Homelessness is as difficult to define as it is to comprehend. According to the United States Department of Housing and Urban Development (HUD),“Homeless describes a person who lacks a fixed, regular, and adequate nighttime residence.”  According to the Public Health Services Act, “A homeless person is an individual without permanent housing who may live on the streets; stay in a shelter, mission, single room occupancy facilities, abandoned building or vehicle; or in any other unstable or non-permanent situation.”  Significantly, unless the housing circumstances are deemed “permanent” the person is still classified as “homeless” by our government’s definition. 

 

Sheltered vs. Unsheltered Homelessness:

Homelessness is classified into two categories: “sheltered” and “unsheltered.”  When we think of “homeless” we generally think of “unsheltered homeless” in which the person’s primary nighttime residence is a place not meant for human habitation such as cars, parks, sidewalks, abandoned buildings, camping grounds, bus or train station, airport, or on the street.  

 

Yet “homeless” also applies to a much broader set of circumstances: “Any other unstable or non-permanent situation.”  For example, people who are “doubled up” or “couch surfing” (staying intermittently with friends or family) are also considered “homeless,” though of course those numbers are very difficult to count.  

 

An individual (or family) who will imminently lose their housing within 14 days is also considered homeless. This could be due to a court order that will result in an eviction, or if they are staying in a hotel but lack the resources necessary to stay for more than 14 days.  

 

“Homeless” also applies to a person being released from the prison or hospital system, or fleeing domestic violence, if they have no known destination nor the resources or support networks to obtain other permanent housing.

 

Someone who is in the “sheltered homeless” category is living in a supervised publicly or privately operated shelter that provides temporary living arrangements.  These can be hotels and motels, “congregate” (group) shelters, and transitional housing. 


Variations of shelter duration and seasonality: Many shelters are only available on a partial basis.  For instance “cold weather” shelters are only available in the inclement weather months or during severe storms. Many shelters such as those offered by churches are only available at night; they open the doors in the evenings and residents must leave the next morning.  “Emergency shelters” are usually on a night-by-night or walk-in basis, while “Navigation Centers” and others are available only by referral.  This often happens by street “Outreach Teams” who find people in encampments, parks, or street corners and help refer them to shelters and enroll them in the various tracking systems.

 

People generally enter the homelessness services “system” by enrolling in what is called the Coordinated Entry System. This is a national program in which an individual participates in an assessment interview with a social worker and is given a ranking that places their priority on the shelter placement list. Various factors influence where the person will be referred; for instance families with small children, veterans, and people who are medically vulnerable receive higher priority. Domestic violence survivors may be directed towards a women’s-only shelter, and families tend to be at family-specific programs separated from single adults.  

 

Many shelters are single-sex, which means a couple would not be allowed to stay in the same location.  Many shelters do not allow pets, which is of course a very limiting factor for an individual who is accompanied by a loyal furry friend. 

 

Classifications of Homelessness:

Situational Homelessness:
Individuals or families who lose their homes after experiencing a crisis are considered “situationally homeless.” Common causes include job loss, a healthcare emergency, divorce, domestic abuse, fire, and natural disasters. Generally their state of being without a home is temporary and can be resolved when the specific situation in their life is addressed.

 

Episodic Homelessness:
Individuals who are consistently at risk of becoming homeless or who experience homelessness from time to time but for shorter periods are considered “periodically” or “episodically” homeless. These individuals generally have fairly disadvantaged lives with jobs that are unstable, and thus have little or no financial buffers against emergencies. 

 

Chronic Homelessness:

A Chronically Homeless Individual refers to an individual who has been continuously homeless for one year or more or has experienced at least four episodes of homelessness in the last three years – while also struggling with a disabling condition such as a serious mental illness, substance use disorder, or physical disability.  

 

How Homelessness is Measured:

It is impossible to accurately know exactly how many people are experiencing homelessness at any given time. The closest most municipalities get is what is known as the Point In Time count (PIT).  As mandated by HUD, every region must conduct a PIT count at least every 2 years.  On a designated night a large group of trained volunteers walk the streets to count, interview, and assess the unsheltered people they encounter. Sheltered homeless individuals are tallied by data provided from shelters, hospitals, prisons and jails, schools and colleges and other systems.  While the sheltered counts are inevitably incomplete as well, the unsheltered counts are by far the most difficult to quantify accurately.  We know that families and undocumented individuals tend to hide, in fear of their children being taken away from them or deportation. Of course the number of people who experience homelessness in the course of a year is far higher than the number on the street at any given time. Yet the PIT counts are the only consistent measuring system we have that allows for  year-over-year and regional comparisons in trends and demographics.

 

Significant terms, strategies, and policies related to homelessness

“Housing First”

In order to understand the complex interweaving of homeless solutions and strategies, it is first important to understand what is known as “Housing First” which is mandated by most federal programs and is law in many states, including California.

 

Housing First is an approach guided by the belief that people need basic necessities like food and a place to live before attending to anything less critical, such as getting a job, budgeting properly, or attending to substance use issues. Thus, Housing First programs do not require people to commit to any prerequisites, requirements, or conditions beyond those of a typical renter in order to obtain housing. These programs are frequently known as “low-barrier”, meaning there are very low barriers to obtaining housing.  Supportive services are usually provided, but with the understanding that those services are only successful if the person engages willingly, participation is not mandatory.

 

Non-Housing First programs that do make such requirements, such as abstinence-based shelters,  are generally not eligible for any public funding. Thus organizations such as The Salvation Army or those operated by faith-based organizations are generally funded fully philanthropically or through limited public programs.

 

Harm Reduction

Harm reduction refers to policies, programs and practices that aim to minimize the negative impacts associated with drug use. Rather than insisting on abstinence, the principles of harm reduction as applied to homelessness systems are to accept, for better or worse, that drug use is part of the individual’s life and therefore works to minimize its harmful effects rather than simply ignoring or condemning them. When 

 

Topics yet to Cover:

Harm Reduction

Racial Disparities/elderly/demographics

Myths about Homelessness

Health and Homelessness:

Health and homelessness are related as both cause and effect.  While an acute physical or behavioral health crisis may lead to homelessness, we know that homelessness itself dramatically exacerbates mental, behavioral, and physical medical conditions. 

 

According to the U.S. Department of Housing and Urban Development, people living in shelters are more than twice as likely to have a disability compared to the general population. On a given night in 2017, 20 percent of the homeless population reported having a serious mental illness, 16 percent conditions related to chronic substance abuse, and more than 10,000 people had HIV/AIDS.

Conditions such as diabetes, heart disease, and HIV/AIDS are found at high rates among the homeless population, sometimes three to six times higher than that of the general population.

People who have mental health and substance use disorders and who are homeless are more likely to have immediate, life-threatening physical illnesses and live in dangerous conditions. Also, more than 10 percent of people who seek substance abuse or mental health treatment in our public health system are homeless.