Homeless in America

Homelessness in America is a complex issue involving approximately 582,500 individuals experiencing both sheltered and unsheltered living situations, as reported in early 2023. The homeless population is categorized into three groups: chronic, episodic, and temporary homelessness. Chronic homelessness persists for extended periods, often associated with severe mental health issues and substance use disorders. Episodic homelessness tends to be cyclical, influenced by factors like poverty and family instability, while temporary homelessness is typically a consequence of short-term financial crises.

Efforts to address this crisis include the Housing First program, which aims to provide permanent housing as a foundational step for rehabilitation, allowing individuals to choose their treatment paths. Despite some progress, such as a notable decline in chronic homelessness prior to the pandemic, overall homelessness saw a slight uptick between 2020 and 2022. The demographic makeup of the homeless population reveals significant racial disparities and a notable presence of families, especially among the temporarily homeless.

Barriers to accessing support include insufficient federal aid for eligible families and long waiting lists for housing assistance. Additionally, systemic challenges like gentrification and the criminalization of homelessness further exacerbate the plight of individuals experiencing homelessness, highlighting the need for comprehensive, culturally sensitive solutions.

Published in: 2023

By: Klassen, Jeff

Subject Terms

Homelessness in America

Abstract

This article presents an overview of the issue of homelessness. In January 2023, the US Department of Housing and Urban Development (HUD) released its 2022 Annual Homelessness Assessment to Congress. According to this report, on a January night in 2022, there were 582,500 sheltered and unsheltered homeless people in the United States. At least three categories of homelessness can be identified: chronic (or literal), episodic (or cyclical), and temporary. The Housing First program and, perhaps to a lesser degree, shelters, and missions operated by governmental, religious, and private groups have responded to this situation commendably, if not quite adequately.

Overview

The number of people categorized as chronically homeless declined by 9.4 percent between 2010 and 2019 (Henry et al., 2020). However, between 2019 and 2020, this category of homelessness experienced a dramatic increase of 15 percent (Henry et al., 2021). The cyclically homeless tend is for a high risk for repeated homelessness due to persistent problems such as violent family environments and the combination of poverty and expenses related to dependent children (Davidson, 2007). This group frequently suffers from post-traumatic stress disorder (PTSD), often resulting from trauma experienced both during pre-homeless and post-homeless periods. PTSD can be traced to specific events and is common among military veterans and abused women and children. PTSD frequently impairs the sufferer from performing tasks necessary to maintain employment and to function socially. The temporarily homeless are homeless in the sense that most have a residence due to a financial crisis and sleep in vehicles, with acquaintances, or in shelters.

The official definition of chronic homelessness is the lack of a residence for more than a year or for at least four episodes in the last three years (Henry et al., 2021). In the 2010s, the federal government began to focus on chronic homelessness in part because that group is more easily identifiable and therefore easier to address. In 2010, the Obama Administration released Opening Doors: Federal Strategic Plan to Prevent Homelessness, an ambitious agenda outlining four goals aimed at preventing and ending homelessness: ending chronic homelessness by 2015; preventing and eliminating homelessness among veterans by 2015; preventing and ending homelessness for families, youth, and children by 2020; and creating a strategy to end all types of homelessness. The Housing First program reversed the conventional emphasis on moving the chronically homeless through temporary housing and treatment programs and sought to provide permanent housing as a basis for rehabilitation; clients can then choose forms of treatment or therapy that are desirable (Davidson, 2007).

Developments in the national homeless situation have been decidedly mixed. The overall homeless population is estimated to have declined by about 10 percent from 2007 to 2020 (Henry et al., 2021). Nonetheless, between 2020 and 2022, homelessness increased slightly by about one percent across the nation (US Department of Housing and Urban Development, 2022). In addition to an overall decline in chronic homelessness in the early 2020s, homelessness among families with children declined by thirty-two percent between 2007 and 2019 (Henry et al., 2020). The mortgage crisis that followed the Great Recession of 2007 may have been beneficial for some low-income earners in the sense that property values fell while more property became available for shelters (Koch, 2008). After Hurricane Katrina in 2005, however, rental expenses and rates of homelessness doubled in New Orleans. A well-publicized streak of "middle-class homeless" emerged in the wealthy community of Santa Barbara, California. The New Beginnings counseling center offered a safe-parking program for those who had lost homes and were living in their vehicles. The center offered a safe place to park free from harassment as a method of enabling people to turn their lives around (ABC News, 2008).

