A Professor Dialogues and Responds to Students on Homelessness, Welfare, and Mental Illness
The word “homeless” makes it sound as though we are talking about someone who is having difficulty finding accommodation.[1] That is not the case and is very misleading. Prior to about 1980, these people were called “bums,” “indigents,” “vagrants,” and “hobos.” Almost invariably, “bums” would have been alcoholics (drugs were too expensive then) and were very likely to be suffering from mental illness. There was a massive push to close mental asylums by progressives in the 1950s with the idea that somehow mental asylums actually make sane people crazy, and to replace them with “community based” institutions. Most of the latter were never built and many of the more severely mentally ill ended up on the streets and in prisons. There was also a move against forcing the mentally ill to take their medication, based on civil rights. Most mad people do not know they are mad, and it is very common for schizophrenics, etc. not to want to take their medication. Paranoid schizophrenics and the like are highly likely to take alcohol or drugs to “self-medicate.”
So, the majority of the homeless are mentally ill and nearly all of them are addicts. Addicts “disaffiliate,” meaning they become exclusively interested in drugs, and will burn all their bridges with friends and family. Someone who is simply having difficulty finding housing will usually sleep on the couch of a relative or friend until he finds something. Addicts and the severely mentally ill make terrible house guests and will often not have that option.
Simply being poor does not exclude you from housing. There are Section Eight housing grants, for instance, that subsidize the poor to help them pay rent if that is an issue for them. Fanny Mae and Freddy Mac provide easier access to mortgages for people who would not otherwise qualify for them.
Providing the mentally ill and or addicts with housing does not solve their drug problems or their mental illness. In fact, “San Francisco launched Project Roomkey last year, ostensibly as a way to thwart the spread of Covid-19. At last count, approximately 8,000 people live on San Francisco’s streets, and starting in April 2020, a few thousand were routed to leased “shelter-in-place” (SIP) hotels and motels. However, since so many were living outside as a direct result of substance use (or mental illnesses associated with or exacerbated by it), lethal drug activity flourished in and around the buildings.
Then came the body count. In 2020, San Francisco saw 713 fatal drug overdoses, mostly from fentanyl. Nearly three-quarters perished while isolated inside the hotel rooms and supportive housing provided by the city. Six died in the Hotel Whitcomb, a designated SIP hotel, in a single month.
The reason: Project Roomkey hotels offer no addiction-recovery treatment or mental health care. Nor is there a sobriety requirement. Residents do, however, get plenty of fresh needles, fentanyl foil, and other drug supplies, courtesy of the harm-reduction teams. As Dr. Hali Hammer of San Francisco’s Department of Public Health admitted in an April 2021 New York Times story on the city’s epidemic of drug fatalities, “What we as the public health department are responsible for is preventing death by giving people the resources they need to use safely.” The entire system erodes the desire and willpower to accept detox and rehab. It’s easier and less painful, at least in the short term, to use in a hotel.”
Throughout this reading is the repeated claim made by the student that poverty causes things like crime, drug addiction, and homelessness. In order for this claim to be true we would have to see crime, drug addiction, and homelessness go up during recessions, and go down when the economy improved. This does not happen. The homicide rate during the Great Depression went up briefly and then remained lower than normal. In a study of New York City that spanned 200 years, poverty and crime were seen not to be related to each other. For instance, poverty had been going down all during the 1950s, as had the crime rate. In the 1960s, there was a massive explosion of violent crime peaking in 1990, while poverty rates continued to go down for both blacks and whites during those years. The standard of living of all Americans went up drastically, so that luxuries, like color TV, and air conditioning, cars with traction control and high-end safety equipment, became common place. A regular person in 2000 enjoys the standard of living of a rich person in the late 1960s. As an additional example of rising standard of living throughout the twentieth century, when it was proposed to put running hot and cold water in the White House for the president’s bath, people regarded this rather outrageous. Now, it would be outrageous and illegal to offer a house for sale or rent that lacked hot and cold running water.
