Combatting homelessness is about more than just finding people homes

Homelessness in Anaheim, California. Image: Getty.

Twenty years ago, Jim lived under a highway bridge in New Haven, Connecticut. He was in his 50s and had once been in the Army.

After an honourable discharge, he bounced from one job to another, drank too much, became estranged from his family and finally ended up homeless. A New Haven mental health outreach team found him one morning sleeping under the bridge. His neon yellow sneakers stuck out from underneath his blankets.

The team tried for months to get Jim to accept psychiatric services. Finally, one day, he relented. The outreach workers quickly helped him get disability benefits, connected him to a psychiatrist and got him a decent apartment.

But two weeks later, safe in the apartment, Jim said he wanted to go live under the bridge again. He was more comfortable there, where he knew people and felt like he belonged, he said. In his apartment he was cut off from everything.

As researchers in mental health and criminal justice at Wesleyan and Yale universities, we have been studying homeless populations in New Haven for the past 20 years. In that moment, when Jim said he wanted to leave what we considered the safety of an apartment, the outreach team, which co-author Michael Rowe ran, realised that, while we were capable of physically ending a person’s homelessness, assisting that person in finding a true home was a more complicated challenge.

Helping the most marginalised people in society feel comfortable in a new and alien environment, where they were isolated from their peers, required a different approach that went beyond finding them a place to live.

The people we worked with needed to see themselves – and be seen as – full members of their neighbourhoods and communities. They needed, in other words, to be citizens.


Record number of homeless deaths

Fueled by the opioid crisis, high housing costs and extreme weather, homelessness and its fatal costs are on the rise.

The U.S. Department of Housing & Urban Development estimates an increase in the homeless population in 2017 for the first time in seven years, with more than 500,000 Americans lacking permanent shelter.

In addition, in cities across the country, there has been a surge in deaths of homeless individuals. Last year, New Orleans saw a record 60 homeless deaths, a 25 per cent rise over two years. Denver saw an estimated increase of 35 per cent over 2016, while Rapid City, South Dakota, with a population of only 75,000, saw five deaths of homeless individuals just since December.

Complicating matters, about 25 per cent of the homeless population is severely mentally ill. Many are deeply distrustful of shelters and the service system, sometimes refusing to engage in services even when their lives are at stake.

We believe our research might provide a hopeful answer for the increasing number of homeless Americans whose lives are in jeopardy on the streets of our cities.

From outcasts to insiders

Jim’s story, and other similar ones, led us on a 20-year quest to create a formal mechanism to enhance a sense of belonging and citizenship among society’s outsiders.

Aristotle said that to be a citizen is to participate in the political life of a city. Much later, Alexis de Tocqueville linked citizenship to civic participation.

We defined citizenship as the strength of a person’s connection to the “Five Rs” – the rights, responsibilities, roles and resources that society confers on people through its institutions, as well as one’s relationships to and with friends, neighbors and social networks.

Fifteen years ago, we got a small grant and created the Citizens Project in New Haven for people with mental illness and criminal histories, including major felonies. Often, they had histories of homelessness. The six-month program meets twice a week at a soup kitchen.

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Two graduates of the Citizens Project, second and third from right, in a performance with the Theatre of the Oppressed NYC, at the International Festival of Arts & Ideas in New Haven in 2017. Image: Mara Lavitt/author provided.

There are four months of classes on the Five Rs of citizenship, covering pragmatic topics such as the capacity to effectively advocate for oneself, public speaking and conflict resolution. A community advocate and peer mentors – people with mental illnesses who are now doing well – teach, support and counsel participants, or “students,” as well as provide them with living, breathing proof that people can indeed change.

Then students undertake a meaningful project in the community, such as training police cadets how to approach people living on the streets in a non-threatening manner. Graduations are held at City Hall, with family, friends and public officials cheering on.

The results?

There were statistically significant reductions – 55 per cent – in alcohol and drug use among citizenship program participants (as compared to 20 per cent reduction in the control group). Additionally, participants’ self-reported indicators of quality of life – such as satisfaction with daily activities and with their employment for those who secured jobs – were significantly higher in the citizenship group than the control groups. We have published the results in peer-reviewed articles and a book, Citizenship and Mental Health.

Criminal charges decreased, as they did in the control group, which received “usual” mental health care. Perhaps most important, each class of students became a supportive community in itself. Participants have taken seriously their new role as students, one that many had not embraced before.

Over the period in which we have conducted the citizenship project, homelessness overall in New Haven has decreased, likely through many factors, including perhaps our own work.

Citizenship approach spreading

Interestingly, however, anxiety and depression increased at various points among our participants. Perhaps the challenge of the intervention had an impact on students. Perhaps also the courage to change brought with it a vulnerability to difficult thoughts and feelings: grief over lost opportunities, lost friends, or lost dreams, even while their quality of life increased.