Only twenty-five percent of eligible families in financial crisis receive federal aid, and there are lengthy waiting lists to receive valuable Section 8 housing choice vouchers. Between September 2013 and August 2014, sixteen of twenty-five cities surveyed reported having to turn away families with children. Sixty-one percent had to turn away individuals seeking access to emergency shelters due to a shortage of resources, according to the US Conference of Mayors study (Conference of Mayors, 2014). Homeless families among households that receive government assistance are also in an undesirable position.

Culhane, Lee, and Wachter (1996) found that family homelessness is predictable based on urban and demographic patterns. Three clusters of poverty in New York City and Philadelphia accounted for roughly two-thirds of families admitted to shelters in those cities. Those "slums within slums" were characterized by highly concentrated poverty and unemployment, a prevalence of households headed by single African American women, few adolescents, immigrants, or elderly individuals, and—surprisingly—high vacancy. These factors might be explained by increased African American family segregation in deteriorating buildings, where families were already "doubling up" to conserve their dwindling resources. These factors may not be revealed in official data because admitting some facts following a medical, social, or law-related crisis might limit access to public resources (Culhane, Lee, & Wachter, 1996).

The number of homeless veterans decreased significantly in the 2010s, with a 50 percent decline from 2010 to 2019 (Henry et al., 2020). In 2020 African Americans comprised 39.4 percent of the homeless population; Whites comprised 48.3 percent; Hispanics and Latinos, 22.5 percent; and Native Americans, 3.3 percent. In 2020, 18.3 percent of homeless people were under the age of eighteen. About 30 percent were in families; 29 percent were individual women; 70 percent were individual men; about 20 percent had mental disorders and 15 percent had a substance use disorder (Henry et al., 2021). As of 2008, slightly less than one-third of those who were homeless had some college, professional, or technical training, one-third had a high school diploma or GED, and slightly more than one-third did not complete high school; 13 percent were employed; 26 percent suffered from serious illnesses such as pneumonia or tuberculosis; and 55 percent had no access to health insurance (Nieto, Gittelman, & Abad, 2008). About a quarter were sexually or physically abused as children; 27 percent moved through foster care; 21 percent were homeless while children; and 54 percent had been incarcerated (Nieto, Gittelman, & Abad, 2008). Older age and an arrest record are generally predictive of long-term homelessness, whereas younger homeless individuals without a history of arrests or substance abuse treatment are more statistically likely to escape homelessness (Nieto, Gittelman, & Abad, 2008).

Earlier studies of chronic homelessness often link mental disorders and substance use disorder as causal factors, which can create the impression that substance use causes mental disorders (or vice versa), and which in turn results in chronic homelessness. Studies have emphasized that these two contributing factors are often triggered in high-risk individuals with a history of family instability by violent events that are likely to result in PTSD, and that the experience of homelessness—in a sort of snowball effect—exacerbates these problems and other impediments to maintaining residence, employment, and the social supports that can prevent homelessness. In other words, individuals prone to homelessness are also prone to mental disorders and substance use disorders, particularly when family instability, exposure to violence, and the experience of childhood homelessness are evident (Booth, Sullivan, Koegel, & Burnam, 2002). It is worth noting, however, that specific patterns of substance use, particularly polydependence, have distinct correlations with patterns of psychological disorders and demographic histories. These patterns can reveal both problems and past achievements (Booth, Sullivan, Koegel, & Burnam, 2002).

Accurate statistical information about the homeless population is often difficult to compile due to its absence from the information used to generate census and IRS data. Much of the data derives from third-hand reports and self-reports collected by homeless advocates, service workers, and academics. Information about PTSD is especially difficult to compile because dissociation is a symptom. Over half of homeless women are thought to suffer from depression, which is also associated with avoidant behavior. These women are self-conscious about their problems and are, therefore, likely to avoid circumstances related to those problems (Hicks-Coolick, Peters, & Zimmerman, 2007).

Although redistribution programs such as public assistance are less generous in the United States than in other countries with comparably high standards of living such as Canada and Great Britain, in some respects the national homelessness situation is more severe in those countries (Nieto, Gittelman, & Abad, 2008). One plausible conclusion to draw from this is that poverty-related problems are informed by cultural behavior or conditions. This hypothesis likely explains the relatively low rate of suicide among the US homeless population. Another explanation might be that generous welfare programs can exacerbate problems that contribute to homelessness. A more probable conclusion is that the patchwork of community and religion-based services provided to the homeless in the United States assumes part of the burden that the government performs in other developed countries and that this cluster of service groups performs its function effectively.