Homelessness went down in some places in the US during 2010 and 2020, while in California it skyrocketed as a result of terrible policies, including an unwillingness to prosecute drug crime, both of dealers and users. California is the richest state in the US, with incredibly generous welfare payments, and billions and billions spent on mental health and homelessness, with the worst problem of all the states – one that was largely solved on the East Coast.
It was the closure of mental hospitals and the eviction of patients on to the streets that massively increased so-called “homelessness” and indigence. Many of those currently in jail would formerly have been treated in mental hospitals.
In what follows, titles have been provided for the student comments or questions, and then a response is given.
Do the homeless turn to drugs because they are homeless or as a result of homelessness?
Question: Where is the evidence which shows that the majority of the homeless population participate in drugs causing them to ruin their lives and end up homeless? Many people turn to drugs when there is nothing else to turn to. I feel maybe drugs are relied on more heavily after homelessness has occurred, instead of before. I am curious to see how the statistics were gotten. Was there a survey of homeless people?
Response:
Ultimately, it is irrelevant whether the “homeless” were addicts before or after they became homeless. We know what the solutions are to radically reduce their numbers either way, and thus to save them for overdosing.
If you walk in the Tenderloin, Civic Center, and the South of Market neighborhoods of San Francisco in “block after block, you’ll see thousands of people who are barely alive. Some are alone; others are piled on top of one another, running into traffic, or standing slumped over, unconscious. They’ll be injecting or smoking heroin, fentanyl, and methamphetamine in front of you, unaware or unfazed by your presence. Scabs cover their faces and bodies, limbs are swollen red and blue, often bloody and oozing pus. You’ll notice the garbage, rotting food, discarded drug detritus, and feces surrounding them. A shocking number are mere teenagers, but many are old or have aged well before their time.
Your immediate reaction will probably be grief and horror. How can we treat our fellow human beings so cruelly, and how did we, as a society, allow things to get this bad? If we can’t admit these individuals into hospitals today, we should at least erect mobile hospitals to deliver critical medical, psychiatric, and addiction treatment before it’s too late.”[2]
You do not need to wonder if the homeless have a drug problem or do a survey. No one in San Francisco, including civil rights activists, is disputing what anyone can see for himself by walking down the street.
The term “homeless” is a misnomer for the crisis in places like San Francisco. What is being described is an open-air drug scene (OADS). Drug addicts will buy drugs from dealers, take literally two or three steps back, and shoot up, smoke, or snort, their drugs right there on the sidewalk. Most of them will remain there, living and sleeping on the sidewalk, to be as close to their access to drugs as possible.
Not all the homeless are mentally ill, but nearly all the mentally ill homeless will also be serious drug abusers.
What Actually Works?
Closing down open-air drug scenes is crucial. The Netherlands tried allowing open-air drug scenes in the 1980s. The number of heroin addicts and homeless skyrocketed, as did crime from thefts and prostitution. Neighborhoods became uninhabitable as people fled and addicts squatted in abandoned buildings. OADS cause homelessness far more than poverty. This did not change until the OADS were shut down. Addicts were fined and if they could not pay, they would have a choice of drug treatment or jail. This policy required police, the courts, and social services to all work together. Social services included a lawyer, a social worker, psychiatrists, the whole nine yards. Social workers would ask the police to be tough and arrest addicts because they knew that the chances that someone would do it voluntarily were low. So, what works is a combination of carrots and sticks. Nice accommodation is provided on the condition that the person does not fail a drug test. If they do, then they must be content with returning to a homeless shelter. A very high percentage managed to stay sober but only with this kind of tough love. The San Francisco policy of providing hotel rooms with no sobriety requirement, and providing drug paraphernalia, resulted in high numbers of deaths.
