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Center for Social Policy
McCormack Graduate School
University of Massachusetts Boston
100 Morrissey Blvd.
Boston, MA 02125-3393
Phone: (617) 287 5550
Fax: (617) 287 5544
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| Trapped in Homelessness |
Author(s):
Editorial
Source(s):
Boston Globe, Section: Editorial Page: A18
Date: November 10, 2004
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ADANGEROUS revolving door spins homeless people off the streets, into care facilities, and back
to the streets again. This vicious cycle is described in a new report from the Center for
Social Policy at the University of Massachusetts at Boston. The report is senior researcher
Tatjana Meschede's local look at the national challenge of ending homelessness.
Meschede studied 174 chronically homeless people at a high risk of death. They included the
elderly, people with histories of frostbite and hypothermia, and those with a "triple
diagnosis": a major physical illness combined with a mental health problem and substance
abuse.
Meschede's goal was to understand how services either succeeded or failed at connecting such
people to housing.
From 2000 to 2002, this group received help from the street outreach team at the Boston Health
Care for the Homeless Program. The needs were glaring: 94 percent had substance abuse problems;
82 percent had a major mental illness. They were repeat users of hospital, respite, and
substance abuse services. Boston Medical Center's emergency room was heavily used by about half
of the homeless. Some visited once, others up to 47 times. There was also heavy use of
substance abuse treatment centers; some people visited up to 72 times.
In an effective system this treatment would lead to improved health and housing. But by the
end of the study period in 2002, Meschede found a safety net full of holes: 92 people
remained on the street in the high-risk category. Forty-two people were better off: 35 in
housing or a long-term treatment program leading to housing, four in treatment programs,
and three in nursing home care. Nineteen had died, and 21 had the left the state or gone to
a shelter or jail.
Meschede also learned what helps people leave the streets. A badly needed resource is
affordable housing. Extremely poor people need a place to live. Otherwise even the best
care is compromised, and so is the effectiveness of the tax dollars spent on this care.
Second, care delivery must be improved. In Massachusetts, a visit to a hospital, detox, or
mental health program should be a gateway to an array of services, including job and
housing help. Whenever possible, the state should have a "housing first" policy that gets
people a place to live and services. Success should be defined as long-term stability. This
requires more joint efforts among state agencies. It means training staff and team members
who can help with substance abuse and mental illness and housing and food stamps and Social
Security benefits.
Support needs to stay readily available, so that even five or 10 years after a person leaves
the streets, he or she can still get help.
The tools to end homelessness exist; local and federal governments must use them.
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