The "New" Homelessness and the Social Isolation of the Homeless. The de-institutionalization of individuals with mental disorders began in the 1960s, and yet the homelessness-related crisis did not fully arrive until the 1980s. In the 1970s, a million or more of the SRO units where the unemployed often resided were demolished, and the gentrification of urban centers through upscale remodeling escalated (Levitas, 1990). In the 1960s, one study found that 75 percent of the homeless were over the age of forty-five and 87 percent of them were Caucasian; by 1986, 87 percent were minorities and 86 percent were under the age of forty-five (Nieto, Gittelman, & Abad, 2008). Even more alarmingly, more families were newly homeless in the 1980s (Nieto, Gittelman, & Abad, 2008). The declining age of the homeless, however, is partially explained by increased government spending on Social Security (Levitas, 1990).

In the 1960s, the transient population that moved through SRO units appeared to be declining, given the high rate of vacancies in those "cubicle hotels" (Dupuis, 1999). As such, the gentrification of city centers did not present such an obvious concern until the 1980s (Rossi & Wright, 1987). Cheap SRO units were conventionally located near railroad freight yards and trucking terminals, where temporary labor was needed (Dupuis, 1999). As the demand for manual labor decreased and homelessness soared in the 1980s, the federal government also cut the budget for Housing and Urban Development (HUD) and Section 8 vouchers in half (Nieto, Gittelman, & Abad, 2008). The McKinney-Vento Act, however, was enacted in 1987 in response to public and government concern.

Peter H. Rossi, one of the best-known sociologists associated with studying homelessness, developed a strategy for collecting quantitative information about homeless individuals. A team of investigators, accompanied by off-duty police officers for protection, examined all accessible streets, buildings, and cars in a specific neighborhood at night. This "blitz" method revealed that the level of chronic, or "literal" to use Rossi's term, homelessness was not as high as expected, but also that minorities and single women with children were increasingly represented. The "modal" (or most often appearing) homeless person was found to be an African American high-school graduate in his late thirties (Rossi & Wright, 1987). All had significant levels of mental, social, and physical disabilities; all appeared to be socially isolated and unable to maintain or form bonds, although 60 percent had experienced at least some recent contact with family members (Rossi & Wright, 1987).

Rossi argued that a new form of public assistance that provided aid to families with dependent adults was warranted to address the demographic change in homelessness. Rossi also observed that the national rate of homelessness was surprisingly low, given that seventeen million individuals earned less than half of the amount designated as the official poverty line in the 1980s (Levitas, 1990).

The later AHMI ethnographic study of women on Los Angeles' "Skid Row" provides a qualification of Rossi's observation about the social isolation of the homeless. That study found that one woman who neglected to eat even when free food was available nevertheless had a network of homeless and other local acquaintances who often sought her out and provided food. Another woman who could barely communicate in any way had a friend with whom she frequently met. Another who is described as psychotic also consumed mission meals and shopped with a close friend. A few others, however, were thoroughly isolated: they avoided companionship; one talked to trees; another's isolation and psychosis were only finalized once she obtained an apartment. In a minority of instances such as this, subjects of the AHMI study were actually worse off once they escaped from street life (Baldwin, 1998).

A Lawyer's "Walking Tour" of Skid Row in Los Angeles. Lawyer Bernard E. Harcourt performed first-hand research about the Skid Row (Central Area East) section of downtown Los Angeles for a trial, but he was not called upon to use that information. Instead, he published a quasi-ethnographic study of his experience that also traced the activities of an influential homeless advocate and a prominent real estate developer who had worked as a housing official for the city. These two individuals and their respective organizations were often in competition to purchase the same buildings, and each argued that their own urban development strategy was the most beneficial for the homeless (Harcourt, 2005).

The attempted gentrification of Los Angeles' fifty-block Skid Row district occurred later than in the inner-city sections of New York and other large cities. Downtown Los Angeles remained "unreconstructed"—that is, filled with tents and cardboard homes, increasingly surrounded by luxury apartments and corporate buildings. Local mission operators claimed that 80 percent of Skid Row residents were addicted to drugs, and drug crime was obvious at night; drug dealers commuted in and out and used needles and various forms of public lewdness were common on sidewalks. AIDS, tuberculosis, and other diseases were about three times higher than the national average on Skid Row, and drug-related deaths were ten times higher (Harcourt, 2005).

