Chronic Homelessness

Defining Chronically Homeless Defining Chronically Homeless | The Los Angeles Homeless Services Authority. Load video

Homelessness is the state of lacking fixed, regular, and adequate housing. Chronic Homelessness is the quality of being homeless frequently or for a long duration of time.

How frequent and how long is considered chronically homeless?

A person is considered chronically homeless if he or she has been homeless for at least 12 months.

If the homelessness is discontinuous, meaning the person became homeless, regained housing, and then became homeless again, a person is considered chronically homeless if he or she was homeless at least 4 times in three years. Each separate occasion of homelessness must add up to one year.

The United States federal definition of chronic homelessness also requires an individual have a disability.

Emily, for example, the local homeless woman who sits out front of Mc Donald's every day begging for burgers, is considered chronically homeless because she has been homeless at least four times in three years. After adding up the days of each time she went homeless, the time she spent without a home in the last three years added up to over 12 months.

Her friend, Stacy also can be considered chronically homeless. While Stacy is homeless for the first time in her life, Stacy has been homeless for over a year.

Another Definition of Chronically Homeless:

Chronically homeless people are those who have "experienced homelessness for at least a year – or repeatedly – while struggling with a disabling condition such as a serious mental illness, substance use disorder, or physical disability."

WHO THE CHRONICALLY HOMELESS ARE

About a quarter of all homeless individuals meet the criteria for chronic homelessness at any given time (✓ 1).

About two-thirds of them live, not in a shelter, but on the streets (✓ 1).

The average age of the chronically homeless is over 50 years old (✓ 1).

In the recent decade, chronic homelessness has been on the rise. The most likely cause for this is an increase in unaffordable housing.

The chronically homeless are people from many diverse backgrounds, and medical statuses'.

Veterans

Compared to the entire homeless population, however, the chronically homeless are more likely to be veterans (✓1).

In fact, according to the Corporation for Supportive Housing, the chronically homeless are more than twice as likely as the temporarily homeless to be veterans.
Three out of four veterans experiencing homelessness suffer from substance abuse disorder.

people with disabilities

A little under half of all people experiencing chronic homelessness are disabled (✓ 1).

About one-quarter of all chronically homeless individuals have a severe mental illness or disorder (✓ 1).

Three out of four chronically homeless are men. (✓ 1).

minorities

The percentage of African Americans and Native Americans who are chronically homeless is higher than the percentage of African Americans and Native Americans in the general population (✓ 1).

victims of domestic violence

Roughly one in ten people who are homeless are victims of domestic violence(✓ 1).

age

Over half of all chronically homeless individuals are over the age of 50 (✓ 1).

young people

Most of the chronically homeless are not youth. For those that are, though, more often than not they are teenagers just leaving foster care. A little under half of all young people who are in the foster care system will become homeless within a year and a half after leaving a foster home (✓ 1).

COSTS, CAUSES, AND SOLUTIONS OF CHRONIC HOMELESSNESS

The cost to society for chronic homelessness is immense. A collaborative study by the University of California and others, for example, found that in just one year, chronic homelessness cost Orange County, California, 299 million dollars (✓ 2).

What for? The study found that the money for chronic homelessness is mostly spent on public services. (Public services include things like social workers and food costs for the homeless.) Other costs included medical, and housing.

causes

In addition to being homeless frequently or for a long duration, to be classified as chronically homeless, an individual must have a disability. Disabilities are often the cause of chronic homelessness. Severe disabilities interfere with employment.

In particular, poor mental health, cognitive impairment, and physical health conditions cause chronic homelessness.

Schizophrenia and schizoaffective disorder, for example, are mental health conditions. These conditions cause hallucinations, severe depression, and anxiety. Many individuals with mental health disorders, even given today's cutting-edge medications and medical treatments, have difficulties holding a job.

Major depressive disorder (MDD) is another example of a mental health condition. MDD makes it hard for the person who experiences it to get out of bed.

Generalized anxiety disorder is also a mental health condition. This disorder makes being at work miserable. As a result, a person with severe anxiety finds it difficult to leave the house.

So mental health issues are one cause of chronic homelessness.

Another cause of chronic homelessness is cognitive impairment. Individuals with cognitive impairments sometimes have difficulties with job performance. Autism, for example, impairs the ability to learn and process information. Both of which are essential for employment.

