A plan to end street homelessness in five years, Part 1: The types of homelessness

You must first understand a problem before trying to solve it

Nobody wants tents on the sidewalks. And nobody wants to sleep in a tent on the sidewalk. Regardless of your political persuasion we can all agree: we need to get people inside.

But nobody agrees on how to do it.

We can solve street homelessness if we make some hard choices, stop letting the perfect be the enemy of the good, and believe that it is our city's biggest moral failing to not help the people who need it most. I expect that no one will be happy with my full set of proposals because I'll be taking a pragmatic rather than ideological approach.

This essay, part 1 of this series, will describe the various types of homelessness. The next parts will describe the policies and programs we can implement, the political feasibility of them, a viable path to implementation, and long-term policies for getting more people in permanent housing.

Suggested prior reading: Understanding Homelessness in San Francisco.

What is "street homelessness"?

People who are experiencing homelessness are not always visible. They may sleep on a friend's couch, in their car, in an SRO, a hotel, or a shelter. You wouldn't be able to pick them out of a crowd. But street homelessness is unmissable.

Street homelessness is the most visible form of homelessness, and what the majority of people think of when they hear the word "homeless." Street homelessness is vicious to people experiencing it: It traps people in poverty, exacerbates or causes physical and mental health problems, and leads to drug and alcohol abuse.

New York City has almost completely ended street homelessness. NYC is one of the few places in the country that has a "right to shelter" law that guarantees anyone a room who needs one. Anyone sleeping outside in New York City's harsh winters would likely die from exposure, so they can't take the same laissez-faire approach that San Francisco does. NYC's success shows that ending street homelessness is possible.

Ending street homelessness will not solve every problem, but it is the first and most important step. When elected leaders do not act, they provoke a backlash. If San Francisco, and California more generally, continue to fail then voters will give up on compassion and opt for harsh solutions. We're already seeing it in the fallout from the Governor recall: Newsom and his opponents are all doing photo-ops clearing homeless encampments, while the people living there have nowhere else to go. Voters want this, even though it's cruel, because at least they see results.

To stop the backlash, we must act.

Types of homelessness

Before proposing policy solutions to street homelessness, we must first take stock of the various types of homelessness. There are a few broad categories: youth homeless, the working poor, temporary homeless, those seeking opportunity, those needing healthcare and mental healthcare, those needing drug treatment, and the long-term homeless. Any one of these groups may experience street homelessness at any time.

Youth homeless

Young people become homeless due to desperate situations at home (emotional, physical, or sexual abuse, negligence, alcoholism and drug addiction), or because they were kicked out for not agreeing with their parents' religion or social values (for example: LGBTQ youth are disproportionately more likely to get kicked out and be homeless than other youth).

Becoming homeless at a young age can permanently alter your life by making it impossible to access education and trapping you in poverty. Young people may be preyed upon and forced into situations where they have to trade sex for safety, food, or shelter.

The working poor

Most adults become homeless because they lost their job, got evicted, left their partner, or got kicked out by their partner. Most people stay homeless because they just don't have enough money to pay rent. Many of these people are "working poor" — they have a job (or two, or three) but they don't make enough to afford a room on their own. Or they make enough to get a hotel every other week, but can't afford a deposit for anywhere more permanent. Given a better job, lower housing costs, or even a small lump sum for a deposit on an apartment, these people can easily get back on their feet.

The working poor are the most invisible of any homeless population. You've probably been waited on by someone experiencing homelessness, or your kids go to school with children whose parents have no permanent housing. In fact, at any given time about 4% of San Francisco's school children are homeless. That's one out of every 25 kids — or about one in every classroom.

Children of homeless parents don't have access to the same opportunities as their housed classmates. They aren't able to take part in the same extracurriculars, especially if those activities require buying equipment, they may not be able to make it to school on time, and they will struggle academically. They are often underfed and school lunch may be their only meal of the day.

The temporarily homeless

The vast majority of homeless in San Francisco lived here when they lost their home. At first they sleep on couches of friends and family, but eventually everyone's charity runs out. Most people in this situation are only temporarily homeless and after a few weeks or months couch surfing, they either move away or find a place they can afford. A shelter, a bus ticket, or a lead on a low-cost room is all they need to make it. Too often, though, temporary homelessness turns into permanent homelessness because they weren't able to access the services and help they needed.

Those seeking opportunity

Some people do move to San Francisco when they're already homeless (though this is a minority: 30% or less of the homeless population). Maybe they heard they can find a job easily, or they can get medical services they need, or maybe they have some friends in town who promised them a couch. Almost none of these people come here because our homeless services are good, and the weather is actually not ideal for outdoor sleeping. It's a myth homeless people move to SF for good services or the weather. People who move to San Francisco and end up homeless are all just seeking a better life.

It is very tempting and easy to think that homeless San Franciscans come here because we're generous, and that thought quite quickly turns into contempt, disgust, and anger. I can't blame anyone for feeling this way — it's a natural reaction that helps people deal with uncomfortable situations. Brains have this incredible ability to minimize the humanity of humans who don't fit our idea of how they ought to look or behave.

I'm not going to tell you you're a bad person for thinking this way. Instead I'll ask that you soberly look at the statistics, the reality of our poor services, and how much people are suffering on the street, and then introspect on why you think someone would *choose* that over other options.

It's tempting to think that just preventing people from coming to San Francisco would solve homelessness. But even if we suspended civil liberties and instituted domestic passports to stop anyone from moving here, we would still have more homeless than shelters, and have violated fundamental human rights along the way, so I won't even consider this as a solution. America is not communist China: people have freedom of movement in this country.

