contributed to by an individual not having an income, education, employment, or support network. These need to be at satisfactory levels of functioning for a person to move out of homelessness successfully. In combination with Maslow's Law and being able to meet one's basic needs, individuals need to be able to have pre- contemplation of their need to move out of homelessness. This is also referred to as the stages of change model; “The Transtheoretical Model (TTM) focuses on the individual's decision-making and is a model of intentional change. The TTM operates on the assumption that people do not change behaviors quickly and decisively" (LaMorte, 2022). Both theory and model show up when looking at the reasoning behind homelessness and the willingness of an individual to get out of homelessness and stay out and not relapse. When looking at the resources that are available to help resolve homelessness issues. In contrast, those resources look good on paper; many people are not receiving this assistance due to the overwhelming number of homeless individuals, so instead of reducing numbers, they are adding to the already high numbers. An example of Maslow's Law would be that homeless individuals do not have shelter, adequate food and water, appropriate clothing, are in good health, or have gainful employment. To satisfy those basic needs, one must begin by finding a suitable place to live so that they can provide food, water, and clothing for themselves. Once that has been satisfied, finding gainful employment to maintain their living situation will be crucial.

6 Once one need has been met, it makes it easier to move on to the next need, as if it were falling dominoes. When looking at the stages of the change model, it implies that an individual needs to be ready in their own time to move out of homelessness. Otherwise, they find themselves back at square one, having to start all over again. An individual can think about moving out of homelessness until they are ready to prepare and participate in the actions needed to move out of homelessness. An example would be that a homeless veteran who suffers from post-traumatic stress is reached out to by Veterans Affairs; they may not be ready as they did not reach out first. However, if that individual turns around and reaches out to Veterans Affairs and asks for help, they are in the action stage of the change model. They will likely be more successful in maintaining a stable housing situation. (LaMorte, 2022) There have been numerous programs that have been invented in order to reduce the number of homeless, and some of those include Section 8 housing and housing choice vouchers, both of which have been proven to help reduce the number of homeless (Coalition for the Homeless, 2023). Another proven solution that has been shown to work is the "Housing First" program, which was started in New York City and eventually made its way nationwide after seeing the positive effects it was having. “Research studies have found that most long-term street homeless people moved into “housing first” apartments remain stably housed and experience significant improvements in their health problems’, (Coalition for the Homeless, 2023). It makes sure individuals have permanent or long-term housing before providing the additional services they most likely will need. "Housing First" and permanent supportive housing have both been known to be far less costly than having to find emergency shelter, which would further add fuel to the fire. “Homelessness prevention programs aim to stop (or at least reduce) the inflow into

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7 the homeless services system and help vulnerable individuals and families maintain housing stability" (Shinn & Cohen, 2019). Case management has been commonly used when helping individuals transition out of homelessness. A social worker is assigned to an individual that is experiencing homelessness and is the link between the individual and the various resources they could be eligible including mental health counseling, housing or rental assistance, health care services, and employment searches. “Case management (CM) is one such intervention where individual case managers respond to the complexity of navigating the healthcare system by assessing, planning, and facilitating access to health and social services" (Ponka, et al., 2020). Case management in combination with other resources that are available to the homeless population. Studies have shown that with case management, individuals are homeless for a shorter period and are more likely to stop drug and alcohol consumption while in stable housing (Ponka, et al., 2020). Stopping people experiencing homelessness before it can occur is a way to help, and these are also seen in eviction support services to help individuals not be evicted, community- based services in which individuals can call and ask for help pending whether the funds are still available for the month. It has been seen that stopping homelessness before it can happen is far more effective than any resources that help after the fact, as it is harder to place an individual or a family that has an eviction on their record. Other strategies include critical time intervention for individuals who have been released from a psychiatric facility and screenings of homelessness potential risk factors. As previously mentioned, eviction prevention programs and community- based financial assistance programs are only as effective as the money for the month is available. Although not all individuals and families can receive assistance, the individuals who asked for assistance when funds were available were able to avoid becoming homeless. “Once they have