The Skid Row Housing Trust, as it was officially termed, refurbished old SRO hotels that eventually looked gentrified with funding from City Hall and the community; it owned nineteen hotels, and its real estate is worth about $100 million; it charged $56 a month for residents on General Relief and $300 a month—the market rate—for residents on Social Security disability. At that time, there were sixty-five SRO-type hotels on Skid Row, many of which were operated by for-profit organizations and for which there were long waiting lists (Harcourt, 2005).

The chief administrator of the Skid Row Housing Trust told Harcourt that the Trust was engaged in a "guerrilla war" with police officers, who performed semi-regular sweeps of the area. Most arrested for minor crimes had existing warrants for their arrest and were given the option of entering treatment or facing incarceration. The real estate developer that Harcourt interviewed emphasized that his company and other similar organizations hired homeless or recently homeless people as laborers and even as security guards. The private security guards that were increasingly prominent in the area often interfered excessively with the homeless and police officers intervened; litigation ensued. However, serious crime declined as the presence of private security guards increased. The city had apparently decided to keep Skid Row intact rather than relocate low-end housing elsewhere, as some homeless advocates urged. This decision is sometimes termed "segregation” or "containment." Missions and shelters had long been located there, and the city attempted to shield some main streets from housing blocks with business-related buildings (Harcourt, 2005).

Harcourt (2005) observes that rising property values on Skid Row would likely affect the homeless population adversely and that the decline in crime in New York likely accounted for a third of the increase in property values. Several poor communities in New York, however, were revitalized through subsidies. Harcourt (2005) mentions that the affluent are likely willing to live near Skid Row due to the lower real estate prices and the Manhattan-like flavor provided by the downtown location. At the same time, however, property-owning individuals were prominent in community police meetings where decisions were made (Harcourt, 2005).

Physical and Mental Health among Homeless Individuals. Although homeless individuals with mental disorders are substantially more likely to commit violent crimes than other homeless groups, they are also prone to violent-crime victimization and are far more likely to be charged with crimes. In 2018 more than 111,000 homeless people had a severe mental disorder, such as schizophrenia, bipolar disorder, or severe depression (US Department of Housing and Urban Development, 2018). Mental illness can prevent individuals from maintaining or finding employment and forming social bonds that can prevent homelessness. Mental disorders can be managed with treatment and medication, although these options are out of reach and unaffordable to poor and homeless individuals. Furthermore, being homeless exacerbates the severity of mental illness, and because homeless individuals are at greater risk of being the victims of violent crime, they are at risk of developing post-traumatic stress disorder (PTSD).

Forced institutionalization of homeless individuals is relatively rare. In Los Angeles, the individual must be "gravely disabled" for such a proceeding to occur. Willing institutionalization is also uncommon, and the resulting period of hospitalization when it occurs is typically brief. The physical health of all homeless groups, however, is about equally poor (Baldwin, 1998). An Atlanta study found that the median age of death among the homeless is forty-four; another study puts the median age at sixty-four (Culhane, Metraux, Byrne, Stino, & Bainbridge, 2013). A Boston study of 119 chronic homeless revealed that 75 percent were men, the mean age was forty-seven, and fifty-one was the average age of death; cancer and liver disease were the most common causes of death. Average ages of death among homeless people in developed nations range from forty-two to fifty-two; the rate of early death among homeless individuals is about four times that of the general population, and the high mortality rate is likely relevant to the small size of the elderly homeless population (Nieto, Gittelman, & Abad, 2008).

In Canada, a Montreal study revealed a nationally atypical high rate of early death (that is, in comparison with the same age group among nonhomeless individuals), half of which resulted from suicide (Nieto, Gittelman, & Abad, 2008). An Ottawa study found that 92 percent of homeless adolescents in that city had attempted suicide (Dupuis, 1999). A Toronto study, however, found that the rate of early death was half that of homeless Americans; the rate of serious illness among the homeless in Toronto was substantially lower. The total number of the homeless in Canada when calculated per capita appeared to be twice that of the United States (Nieto, Gittelman, & Abad, 2008).

