A Homelessness Agenda for San Francisco
Some of the world’s most exciting progress is occurring today in San Francisco. But human tragedy is occurring right alongside it. The homeless filling the streets of the city lack for their most basic needs. Many also suffer from major problems like addiction, untreated mental illness, disconnection from family, and persistent unemployment.
Throughout San Francisco’s homelessness media blitz occurring this week, we are bound to hear about lots of old solutions pitched as new ones, things like Housing First (giving homeless people permanent housing) and new shelters. Unfortunately, they won’t be enough. In order to make real progress, we have to think differently.
The old way of thinking
We often hear that homelessness is one of society’s biggest, most intractable problems. Or that the homeless are a scar on our moral sensibilities. These sentiments are (hopefully) never borne out of malice, but they can sometimes lead to a twisted logic: The homeless turn into a problem to get rid of at the lowest possible cost.
Why is that bad? It dehumanizes the very people who we want to help, turning them into a burden whose only value accrues from disappearing. In fact, an influx of new studies has shown that homeless people cost taxpayers a lot of money in the form of emergency rooms, jails and shelters.
Treating people as liabilities
Unfortunately, this way of thinking has spurred a wholesale embrace of solutions that treat people as liabilities, claiming (often falsely) to save us money. An idea known as “Housing First” accepts the most vulnerable into housing and offers an array of supportive services. On the positive side, Housing First keeps people housed longer than other solutions. But it has not succeeded in improving people’s lives in other ways, such as overcoming addiction or improving mental health. As a result, Housing First doesn’t do enough to reduce homelessness because resources are tied up by a small number of people who continue to struggle (albeit in housing) rather than move on with their lives.
There are undoubtedly even worse ways of dealing with homelessness. Throwing homeless people in jail or busing the mentally ill out of town are unlikely to help people rebuild their lives. That doesn’t mean we should discard laws that protect public safety, or that tents and encampments should be freely allowed across the city. And indeed, police officers can be tremendous assets in serving all members of the community (homeless or not). But these strategies don’t work when the homeless are seen only as a problem to get rid of.
Thinking differently
To make real progress, we first have to think differently about the problem. Yes, homelessness is bad; but it is also a signal that a lot has gone wrong in someone’s life, including addiction, debilitating mental illness, disconnection from family and/or unemployment. It is not only the right thing to help people overcome these other obstacles. But if we can do so successfully, then people can move on from expensive services and we can free up these resources for people in the future. This would give us a real chance at reducing homelessness in the long run.
New solutions
In a recent article, I describe how this could work. I suggest prioritizing the most vulnerable people sleeping on the streets for housing with supportive services. Once there, service providers should be free to implement the practices they think work best. But in return, they should be held accountable for results. If they help clients rebuild their lives more effectively and more quickly than other providers, they should receive more money and be assigned more clients. If not, funding should be cut and clients reassigned.
Or San Francisco can be even bolder. In another report, I propose unleashing the power of technology and big data to transform how we serve the homeless. Homeless individuals can be offered free smartphones and full service plans (if they don’t already have them) in return for providing data on themselves — their health status, sleeping accommodations, service use and even happiness levels. That data could be accessed by experts to figure out what interventions are working best, and then to experiment with new ideas. For example, Uber credits and cash incentives through e-banking accounts could be offered for positive actions like checking in at a shelter. Ultimately, each individual could receive an individualized, evidence-based package of interventions that most effectively rebuilds his or her life.
Recognizing humanity and embracing innovation
San Francisco, like other cities across the country, is realizing that homelessness is not a problem that can be ignored. But treating homeless people solely as a costly problem to get rid of is not the answer. We will achieve real progress when we pair a recognition of the humanity of our homeless neighbors with an unrelenting drive for results. It’s time for San Francisco to unleash its culture of innovation for those who need it the most.