Philadelphia, New York, and Miami used police to shut down their OADS, and in Miami, for instance, homelessness (which is really just drug users shooting up in public and living on the streets) went down 57% between 2010 and 2020. They also provided shelters and drug rehabilitation. If homelessness were just a matter of poverty, such policies would not work.
What Does Not Work”
Housing First does not work. Housing First is an activist group that provides no strings attached housing for the homeless under the belief that it is not having accommodation that is the real problem for most homeless people, not drugs or mental illness. The fantasy is that providing accommodation will allow such people to get their lives in order and the mental illness and addiction problems will take care of themselves. In fact, a Harvard Study in Boston found that 47% of people provided housing with no sobriety requirement were dead within ten years. Most prior studies had only been for two years, so this was news to many.
Harm reduction does not work. Harm reduction is another activist movement, enabling drug use by supplying clean needles, a safe place to shoot up, maybe Narcan, and other drug paraphernalia, but NO attempt of any kind at rehabilitation pushing drug treatment.
If parents heard that you had found their daughter and that she was addicted to drugs and living on the streets and most probably selling her body to pay for drugs, and all you did was give her clean needles, making no attempt to help her in any way, those parents would hate your guts. The person most famous for “harm reduction,” Dan Bigg, was himself found dead from an overdose and had multiple hard drugs in his system including meth, heroin, and fentanyl at the time of death. Drugs kill. Do not facilitate drug use. There is no “safe” way of using hard drugs.
Offering drug treatment but purely on a voluntary basis. A few people seek voluntary drug treatment. For the rest, drug treatment must be accompanied by threats of jail terms, or losing access to very nice accommodation, or some “stick” or other. We know this empirically. Plenty of cities have had voluntary treatment without the penalty, or penalty without treatment, and neither one works well at all.
Focusing on building permanent single residency apartments for the homeless. Most San Francisco homeless live on the streets, partly because there are not enough homeless shelters in San Francisco. Homeless advocates there typically actually prevent politicians from supporting the building of adequate shelters because the advocates think this will detract from permanent housing for the homeless. New York City shelters 97% of their homeless thanks to shelters. San Francisco does not.
Permanent apartments in LA cost 525,000 each (up to 750,000) to build. That is an astronomical amount of money. There will never be enough of these apartments because once you start providing free luxury apartments (in terms of price), the demand increases. The advocates for this policy do not dispute this. They know that there will be a line around the block for free housing and that people will come from out of state to take advantage of the offer.
Homelessness is all about money
Question: Even if someone is in a state of poverty, then turned to drugs, and then end up homeless, this is more of an economic issue than a drug issue among the homeless population. Of course, once someone becomes addicted, they will most likely pick drugs over anything, it is a disease. So, it makes sense the homeless would not choose shelters on condition of sobriety. That is not where the problem needs to be paid attention to. I think it needs to start before homelessness occurs with our welfare system helping people in poverty. See the book “Two Dollars a Day.”
Response:
Homelessness is not caused by poverty in most cases. We have a welfare system. Most welfare recipients are not homeless. Long term homelessness is almost always accompanied by mental health problems or drug addiction.
Offering nice accommodation in return for sobriety has been proven to work.
Offer rehab, not jail
Those who do abuse drugs, causing them to be homeless should be offered rehab instead of being incarcerated. Incarceration for addicts is not proved as effective either, most reoffend shortly after their release. Our prisons are already overcrowded and the cost of giving someone rehab is cheaper. Therefore, it should be rehab first and if it does not work, then it should be incarceration.
Response:
No. The Dutch proved it first, but American cities like New York, Philadelphia, and Miami, have also proved that the most effective remedy for homelessness is a combination of social services and policing – most importantly, closing down open air drug scenes. San Francisco has not followed suit. As a result, homelessness has proliferated and the homeless are dying in huge numbers and living a miserable existence filled with violence. In Holland, hard drug users are first fined. If they cannot pay, which is common, they are offered a choice between drug treatment or jail. It is not simply a matter of incarcerating addicts. The issue is how to get someone motivated to get into treatment. Many addicts end up being grateful for this tough love approach and acknowledge that they most likely would not have been able to quit on their own, and that they would probably have died, like a lot of their friends.