As of 2007, among the US homeless population, violent assaults accounted for 39 percent of hospitalizations; the figure was lower for illness. Women are more likely to develop depression or PTSD after a traumatic event, whereas substance use is a more common response among males (Kim & Ford, 2006). Long-term PTSD is about twice as likely to emerge among women than men, according to the National Alliance on Mental Illness. A conduct disorder, which is characterized by aggressive and socially inappropriate behavior, is the strongest overlapping factor with PTSD among adolescents (Whitbeck, Hoyt, Johnson, & Chen, 2007).

Substance dependence among homeless men and women is also a strong predictor of crime victimization, as is sleeping outside (Kim & Ford, 2006). Homeless women appear to be more severely victimized by crime than men as measured by alcohol abuse, psychotic symptoms, criminal history, the level of chronic homelessness, and general quality of life (Kim & Ford, 2006). In short, street life does nothing to alleviate past victimization and much to increase future victimization. Most studies of homeless adolescents do not have the benefit of parental reports, but it is relatively safe to conclude that substance use among runaways functions as a form of self-treatment and self-medication for psychological disorders and often exacerbates those disorders (Whitbeck, Hoyt, Johnson, & Chen, 2007). There is a strong relationship between PTSD and subsequent substance dependence or abuse (Kim & Ford, 2006).

Variations in Substance Dependence among the Chronic Homeless.A 1990–91 study by the RAND Corporation, a prominent think tank, attempted to compile an account of substance-dependent homeless individuals without mental disorders on Los Angeles' Skid Row. Thirty five percent of the thousand-plus possible participants who clearly exhibited signs of severe schizophrenia, mania, or manic depression were omitted from the list of participants. This study used both Rossi's street-blitzing method and a sample of homeless persons found in locations visited by SRO residents. It found that patterns of substance use revealed socioeconomic and psychological trends and that the vulnerability factors that result in mental disorders are also prominent among substance-dependent homeless persons without mental disorders. These factors include low income, childhood disturbances, and poor social support. The non-substance-dependent homeless individuals in the study exhibited a less severe degree of these vulnerability factors (Booth, Sullivan, Koegel, & Burnam, 2002).

This study distinguished between non-dependent, alcohol-only, drug-only, and polysubstance-dependent individuals using both alcohol and drugs. As expected, the polysubstance-dependent group revealed the most severe psychological symptoms and the non-dependent group lacked exposure to childhood trauma and were often experiencing their first episode of homelessness (Booth, Sullivan, Koegel, & Burnam, 2002).

Women comprised 26 percent of the participants of this study. About 70 percent of all participants were high school graduates; half were experiencing homelessness for the first time; they had been homeless an average of forty-three months; half slept in some sort of bed or room over the last month; 67 percent had been diagnosed with long-term substance dependence; 55 percent were alcohol dependent; 23 percent belonged to the alcohol-only group; 13 percent exhibited polysubstance dependence; 12 percent were dependent on only one drug; 32 percent of participants used some form of cocaine, followed by marijuana at about 16 percent, and heroin about 9 percent; 33 percent belonged to the non-dependent group. Men were more likely to have had children and a relatively high income but also more likely to exhibit substance dependence. In terms of socio-demographics, all participants, however, were more alike than dissimilar (Booth, Sullivan, Koegel, & Burnam, 2002).

The alcohol-only group was associated with the lowest quality of shelter over the previous month, the highest rate of chronic homelessness, the greatest overall probability of having become homeless, and was older by an average of about ten years. As such, the study argued that the alcohol-only group should be classified as a different subcategory of the substance-dependent homeless. The non-dependents, however, were also of about the same age as the alcohol-only group at nearly forty. These two groups exhibited similar tendencies in terms of conditions resulting from childhood trauma or the lack thereof. The drug-only group was significantly less associated with poor sleeping conditions than the alcohol-only group, but more associated with childhood trauma and past institutionalization (Booth, Sullivan, Koegel, & Burnam, 2002).

The polysubstance group reported a substantially higher level of income and of having had children than the other groups but also reported far more psychological difficulties at a young age and more recent physical and mental-health problems. That group's average age during their first incidence of homelessness was about twenty-eight, significantly younger than all other groups. The different drug-dependent groups were also associated strongly with childhood family instability or abuse and long and multiple experiences of homelessness, but also higher levels of social support. Much of that support, however, derived from shelter workers rather than acquaintances or relatives (Booth, Sullivan, Koegel, & Burnam, 2002).