The project has run for years now, graduating hundreds. We’ve received funding from federal and state government. A state-wide social service agency is making their primary focus the enhanced citizenship of its 6,000 clients. Citizenship projects, based on our our model, have been launched at a state forensic hospital in Connecticut and internationally; in mental health programs in Quebec, Scotland, and soon, Spain and New Zealand.

It seems our citizenship program born 20 years ago is now coming of age. The intervention is inexpensive and follows a straightforward manual. The costs of doing nothing are certainly higher.

And Jim? He did pretty well for a while, then one day ranted enough about a public official that it had to be reported as a threat. Though completely exonerated, he fired his treatment team and refused all help once again. The Citizens Project had apparently arrived too late to help him.

The stakes of full membership in society are indeed high as we undertake this work for people on the margins. But our graduates – as they are recognised at City Hall by the mayor, as they train the police, as they serve on boards of homeless shelters where they once lived – say that seeing themselves as citizens helps.

And when we see the smiles on our graduates’ faces, or when they talk about their new employment, or when they talk about their joy in getting away from drugs and alcohol, we know that their new-found citizenship helps others, too.

Michael Rowe, Professor, Department of Psychiatry, Yale University and Charles Barber, Visiting Writer, Wesleyan University.

This article was originally published on The Conversation. Read the original article.

 
 
 
 

Treating towns as bastions of Brexit ignores the reasons for the referendum result – and how to address them

Newcastle: not all cities are booming. Image: Getty.

The EU Referendum result has often been characterised as a revolt of Britain’s “left-behind” towns and rural areas against the “metropolitan elite”. But this view diverts attention from the underlying issues which drove the Brexit vote – and ironically has diverted policy attention away from addressing them too.

It’s true that a number of big urban authorities, led by London, voted to stay. And overall people living in cities were less likely to vote leave than towns. Setting aside Scottish cities and towns, which both voted very strongly for remain, Leave polled 51 per cent of the vote in English and Welsh cities, compared to 56 per cent in local authorities that include towns. (Consistent data isn’t available below local authority level.)

Yet there is a lot of variation underlying this average across towns. In Boston, 75 per cent voted Leave, and in Hartlepool and Grimsby it was 70 per cent. But at the other end of the scale, there were a number of towns that voted to stay. For example, Leave polled at 49 per cent in Horsham and Harrogate, and 46 per cent in Windsor and Hitchin. In places such as Winchester, Leamington Spa and Bath, the Leave voted amounted to less than 42 per cent of the vote.

What drives this variation across towns? Data from the Centre for Cities’ recent report Talk of the Town shows economic outcomes were the biggest factor – with towns that voted Remain also having stronger economies.

For a start, pro-Remain towns generally have smaller shares of people who were either unemployed or claiming long-term benefit. (This is based on 2011 data, the latest available.)

Towns which voted Remain also had a higher share of jobs in high-skilled exporting businesses – an indication of how successful they have been at attracting and retaining high-paid job opportunities.

And both measures will have been influenced by the skills of the residents in each town: the higher the share of residents with a degree, the stronger the Remain vote.

So the Brexit vote was reflective of the varying economic outcomes for people in different parts of the country. Places which have responded well to changes in the national economy voted to Remain in the EU, and those that have been ‘left behind’ – be they towns or cities – were more likely to have voted to Leave.

This sends a clear message to politicians about the need to improve the economic outcomes of the people that live in these towns and cities. But the irony is that the fallout from the Brexit has left no room for domestic policy, and little progress has been made on addressing the problem that, in part, is likely to have been responsible for the referendum outcome in the first place.

Indeed, politicians of all stripes have seemed more concerned about jostling for position within their parties, than setting out ideas for domestic policy agenda. Most worryingly, progress on devolution – a crucial way of giving areas a greater political voice – has stalled.


There was talk earlier this year of Theresa May relaunching her premiership next summer focusing on domestic policy. One of her biggest concerns should be that so many cities perform below the national average on a range of measures, and so do not make the contribution that they should to the national economy.

But addressing this problem wouldn’t ignore towns – quite the opposite. What Talk of the Town shows is that the underperformance of a number of cities is bad not just for their residents or the national economy, but also for the residents in surrounding towns too. A poorly performing neighbouring city limits both the job opportunities open to its residents and impacts on nearby towns’ ability to attract-in business investment and create higher paid jobs.

This isn’t the only factor – as the last chart above suggests, addressing poor skills should be central to any serious domestic policy agenda. But place has an influence on economic outcomes for people too, and policy needs recognise that different places play different roles. It also needs to reflect the importance of the relationships between places to improve the access that people across the country have to job opportunities and higher wages.

The Brexit vote didn’t result from a split between cities and towns. And if we are to address the reasons for it, we need to better understand the relationship between them, rather than seeing them as opposing entities.

Paul Swinney is head of policy & research at the Centre for Cities, on whose blog this article first appeared.

Read the Centre’s Talk of the Town report to find out more about the relationship between cities and towns, and what this means for policy.