8 left homelessness for permanent housing, many formerly homeless families and individuals can benefit from support services to help maintain housing stability. This includes job training, childcare, and community-based counseling services. More fundamentally, enhancing housing stability for poor and low-income renters involves broader policy changes, including living-wage jobs; access to affordable health care; and adequate public benefits for people with disabilities." (Coalition for the Homeless, 2023). In summary, homelessness is seen everywhere, and it is a significant public issue as the numbers continue to rise every year. There are many contributing factors to why an individual or family becomes homeless: drug and alcohol abuse, eviction, mental health crisis, fire, or employment loss. The homeless population is made up of individuals with no families, families with young children, veterans, and minors with no parental presence. Veterans have been seen to make up a significant portion of the homeless population, mainly due to suffering from mental illnesses such as post-traumatic stress disorder. The cost of living has significantly increased since the pandemic, leaving many individuals struggling to buy groceries and other everyday expenses, including rent, and are turned down for help when needed as funds are allocated quickly due to the demand. Individuals need to meet their basic needs according to Maslow's Hierarchy of Needs. Until those basic needs, such as having adequate food, water, clothing, and shelter, they are unable to have a good quality of life. Some individuals find themselves chronically homeless and unable to break the cycle of homelessness, making it so they need to want to make the effort to change their situations. If an individual does not want to make the change, there is a high probability that they will relapse. This is where the social change model comes in and is seen with many individuals experiencing homelessness. However, if they want to change their

9 situation, ask for help, and put the work in, they will get further than if they do not ask for help. Finally, strategies that have been the most effective are the homelessness prevention programs such as rental assistance before an eviction can take place and case management after the fact as one individual is assigned to create access to resources that are available to individuals attempting to break free of homelessness. Those include mental health services, health care services, housing, rental assistance that helps pay deposits or late rent, and employment search so an individual can remain in permanent housing and not relapse into homelessness. It has been shown that if an individual can stop homelessness from happening to begin with, it is a lot more cost-effective, and it is also likely that they can remain in their housing.

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10 References Balasuriya, L., & Buelt, E. (2020, May 29). The Never-Ending Loop: Homelessness, Psychiatric Disorder, and Mortality . Retrieved from Psychiatric Times: https://www.psychiatrictimes.com/view/never-ending-loop-homelessness-psychiatric- disorder-and-mortality Coalition for the Homeless. (2023). Proven Solutions . Retrieved from Coalition for the Homeless: https://www.coalitionforthehomeless.org/proven-solutions/#Housing- BasedSolutions Fowler, P. J., Hovmand, P. S., Marcal, K. E., & Das, S. (2019, April). Solving Homelessness from a Complex Systems Perspective: Insights for Prevention Responses. Annual Review of Public Health, 40 , 465-486. doi:https://doi.org/10.1146/annurev-publhealth-040617- 013553 LaMorte, W. W. (2022). The Transtheoretical Model (Stages of Change) . Retrieved from Boston University School of Public Health: https://sphweb.bumc.bu.edu/otlt/mph-modules/sb/behavioralchangetheories/ behavioralchangetheories6.html Lee, B. A., Shinn, M., & Culhane, D. P. (2021, April 2). Homelessness as a Moving Target. The ANNALS of the American Academy of Political and Social Science, 693 (1), 8-26. doi:https://doi.org/10.1177/000271622199703 Mccleod, S. (2023, October 24). Maslow’s Hierarchy Of Needs . Retrieved from Simply Psychology: https://www.simplypsychology.org/maslow.html Ponka, D., Agbata, E., Kendall, C., Stergiopoulos, V., Mendoca, O., Magwood, O., . . . Pottie, K. (2020). The Effectiveness of Case Management Interventions for the Homeless,

11 Vulnerably Housed and Persons With Lived Experience: A Systematic Review. PLoS One, 15 (4). doi:https://doi.org/10.1371%2Fjournal.pone.0230896 Red Nose Day. (2021, December 6). What Are Four Types of Homelessness . Retrieved from Red Nose Day: https://rednoseday.org/news/what-are-four-types-homelessness Shinn, M., & Cohen, R. (2019). Homelessness Prevention: A Review of the Literature. Center for Evidence-Based Solutions to Homelessness. Statista Research Department. (2023, June 2). Homelessness In The U.S . Retrieved from Statista: https://www.statista.com/topics/5139/homelessness-in-the-us/#topicOverview U.S Department of Housing and Urban Development. (2018). Definitions of Homelessness . Retrieved from Substance Abuse and Mental Health Services Administration: https://soarworks.samhsa.gov/article/definitions-of-homelessness#:~:text=The %20definition%20of%20those%20who,not%20meant%20for%20habitation%2C%20or

Homelessness in America.edited

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