The polysubstance-dependent group was more likely to have had substance use disorder before their first experience of homeless, but only about 10 percent of those with some sort of substance dependence reported such a severe condition after their first experience of homelessness. In short, it appears that the polysubstance-dependent group had experienced more successes (or achievements) and more failures than the other groups. This study also concludes that attempting to eliminate substance use without treating the psychological conditions that encouraged it would probably lead to continued homelessness; and that homelessness induces behavior that resembles that of individuals with conduct disorders, including long-term unemployment, carrying a weapon, and an extensive arrest record (Booth, Sullivan, Koegel, & Burnam, 2002).

Viewpoints

Support for Social Programs to Aid the Homeless. One theory about apparent public apathy about homelessness is known as "compassion fatigue," which refers to declining support for social issues that appear to remain unchanged or even deteriorate in condition. A related factor is that the media tends to escalate the severity of sensational portraits of familiar stories, such as chronic homelessness, in an effort to render them topical. The American Sociological Association, however, has provided a qualification of this trend under the rubric of the "contact hypothesis." Indirect exposure through the media is not likely to induce sympathy or result in support for the rights of homeless people. The respondents most likely to have been limited to indirect exposure to homeless persons were older individuals in rural areas ("Exposure to the homeless," 2004). It seems probable, however, that testing this contact hypothesis along the edges of Los Angeles' gentrified Skid Row would result in a less-neat conclusion.

Although the Housing First program is considered a limited success in the sense that it only addresses a portion of the chronically homeless population, its theoretical foundation has been praised as a de facto procedural model of civil rights for homeless individuals in the future. Residents of the new SRO-type units appear to be very satisfied with the conditions and autonomy that Housing First provides (Groton, 2013). It is also possible that the equality, liberty, and dignitary interests that Housing First attempts to instill will function as a guide for additional programs or for altering existing legislation, and thereby minimize the adversarial nature of the relationship between the homeless and service providers (Davidson, 2007).

Rights for the Homeless. Attempting to assert the rights of homeless persons through conventional legal advocacy has proven to be very challenging. Impositions on the rights of homeless people include anti-panhandling laws and laws restricting freedom of movement, the right of access to public libraries, and the right to live on unoccupied public land. One law aimed at the homeless population has prohibited the opening of containers in public. Legal defenses based on the prohibition of "cruel and unusual punishment" have had some success: Legislators are not supposed to have the authority to criminalize "status" rather than "actions." Some states have considered adding "people experiencing homelessness" to the list of protected groups covered in hate-crime statutes. However, legal defenses or assertions of rights based on "entitlements" are difficult to establish in many contexts. Homeless advocates tend to rely on the constitution and state legislation rather than federal regulations in these arguments (Davidson, 2007).

The counseling of the homeless that occurs in shelters and missions appears to be somewhat less challenging than the task that faces legal advocates. The rights and safety of shelter workers, and indeed those inhabiting the neighborhood where shelters are located, however, are also a pressing concern. Drop-in clinics often attempt to allow clients to choose the programs in which they want to participate and to maintain the same case worker or workers in order to establish a bond (Davidson, 2007).

The Mission Neighborhood Resource Center in San Francisco, operated by several community and governmental groups, serves homeless individuals in an eclectic neighborhood. The staff is trained in preventing violence and overdoses, and the central approach is based on a harm-reduction model of minimizing disease based on high-risk sexual and drug-related behavior. Sobriety tests are not required, services for Spanish-only clients are provided, and peer-advocates attempt to form bonds with new clients. The center also, however, attempts to respect other neighborhood inhabitants by keeping clients off the streets and by encouraging a sense of client "ownership" in the program (Wenger, Leadbetter, Guzman, & Kral, 2007).

Shelters in New York City maintain the right to evict troublesome clients, but that right is rarely exerted; it is more commonly used as a threat. A 1981 court order required the city to provide free shelter. Employed shelter residents, however, are required to save money for their own residences. A court battle emerged involving a man with a $7-an-hour job who did not want to leave his free and relatively high-end room. Ironically, his legal advocate argued that his previous experience of leaving a well-paying job to avoid commuting was a sign of a mental or psychological disorder and that he should be allowed to stay. The city claimed that he was simply violating the rules, and he had not been provided counseling (Kaufman, 2005).