It’s about money and racism
The United States cares about the white and the rich. People just don’t want to see homeless people, so they associate homelessness with drugs and they want them in jail so they are simply out of the public eye.
Response:
The United States, in terms of academia, the media, the government, big tech, and the civil service currently actively hate white Americans and describe at least half of them as “deplorables,”[3] and “enemies of the state.”[4] Any success a white person achieves is claimed to be the result of white privilege and any failure is his own fault. White American children in many grade schools are told that white people are evil and were responsible for slavery and therefore that they should be ashamed to be white, even though they were not born when slavery was taking place and no living black American has been a slave. White people also pretty much ended the international slave trade for the first time on the planet, created the Industrial Revolution, most of modern medicine, and most of what we now think of as modern life with heating, air conditioning, modern plumbing, the internet, social media, you name it. 47% of white male college applicants have lied about their race in order to try to benefit from affirmation action for people of color and 26% of white female students have done the same. The most popular claim is to be part Indigenous American. Whites are actively discriminated against for jobs and promotions. All academic positions currently emphasize “diversity” and contain statements like “women and minorities are encouraged to apply.” White males are literally their last option.
Black Americans will be found to be the recipients of government handouts and largesse in greater numbers than whites. It is not true that the United States only cares about white and rich people.
The homeless in San Francisco are living a vile existence. They are likely to die young and they turn their surroundings into a crime ridden hellhole filled with used needles, human feces, prostitution, rape, and violence. San Franciscans do not want to live in a city with these problems and who can blame them? Getting rid of open-air drug scenes (OADS) has been proven to reduce crime, clean up the streets, save the lives of addicts/homeless, and everyone can be happier. It is not just a matter of “out of sight, out of mind.”
If welfare were easier to get, then this would improve poverty, homelessness and drug abuse.
Our current welfare system is not effective and it makes people jump through hoops for very basic needs for help. While, yes, many people abuse the system, it makes it ineffective for those who truly need it.
Response:
Nothing I have read indicates that making welfare easier to get will improve any of those things. The most effective way of not leading a life of poverty is to not have kids until you are over twenty, to get married, and to have at least one household member with a full-time job. Homelessness is not primarily an issue of not having enough money. Drugs are very very expensive. Money spent on drugs could, in principle, be spent on rent. Poverty is very much relative. Americans enjoy the highest standard of living of any country. Poor people and children in some countries scour garbage dumps as a full-time occupation. They mostly do not have the money or opportunity or desire to become drug addicts. If you earn $30,000 a year, you are in the top 1% of the world’s population.
Welfare “gets people on their feet” but does not keep them mired in intergenerational poverty
It’s simply supposed to get people on their feet, not to give them everything. It’s up to the person.
Response:
I don’t know who says it is just supposed to get people on their feet. If it were, welfare would have strict time limits to prevent welfare dependency.
Assertion: homeless people turn to drugs because they have lost hope
If people are homeless and hit rock bottom, it does not surprise me that they turn to drugs. I probably would if I had nothing left.
Response:
You have it around the wrong way. By closing down open air drug scenes, and providing social services combined with threats of jail, and brief stints in actual jail if necessary, many homeless people manage to turn their lives around.
Homelessness is caused by poverty
We need to fix the before (falling below poverty level) instead of focusing on the after (drugs among the homeless population) because this is a result of something. We know the something.
Response:
Again, you imagine that “the homeless” are just having trouble finding a place to live. This is not true for most of them.
If there were a smaller gap between rich and poor we would not have homelessness, poverty, and drug abuse
It is the very large gap between the rich and the poor. We just refuse to acknowledge it and do something about it.