Next, chronic homelessness is also caused by physical health conditions. Some of the chronically homeless have several physical health conditions which make it impossible to work.

Finally, chronic homelessness is sometimes caused by a personal choice to be homeless. An individual in this category may have an underlying disability that makes work difficult, but not impossible. The person chooses homelessness, however, because to them, the problems faced by employment far exceed the challenges faced by homelessness.

Thus, chronic homelessness is caused by mental health, cognitive impairment, physical health conditions, and a personal choice to be homeless.

solutions for chronic homelessness

Solutions to chronic homelessness usually focus on housing, medical treatment for the underlying disability, and job training.

Another often overlooked means for solving chronic homelessness, though, is an investment in research on the underlying medical conditions that cause chronic homelessness. As of late, no good treatments exist for Parkinson's disease, and schizophrenia, for example.

These disorders are debilitating. They impair the chronically homeless individual's ability to work and have a normal, optimal life. More funding for medical research is needed.

The more dedicated funding for medical research for treatments and cures for the underlying medical conditions that cause chronic homelessness, the more likely it will be that chronic homelessness will one day be a thing of the past.

Thus, solutions to end chronic homelessness include housing and medical care. In addition to the usual remedies, more funding for research for cures and treatments for the underlying medical causes of chronic homelessness is needed.

TYPES OF CHRONIC HOMELESSNESS

The four types of chronic homelessness are

1. willfully, reversibly, chronically homeless,
2. willfully, irreversibly, chronically homeless,
3. unwillingly, irreversibly chronically homeless,
4. and unwillingly, reversibly chronically homeless.

People like Emily, (the homeless woman who was mentioned in the introduction of this article,) are homeless due to one of four possibilities. Each possibility encapsulates a particular type of chronic homelessness.

The first possibility is that they choose to be homeless. They may or may not be able to get out of homelessness on their own.

For example, upon talking with Emily, we find out that she chooses to be homeless because she enjoys the freedom of "sleeping under the stars," and "living amongst the birds." But even if being homeless wasn't her own decision, she may lack a realistic means to get out of homelessness on her own. For example, Emily may have a severe mental health condition. That mental health condition prevents her from working and maintaining a proper home.

The second possibility also has to do with a person choosing to be homeless. The difference with this possibility in relation to Emily, however, is the person couldn't get out of their situation if they tried. Steve, for example, an ex-marine who spends his day gathering aluminum cans and reading discarded newspapers, has been homeless for more than a decade and has no physical or mental conditions that prevent him from working.

Steve, is both chronically homeless and chooses to be. Emily is also both chronically homeless and chooses to be.

The difference between Steve and Emily though is that Steve could if he ever chose to, fill out some applications and get to work. Emily, on the other hand, could not. Her severe schizophrenia prevents her from ever getting out of homelessness on her own.
The term that is used to describe the difference between Steve and Emily is reversible.

Thus, Steve is reversibly, chronically homeless, while Emily is irreversibly, chronically homeless. Both meet the criteria for chronic homelessness, but Emily, if she ever changes her mind about wanting to be homeless, will need help from society to get out of it. Steve, on the other hand, would just need maybe a shower and a fresh pair of clothes.

The third possibility for chronic homelessness is encapsulated in Amanda's situation. Amanda has been homeless for over six years. While she hates being homeless and does not choose to be, she can't get out of homelessness due to personal issues.

Amanda may have a severe heroin addiction, for example. Her addiction prevents her from holding down a job. While Amanda doesn't choose to be homeless, if she were to just give up her addiction she could get out of it. (Of course, giving up a heroin addiction is immensely challenging.) Nonetheless, Amanda does not choose to be homeless. She chooses to do drugs which keep her homeless.

Since Steve, the ex-marine, can realistically get out of homelessness if he tried, and Amanda the heroin addict can equally as well, both can be considered reversibly, chronically homeless. The difference with Amanda is she does not choose to be homeless.

The distinction for Amanda can be pointed out by a new term. We can say that Amanda is unwilling to be homeless. Thus Amanda is unwillingly, reversibly, chronically homeless. Steve on the other hand is willfully homeless. So he is willingly, reversibly, chronically homeless.

While Emily, (the woman who experiences schizophrenia,) is willingly, irreversibly, chronically homeless.