Shelters run primarily by religious organizations often impose stricter sobriety requirements than other walk-in shelters. Hicks-Coolick, Peters, and Zimmerman (2007) find that one such shelter in Atlanta tended to force out the most vulnerable residents: substance-dependent single mothers. That walk-in shelter allowed short-term stays without restriction, but long-term stays required drug tests and compliance with a program to develop self-sufficiency. A point system was established to punish noncompliance, messiness, or begging near the shelter. Men tended to leave the program after failing the sobriety tests, whereas women tended to leave due to the accumulation of too many demerit points (Hicks-Coolick, Peters, & Zimmerman, 2007).

Chances for escape from street life appear to decline substantially as time on the streets increases. Kennedy (2007) emphasizes the resilience that homeless adolescents can exhibit through self-improvement and resourcefulness; that pregnant adolescents have been able to maintain adequate academic performance and other goal-oriented behavior; and that academic performance can resume following homelessness after a short period of adjustment. These traits, however, are all bolstered by the presence of mentors and general social support (Kennedy, 2007).

Homeless, substance-dependent veterans that have attachments with former caregivers and have received treatment are also more likely to avoid re-hospitalization than those without such social support (Kim & Ford, 2006). In 1996 there were an estimated 250,000 homeless veterans, and by 2006 that number had declined to 196,000; about a quarter were considered chronic (Eckholm, 2007). By 2012, the number had shrunk to 60,579. This decrease continued into 2019, when, on a given night in January, there were a reported 37,085 homeless veterans, a 2.1 percent decline from the previous year (Henry et al., 2020).

So-called defensive architecture, such as placing spikes in places where homeless people may attempt to sit or angling benches to prevent people from lying down on them, has received widespread criticism. This is for failing to address the underlying issues of inequality, poverty, and lack of affordable housing. The solution, instead, is to push homeless individuals out of sight. A 2014 report from the National Law Center on Homelessness and Poverty reported on a national survey by the Western Regional Advocacy Project that found the majority of homeless individuals who were surveyed reported being harassed for sleeping (81 percent), loitering (78 percent), and sitting or lying down in public (66 percent). In addition, a large portion of homeless individuals surveyed reported being arrested for sleeping (30 percent), loitering (26 percent), and sitting or lying down in public (25 percent). Furthermore, the center's 2018 report looked at 187 US cities between 2006 and 2017 and reported that 33 percent had city-wide bans on "camping" in public, 18 percent had city-wide bans on sleeping in public, 47 percent had laws prohibiting sitting or lying down in public, 39 percent had laws prohibiting sleeping in vehicles, and 6 percent had laws prohibiting sharing food with homeless people. The report noted an increase in laws criminalizing homelessness beginning in 2006, particularly city-wide bans on "the life-sustaining conduct of homeless people" (National Law Center on Homeless and Poverty, 2018). Obtaining an arrest record for such offenses further compounds the difficulties facing homeless individuals in finding employment. These laws criminalizing homelessness have been criticized for violating the civil and human rights of homeless individuals and for being less cost-effective at addressing homelessness than providing affordable housing.

Terms & Concepts

AHMI: The ethnographic "Adaptation of the Homeless Mentally Ill" study of a small group of homeless women which was conducted in downtown Los Angeles between 1987 and 1990. This study is used as a source of anecdotal details in this essay. Baldwin (1998) mentions that about half the participants in this study were distinctly less physically and mentally healthy at the end of this three-year period. A few remained stable, and a few others actually seemed healthier and generally better adjusted by the end of the study.

Chronic: Chronic homelessness is the most severe category of homelessness. It is often associated with the comorbidity of substance use, abuse, or dependence and severe mental disorders such as schizophrenia, mania, or manic depression. The intermediate category, cyclical homelessness, is also associated with disorders such as Post-Traumatic Stress Disorder substance abuse, but these condition are often thought to result from parental or domestic abuse and can be treated through therapy. The rehabilitation of the chronically homeless, by contrast, is viewed as an unrealistic goal in many cases by medical and psychological professionals.

Comorbidity: Comorbidity is a medical term that denotes the co-existence of a distinct medical condition with another condition. "Dual diagnosis" is a largely overlapping term. Conventionally, the term does not indicate that one condition causes another condition (e.g., that substance abuse causes mental illness), but this meaning is relatively common in studies of homelessness.