Response:
For most people, homelessness is not the result of poverty. The American standard of living is the highest in the world. If black Americans were a country, they would be something like the 23rd richest country in the world.
If we did not have billionaires and millionaires homelessness, poverty, and drug abuse would cease
There are so many billionaires and millionaires that could probably solve this issue, but the wealth is not shared. People hoard money. In my opinion, that is the problem.
Response:
The money of billionaires circulates throughout the economy. They invest their money and it is used in industry and services. It is not simply “hoarded.” Most of Elon Musk’s putative wealth exists only on paper. It exists mostly in the stocks he owns in his own company. He would only make money were he to sell them. Of course, the value of those stocks would go down once he started selling due to supply and demand. If you took all the money away from billionaires it would not make any noticeable difference to American life. It would not fund, say, a single-payer health care, or any other big government program. The Biden government has already spent several trillion dollars and it has not cured America’s problems. We have spent
21 trillion dollars since the 60s on welfare problems and fighting “the war on poverty” already.
There is some other form of government that would solve all these problems
There is a reason by we cannot seem to solve these problems with our form of government.
Response:
Other forms of government would lower the standard of living for everyone, it would reduce the amount of money available to spend on social programs, or anything else. The poor in particular would not be better off. We know that social mobility does not change under communism. In a study of Hungary, scientists compared who was poor and who was elite under communism with what happened under capitalism. The answer was that nothing changed. The Roma (Gypsies) were at the bottom of the heap under communism and under capitalism. Those with aristocratic last names (they end in “y” in Hungary) continued to be among the elite under both systems as seen by how many were in the Hungarian Academy of Science. 29% of Hungarian prime ministers are from an aristocratic background despite making up maybe 1% of the population.
Social Mobility and Political Regimes – Intergenerational Mobility in Hungary 1949-2017
Smart motivated people will game the system, whatever the system is. If the system says all white people must be “race traitors” and attack members of their own race and promote people of color, then smart motivated white people will do that and get richly rewarded for being “one of the good ones.”
Nothing changes under communism, besides the fact that the entire standard of living is lower for everyone, except for the communist party members running the country who live in extreme luxury – exactly the kind of luxury you might imagine billionaires living in. Actually, better in some ways. The Soviet Union had special lanes, in places, for the limousines of party officials. The US has no such lanes for billionaires. Why it is preferable for totalitarian dictators to live in a grand manner rather than billionaires who actually earned their money by providing useful services like Amazon, or good electric cars and space rockets like Elon Musk, is unclear.
East and West Germany served as a useful experiment, by applying communist principles in the East and capitalist in the West. The West enjoyed a much higher standard of living than the East and obviously much more freedom – so nearly everyone benefited. Easterners had to be banned from trying to leave and around 35,000 were shot over a multi-decade period trying to escape over the Berlin Wall.
Having nearly everyone live a third world type existence because you feel sorry for the poor seems like a bad idea.
If you have to threaten to shoot, and actually shoot, people who are desperate to leave a country, something has gone badly wrong in that country. East German communism—all communism—depended on terror to exist. Neighbors and friends were encouraged to spy on and report each other, and there was a full-time secret police called the Stasi, who did nothing but surveille and terrorize the general public, imprisoning, torturing, and executing dissidents.
There is scientific evidence that people who hate the rich are motivated far more by malicious envy of the rich than by concern for the poor. Here:
We have a funny kind of game where white people can compete with other white people about who is more caring. It is a form of self-promotion and also of competition with large monetary and status awards for the winner. The game does not benefit the supposed target of all this caring. Instead, it is likely to demoralize people by convincing them that the system is stacked against them and there is nothing they can do about it.
[1] Much of the information here comes from “San Fransicko: How Progressives Ruin Cities” by Michael Shellenberger.
[2] https://www.city-journal.org/san-francisco-substance-abuse-crisis
[3] Hillary Clinton.
[4] Nancy Pelosi.
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