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    Housing the homeless: Should mental illness trump hard work?

    Why Bill Hobson, a veteran provider of homeless services, advocates tying housing to vulnerability.
    Bill Hobson, Executive Director, Downtown Emergency Services Center

    Bill Hobson, Executive Director, Downtown Emergency Services Center Courtesy of Washington State Housing Finance Commission

    If you say something about homelessness where Bill Hobson can hear it, he’ll have something interesting to say back. The day after my story on homeless youth and young adults appeared in Crosscut a few weeks ago, this message from Hobson arrived in my mailbox: 

    Nice piece. It could have used a bit broader context. We too often focus on subsets of the homeless population without doing that – fitting them into the broader homeless context and policy responses to it. Big conversation I'd like to have with you someday.

    So I dropped by Hobson’s office at DESC (Downtown Emergency Services Center), where he's been executive director since 1988.

    Our conversation came at an emotional time. The previous weekend, two off-duty firefighters and a female executive at Amazon were arrested for their drunken assault on two homeless men sleeping at the firefighters’ memorial in Pioneer Square’s Occidental Park. It reminded me how vulnerable homeless people are, reviving memories of the pain I'd felt when a beloved family member suffering from schizophrenia slept in parks and under bridges for a whole year.

    Hobson started our talk by reviewing King County’s January homeless counts, which found 3200 adults and 124 unaccompanied youth and young adults sleeping outside. If the estimate I read in E. Fuller Torrey’s book Out of the Shadows is correct – that one in five who are homeless suffer from serious mental illnesses – then King County has 665 sick, highly vulnerable adults and 13-25-year-olds sleeping in dangerous places.

    “The last thing I want to do is trivialize the plight of anyone homeless, whether kid, vet, or single adult,” says Hobson. But available resources can’t cover everyone, so our policy across the board should be to prioritize the most vulnerable.

    He concedes that it makes sense to customize services for subsets of people, because the needs of homeless youth differ from the needs of homeless families, which differ from the needs of chronically homeless single adults. Still, regardless of subset, the individuals most in danger should be first in line for shelter and housing. “All the shelters are full because transitional housing is full, because there’s not enough affordable housing” to accommodate all the people who are ready to move up from transitional to more permanent homes.

    Prioritizing the most vulnerable means putting roofs over the heads of children and people living with mental illness first, says Hobson, while leaving many who may seem more deserving, such as homeless veterans, out in the cold. Also last would be homeless individuals who are managing to hold down jobs (about 25 percent are employed, nationwide).

    A most-vulnerable-first policy would routinely place non-disabled homeless young adults in the bottom tier of applicants for transitional and permanent housing. King County’s Youth Housing Connection (YHC) has adopted this policy and gives priority to the most vulnerable 18-25-year-olds, identified as such by its intake assessment. Today’s housing shortage consigns the less vulnerable majority to such long waits that many will outgrow their YHC eligibility before ever getting a home.

    Nearly all homeless veterans, too, belong at the end of the line for housing, says Hobson. The Vulnerability Assessment Tool used to determine eligibility for DESC housing shows that “as a group, even with the consequences of PTSD, vets are higher-functioning than the person living with paranoid schizophrenia who is preyed upon by every thug on the streets of downtown Seattle,” he says, recalling his classmate in grad school who left because of a disabling mental illness. “David was beaten to death in Kinnear Park in 2001. Every year here, someone is beaten to death."

    According to Hobson, it would take $800-$900 million in rent subsidies or capital development dollars to house all of our homeless. But “we go home and sleep warm in our beds, and don’t muster the political will to get the money.” This despite having calculated the gigantic downstream costs of homelessness (high rates of unemployment, of incarceration, of hospitalization), and having taken on public projects of far greater magnitude – Century Link Field and the tunnel, for instance, he says.

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    Posted Wed, May 7, 8:27 a.m. Inappropriate

    Fortunately King County has vowed to "end homelessness" by 2015. At least that's what they promised when they took the money.


    Posted Wed, May 7, 11:06 a.m. Inappropriate

    Thank goodness. It's pretty exciting to think that King County is on the verge of doing what no civilization has done since the first cities arose.


    Posted Wed, May 7, 9:54 a.m. Inappropriate

    How good to see someone who knows his business point out that "the homeless" should be lumped together as one generic group, and to also place priorities on those with the most critical needs. An ambitious capital construction program to provide housing for those with serious mental illness should be the top priority for those concerned with mental health, public safety, and basic humanity.

    Abe Bergman, MD

    Posted Wed, May 7, 11:05 a.m. Inappropriate

    But we did away with big housing facilities 30 years ago for the mentally ill because we were concerned with mental health, public safety and basic humanity.