Those needing physical healthcare

A few minutes in San Francisco will make it obvious that a lot of homeless people are suffering from something. Whether that be open sores, swollen legs and feet, tooth decay, rashes from not washing, broken bones, infections, or any number of other issues: they all need a little medical care. Your body can rapidly deteriorate in difficult conditions and give you an ailment that makes it impossible to get around, clean up, and find a job. Being healthy and clean makes it so much easier to find a job and an apartment.

We don't have socialized healthcare, but hospitals are obligated to give everyone treatment. So, at least they can get help in an emergency. But good health requires so much more than occasional emergency room access: you need clean water, a bed, clean clothes, and sanitary food — all of which are incredibly hard to obtain when homeless.

Those needing mental healthcare

Most people assume that all homeless people suffer from mental health issues. This is part of our natural defense mechanism: we assume "those people" are "crazy," which helps absolve us of our guilt.

But, in fact, only 8% of people become homeless due to mental health issues. However, they are exceptionally visible: shouting, walking out into traffic, making messes, talking to themselves, and are often unable to keep themselves clean. They have no options: shelters won't let them in (either because they're already disruptive or have been disruptive in the past and have been banned), their fellow homeless don't want them around because a quiet and clean encampment is less likely to be shut down, and neither the police nor hospitals want to keep them any longer than absolutely necessary.

People suffering from mental health issues that prevent them from obtaining assistance need the most help and should be forced into it if they refuse help. It is inhumane to let people clearly suffering from mental health crises waste away on the street with no access to services. Most advocates for the homeless will disagree with me here, but I believe it is necessary to force some people into the care of the state.

Those needing drug or alcohol treatment

Like those needing healthcare, it's obvious many homeless people need drug treatment. Only 18% of people become homeless due to drugs or alcohol. However, many people develop a drug or alcohol problem once they are homeless: 42% of homeless people in San Francisco report using drugs or alcohol.

Drug treatment is outside the scope of this essay, so I'll briefly summarize my views: we need to open safe consumption sites where people can use drugs and be given medical attention before and after, and then have a zero-tolerance policy for open-air drug use. Anyone doing drugs on the street should be taken to a safe consumption site (not jail!). We will never end drug use; all we can do is minimize the harm it has on society. And needles lying around everywhere, people smoking fentanyl on public transit, and people nodding off on the sidewalk all harm our social fabric.

The chronically homeless

A small number of people are "chronically homeless". This means they've been homeless for a year or longer, or have experienced bouts of homelessness more than three times in the past three years. When someone is chronically homeless, it means all of our interventions and outreach have failed to make a lasting and meaningful impact in their lives.

What are the current shelters like?

San Francisco has over 8,000 homeless people and only 3,000 shelter beds. So every night there are at least 5,000 people sleeping on the street. But for the lucky 3,000 that can find a spot indoors, what is it like?

Most people have a contradictory view of homeless shelters: they picture a place that's simultaneously cushy and loaded with amenities while being a dirty and unsafe place they don't want to live near. The truth is, as it always is, more nuanced.

The most basic shelter facility is only open at night and people sleep on small cots or bunk beds, with many people sharing the same room. Spouses, partners, children, and pets, are all forbidden: these shelters only accommodate individuals. Also, drugs and alcohol are prohibited. There are basic bathrooms and showers onsite. You must wait in line to get in, and the staff may choose to take someone they deem higher priority than you, even if you're ahead of them in the line. You are kicked out every morning and must take all your belongings with you; there is no food storage and no lockers for your belongings. (Note: All of these facilities were shut down at the start of the Covid-19 pandemic due to the high risk of transmission in such a crowded setting.)

Faith-based shelters are similar: they let people in at night and kick them out in the morning. Sometimes, these shelters are only open a few nights per week. Many faith-based shelters also serve food and some allow families.

A small number of shelters allow drugs and alcohol. This was popularized during the "housing first" movement that sought to get people into housing first and then help them deal with their drug or alcohol abuse problems. I believe in meeting people where they're at and think that these "wet" shelters are vitally important. Both dry and wet shelters are part of the spectrum of solutions.

The next step up is San Francisco's navigation center concept. This is designed as a 90 day intervention to help people get back on their feet. Residents are able to bring partners and pets, and are assigned a bed and a locker so they don't need to move their belongings every day. There are no curfews or set meal times so people live normally. This stability, secure storage, and especially the reliable access to showers, is a huge benefit for people looking for a new job. Someone who hasn't showered in a week or who has to bring all of their belongings with them wherever they go has a nearly zero chance of finding a job.

One more step up is a daily or weekly room, commonly called residential hotels or SROs. These facilities are not free, and they're not that cheap either. Someone who lives in an SRO usually spends the majority of their income on rent. Many SROs also rent monthly. These facilities mostly cater to the "working poor" who just don't get paid enough at their jobs (and they often have more than one) or those living on a fixed income, like social security. Like all other types of housing that aren't for multi-millionaires, it's illegal to build new SROs. Bad government policy ensures that low-cost housing is not attainable to people who need it. The existing SROs are old and in various states of disrepair, with no handicapped accessibility to speak of.

Check out Shelterlist to see all of the types of homeless shelters in San Francisco.

Stay tuned for Part 2: The Plan

In Part 2, I'll lay out what I believe is a feasible plan to end street homelessness in five years. I think it can (and should) happen faster than that, but building the requisite political capital takes time.

Subscribe now so you don't miss part 2.