The final possibility for a chronically homeless person is unwillingly, reversibly, chronically homeless. This is the classification of Bob's situation. Bob has been homeless for over eight years. He hates every day of it. While he has a disability and could work if he wanted to, he chooses to not. Bob hates work for the same reasons I do:

He doesn't like "some young college grad telling him what to do."

He doesn't like the fact that he works forty to fifty hours a week only to barely have enough money to pay the rent.

He doesn't like the type of work he is limited to because he lacks "some fancy college degree."

And he doesn't like how his entire life must be spent at work to afford a roof over his head when he has other dreams and goals to pursue.

Clearly, Bob hates work. That's why he doesn't do it. The reason why he's homeless then is because he'd rather be than work.

What's interesting about Bob is many people are like him. Many houseless people are unwillingly, reversibly, chronically homeless. They may have a disability that would make work difficult, but if they wanted to work, it would not be impossible to do so. This classification is not appropriate for the majority of the chronically homeless, however.

most of the chronically homeless are irreversible homeless

The irreversibly homeless are people who, for the rest of their life, lack the propensity to increase their income significantly enough to meet their costs and need for shelter. It's not that they need a job – they are unable to work! It is not that they need to get back on their feet – they have no feet!

The irreversibly homeless are prisoners of mental and physical disabilities, financial dependents of family members, and governmental agencies, characterized not by the duration of time they have been homeless, but by the assumptive likelihood that they will always be homeless.
Most of the chronically homeless are unwillingly, irreversibly, chronically homeless.

FINAL THOUGHTS

It might be said that though chronic homelessness is a term reserved for individuals who have underlying health conditions, many of the chronically homeless, like Bob, (the person mentioned in the types of chronic homeless section,) can work. The reason that they hang out under a bridge instead of working at McDonald's is that they choose to. Thus, the chronically homeless don't deserve our help.

People with schizophrenia, for example, are fully capable of holding down a job. They need only to take medicine as prescribed by the doctor. So instead of putting the chronically homeless in houses and giving them food and spending money so they can play hooky from work and sit around the free house all day, we ought to give them what they need to work, and then withdraw funding from them so they go get a job.

While it is true that some people with schizophrenia can sometimes work, and many of the individuals who are classified as chronically homeless can work as well, forcing them to work by withdrawing funding will do little for ending chronic homelessness.

Severe medical conditions make maintaining employment challenging. If we were to just give homeless people job training and then require them to work to continue receiving help, many of the people would just choose to go back to homelessness.

While it might be true that if that is the case then they get what they deserve, society would also be worse off with more homelessness.

Homelessness in general is a problem for many reasons. Most important to my point though, is it is problematic for society as a whole. Thus, for those people that truly do want a home and have trouble attaining one on their own, it is in both the homeless individual's and society's best interest for the chronically homeless to live in a home.

summary

In short, a person can be considered chronically homeless if he or she has been homeless for over twelve months in three years. If the episodes of homelessness were discontinuous, meaning an individual became homeless, regained housing, and then became homeless again, the duration of each episode of homelessness must add up to one year.

The discontinuous episodes of homelessness must also happen at least four times in the past four years. The federal definition of chronic homelessness additionally requires that an individual have a disability.

Next, the chronically homeless are more likely to be older, veterans, disabled, and members of a minority group. About one in four of all homeless people meet the criteria for chronic homelessness at any given time.

The costs of chronic homelessness are immense. One study in California found that chronic homelessness costs Orange County, CA alone almost 300 million per year.

The causes of chronic homelessness are by large synonymous with the causes of underlying medical conditions that prevent chronically homeless individuals from working. Personal choice to remain houseless is a factor, but it is minuscule in comparison to the population of chronically homeless individuals.

Finally, four types of chronic homelessness exist. The dimensions on which these types are based are willingness to be homeless, and an individual's ability to reverse homelessness. These two dimensions yield four possible types of chronic homelessness:

1. willfully, reversible chronic homelessness,
2. unwilling, reversible, chronic homelessness,
3. willingly, irreversible, chronic homelessness,
4. and unwilling, irreversible chronic homelessness.

conclusion

So the next time you see a homeless person, think about the fact that they may be chronically homeless. Think about the fact that they may have a disability and that disability prevents them from working. Many of the chronically homeless are good people. Offer them a dollar or two if they look like they need it.