    Posted Thu, May 8, 11:43 p.m. Inappropriate

    In Washington State in the 80s we semi-opened the door to state hospitals in order to allow mentally-ill people to receive services in the community. Unfortunately, the community didn't offer those services. That was also unfortunately the time when under Reagan, the federal government stopped investing in public housing. Those combined factors led to the increasing numbers of homeless mentally-ill people.


    Posted Wed, May 7, 9:55 a.m. Inappropriate

    edit to above comment: "should NOT be lumped together..."

    Posted Wed, May 7, 1:48 p.m. Inappropriate

    Good article. I have a question: is part of the effort to provide housing for the homeless directed at finding SHARED housing? can the homeless individual have any hope of being guided to a room in a house or a room in an apartment as his/her shelter? Does a program that aids in making that connection exist? or is that possibility made too utterly unlikely by the prevalent psychological troubles and dependencies of the homeless?


    Posted Thu, May 8, 11:40 p.m. Inappropriate

    Some formerly homeless people live in apartments with shared kitchens/community rooms. But a room in a private home or apartment is not appropriate for a severely-mentally-ill individual.


    Posted Sun, May 11, 8:50 a.m. Inappropriate

    Good question, Kieth. Nonprofits National Alliance on Mental Illness Greater Seattle(NAMI-GS) and Plymouth Healing Communities both sponsor residences that have independent rooms and common kitchens (http://www.nami-greaterseattle.org/Hofmann) or facilities with complete apartments (http://www.plyhc.org/Facilities.html - click on the Argonaut and Admiral). This type of housing is for individuals with serious mental illnesses (many of whom were homeless) who are "in recovery," meaning in treatment sustained through regularly scheduled meetings with caseworkers and clinicians from places like Seattle's Community Psychiatric Clinic.

    People with mental illnesses who require continual supervision but not hospitalization are often well served by supportive housing - group homes or apartment buildings that have resident staff. Sound Mental Health, like DESC, has established a number of these residences.

    Posted Wed, May 7, 3:13 p.m. Inappropriate

    Homeless people do not all look like those folks who live on the streets, perhaps sleeping in doorways or pushing their belongings in shopping carts. Homeless people are also well-educated, well-spoken people who may live in transitional housing, landing there because devastating illness and/or major financial disasters have left them penniless. And, folks living in transitional, ie, time-limited housing, are also homeless. And permanent, affordable housing is harder and harder to find because the need is growing. So, sometimes transitional housing is harder to access because the facility's residents can't get permanent housing because there seem to be fewer and fewer affordable, permanent housing apartments/spaces available.

    Posted Thu, May 8, 11:49 p.m. Inappropriate

    The firefighters wouldn't be under threat of indictment if their superiors had made plain to them that they were public servants (even when off duty), and as such they were required to treat ALL Seattle residents with respect. That respect would include not beating up someone because they were sleeping in the open on a monument to those firefighters' public service -- the saddest irony I've heard of yet.


    Posted Fri, May 9, 8:18 p.m. Inappropriate

    Um, helloooo. Sarah90 you actually believe that firefighters need a directive from their superiors that as public servants, even when off duty, they are required to treat ALL Seattle residents (and visitors ma'am) with respect? Do you actually believe that public servants get to ever go "off duty" and get to treat anyone with disrespect?

    Professional standards never go off duty.

    Posted Sun, May 11, 2:47 p.m. Inappropriate

    I do believe that we should care for those who are unable to care for themselves, especially if through no fault of their own, which would include children/youths, the old, the disabled, and the mentally ill. Those unable to take care of themselves due to alcohol and drug addictions should be helped if enrolled in rehab/treatment/training programs.

    The best way of helping the "working poor" is through wage subsidies (higher minimum wage and earned-income tax credits) and dramatically increasing the supply of affordable-housing through set-asides and tax-credits.

    Posted Mon, Jul 28, 7:17 a.m. Inappropriate

    Thanks for this article Judy Lightfoot and thanks too for your informed and reasonable comments sarah90 and others.

    I spoke yesterday with someone living at the Theodora apartments. He along with other disabled people and vets are at risk of losing their housing because some developer wants to buy the property in order to redevelop/gentrify it and thus force the vets and disabled people living there to move.

    This is what has been happening during the 10 year plan to end homelessness. During that period a respectable amount of low income housing has been built but, at the same time, existing affordable housing has been destroyed and replaced by more expensive housing.

    The set-asides and tax credits currently offered to developers to sustain and even to increase the supply of low income housing are not sufficient to do the job. A change in policy is needed to correct the situation. Until now, I don't know that the political will exists to do that.


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