Conduct Disorder: A conduct disorder, which is normally diagnosed in minors, refers to repeated destructive behavior including aggressiveness, cruelty, maliciousness, and even criminal activity such a theft and vandalism. It routinely results in the violation of social norms and the well-being of others, and it is identified with the similar and more severe "antisocial personality disorder" in adults.

Dissociation: Dissociation, a symptom of Post-Traumatic Stress Disorder, is an involuntary condition characterized by non-responsiveness, distance, or detachment from live events or memories. A relevant example would be child watching television while his or her mother is being beaten. It is sometimes described in terms of "compartmentalization," a process by which traumatic memories are stored away and only seem to emerge in an entirely different personality.

Gentrification: For the purposes of this essay, gentrification refers to the upscale remodeling of inner-city real estate that is often deteriorating. The process of gentrification often results in the displacement of low-income housing, and occasionally it results in the lower availability of middle-income housing. In other contexts, gentrification can also refer to the changing ethnic or socioeconomic make-up of a neighborhood.

Housing First: The Housing First program is part of a series of ten-year plans to eliminate chronic homelessness and is coordinated by the federal Interagency Council on Homelessness, which includes public and private funding. As the name suggests, the primary goal is to secure home units for the chronically homeless. Drug tests and therapy requirements are not stipulated. It is hoped, however, that the independence provided by permanent shelter will result in treatment and rehabilitation.

HUD: The United States Department of Housing and Urban Development is primarily concerned with urban growth and mortgage assistance, but it also deals with subsidized public housing and temporary shelters.

McKinney-Vento Act: The McKinney-Vento Act of 1987 enabled the development of local soup kitchens, shelters, and long-term housing projects. It was enacted in response to the growth of the homeless population in the 1980s and is the only federal legislation dealing with the homeless.

Pathways Approach: The pathways approach theory regarding homelessness attempts to reconcile the conventional conflicting theories about poverty-related issues: Namely, individual-oriented and structurally-oriented approaches. The first, termed the "Social Stratification Paradigm" in this context, emphasizes individual traits and abilities as causal factors. The second, termed the "Conservation of Resources Model," emphasizes structural (that is, political and economic) factors: For example, the loss of resources associated with homeless causes both tangible and intangible strains. The pathways approach uses a structural model to examine how institutions and policies affect the actions of which homeless individuals are capable (Kim & Ford, 2006).

Polysubstance: Polysubstance dependence technically means addiction to more than one substance, but for the purpose of this essay it denotes a dual dependence on drugs on alcohol. The RAND study (Booth, Sullivan, Koegel, & Burnam, 2002) uses the term in this limited sense to emphasize the distinct characteristics shared by individuals that feature a mixed drug and alcohol dependence.

PTSD: Post-Traumatic Stress Disorder, earlier known as "shell shock," is a condition that often results from exposure to violence. The condition is characterized by nightmares or "flashbacks" about the original traumatic event, unconscious aversion to any reminder of that event, what is known as increased arousal (insomnia, inability to stay asleep, anger), and a resulting inability to function normally. It has been treated both through therapy and medication, but it is sometimes described as resulting in a chemical imbalance that induces stress and even suicidal behavior. PTSD is relatively common among veterans who have experienced close combat (that is, physical carnage) and runaway adolescents who have experienced physical or sexual abuse.

Section 8: Section 8 vouchers, part of the Housing Choice Voucher Program, were established in 1974 in response to the high cost of building public housing developments. These vouchers limit the holder's expenditure on rent to 30 percent of his or her income with participating private landlords; the federal government pays the balance based on what it determines to be a fair market value. The Section 8 system is highly malleable and is often described as the most effective development for housing low-income earners, but waiting lists to acquire such a voucher often require a waiting period of several years.

SRO: Single room occupancy hotels, sometimes termed "flophouses," are usually dorm-like rooms with shared bathrooms and kitchen facilities. They were conventionally located near locations where temporary labor employment was available, but they have since become increasingly associated with the housing of—and later not housing—individuals with mental disorder that were deinstitutionalized after the 1960s.

Substance Dependence: Substance dependence is usually described as a more severe condition than substance abuse, but both are usually present together. Whereas substance dependence primarily describes a physical condition wherein escalation of use is common and unpleasant withdrawal symptom occur without use, substance abuse primarily refers to behavioral and social factors.

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