Congressional Research Service
The Library of Congress
HOMELESS IN AMERICA
In response to numerous requests on the subject of the homeless, we have
compiled the enclosed packet of information.
This material discusses questions dealing with the number of homeless
Americans as well as trends in society's attitudes toward such people. The
incidence of mental illness and the appropriateness, or lack thereof, of
deinstitutionalization for such patients is another aspect of the problem
which is covered in this packet. A CRS report gives an overview of the
situation and of the Federal response.
Additional information on this topic, primarily in the form of
local library through
newspaper and periodical articles, may-be-foundin
the use of such indexes as the Readers' Guide to Periodical Literature,
the Public Affairs Information Service Bulletin (PAIS), and the New York
Members of Congress may obtain more information on this topic by
c a l l i n g ~ c ~at
We hope this information will be helpful.
Homelessness is on the rise, and public efforts
to solve the problem have proven sorely inadequate.
hey have always been with us. The
ancient Romecanbe found today on Colfax
Avenue in Denver, still thirsty for wine; the
bruised and broken woman whoslept in the
gutters of medieval Paris now beds down in
a cardboard box in a vest-pocket park in
New York City. They exist on the fringes,
taking meals when they find them and
shelter where they can. Most have drifted
well past the limits of respectability, many
deep into alcoholism or mental illness.The
public usually views their very existenceas
it must be faced at all-with averted eyes.
The tattered ranks of America's homeless are swelling, and the economic recovery that made this Christmas memer than
last for most Americans has not brought
them even a lump of coal. As subfreezing
temperatures settled in last week, scattered
anecdotes gave way to chilly facts. Unem-
but cities and voluntary groups across the
requests for shelter than ever. In Philadelphia, 15,000 received emergency family
housing in 1983-five times the number
sheltered in 1981. In Detroit, auto sales are
stronger, but the city estimates homelessness is up 50 percent. In St. Louis, the
Tom l v s
Salvation Army alone received 4,155 requests, up47 percent over last year.
No region has been spared. Atlanta's
first overnight shelter opened in 1979;now
the city has 27. Salt Lake City's mayor
insists his city has become a "blinking
light" for wandering homeless, whilePhoenix and Tucson complain that hordes of
transients have descended on Arizona and
must be repulsed (page 26). "Our shelters
were full in September,longbeforeit turned
cold," saysAudrey Rowe, commissioner of
social services in Washington, D.C. With
100 city beds for about 20,000 homeHuddled against tho chill
in Phoonix: The otonomy is
brightor, but not for the
poorest of tho poor
G' r9h4 Newsweek, Inc. Reproduced by the Library of Congress, Congressional Research
S w s t l c awith permission of copyright claimant.
less, Chicago, like most localities, relies on
church and community groups. Sister Carrie Driscoll says she turned away 112 pmple in one day recmtly from the Catholic
Charities shelter she runs in the city's devastated Woodlawn area. "At night 1pray,
'Lord, give me one more bed'."
The bedraggled homeless are walking
emblems of poverty and suffering-the
onlv wvertv manv Americans ever see.
~ u i & l u & for &cis plight are not easily
found. For one thing, the forces that
caused it are longstanding and complex:
everything from the disintegration of family ties to significant failures in America's
approaches to housing, mental health and
welfare for the poorest of the poor. For
another, the homeless move outside the
wdinrry Urtructurar that might help
resist m y dfort to bring
them in. The result is an entire underclass
of people who have managed to slide right
through the safety nets and into the gutter.
W.ltlnq tor lvnoh at a
Warhlngton,D.C, . w p khhon: Poverty wlth a womthe-akn
"In the missions you sleep on a folding
chairand wke up in the middle of the niaht
with some m y tdking weird a d droofing
all overyou,"says Billy Collins, a 23-yearold ex-machine-lathe owmtor who lefi his
family and lit out fo; Florida and-then
Crrli/omia He did not jind w r k - o r adnnture; instead, he en& up eating scmps
out ofthe Dumpers behind McDonald's
and Kentucky Fried Chicken "The old
guys riding the mils will be d y to share
what they've got, " says Collinr. "But people like me willjust beat them up and rip
Because they live without addresses,htme
homeless are unable to receive food stampS
and welfare in most states, invisible in un1employment statistics and impossible t~0
count. Estimates ranne anywhere fromn
250,000 to 2 million Gationwide, tens of
thousands of whom hPzard the elements
every night. The largeat private sponsor of
shelter, the Salvation Army. provides only
42,000 beds-a drop in the bucket. The
largest publicly sponsored shelter system
is run by New York, which now houses
6,000. That's double the capacity of two
years ago and more than during the Great
Shelter in a New York
phone booth: 'This system
doesn't make a man go up,
It makes him go downs
insufficient in a city
where officials estimate 20,000 homeless in
theunder-2 1categoryalone. Thechairman
of the city's Board of Health says that an
averageof one homeless person a day is now
found dead in the streets.
Like the rich, the homeless judge status
by where they sleep. The less chance of
interruption by police or other vagrants,
the more rest they get. Informal turf arrangements, say skid-row veterans, are beginning to break down under the weight of
the new arrivals. But certain distinctions
remain. The most successful find refuge in
garages or abandoned buildings, over hot
air grates or under bridges. The less discriminating settle for phone booths, park
benches, trash Dumpsters.
he people whopass thenight in such
accommodations are a much more
diverse lot than in the past-and
much younger, now averaging in their low
30s. Twenty years ago the homeless consisted almost exclusively of alcoholic skidrow men, mostly older white males. They
have been joined by huge numbers of released mental patients, who now make up
one-third to one-half of the total, and have
added thousands of women to the streets.
It's hard to tellwho wereseriously illbefore
becoming homeless, and who were driven
over theedge by therigors of street life. Few
aredangerous to anyone but themselves.
During the recession there was a sharp
increase in younger variations on the traditional hobo-unskilled drifters heading
south and west in a futile search for work,
many with their families. Recently, however, cities are reporting that the bulk of their
homeless aren't transients at all. Many of
the locals, says Ed Loring of the Open Door
Community in Atlanta, are young men
whocome out of housing projects and high
schools without any marketable skills.
Most male homeless have worked at some
point, but usually inmenialjobs.
The new drifters and dropouts are different from the winos and bag ladies. "You see
the embitterment and disillusionment of
life in them," says Capt. Cliff Jones of the
Grand Junction, Colo., Salvation Army.
Inside New York's Ft. Washington Armory, older men sleep gripping their shoes
so they aren't stolen by the newer arrivals.
Contrary to myth, most homeless welcome
any roof over their heads, but crime in
certain urban shelters is so pervasive that
some now take the same approach as their
psychotic brethren on the street-refusing
any offer of shelter.
The paradoxes of homelessness are practically endless. As cities revitalized their
downtowns in the 1970s by tearing down
dilapidated hotels, they threw thousands
who could afford nothing else into the
street. As states emptied overcrowded and
ill-staffed mental hospitals, they set thousands free to fend for themselves. And now,
as local governments and charitable organizations stretch to provide relief, they find,
according to some accounts, that the more
they do, the more they increase demand.
Meanwhile, what they cannot do-from
providing underwear (an item, unlike overcoats, that's rarely donated) to findinnfamily backing and-permanent housing--is
what the homeless often needmost.
he immediate reason people are
homeless, logically enough, is that
they don't have homes, and the primaryreason forthat is what wasoncecalled
the low-income-housing crisis but is nowadays more dimly recalled as "something
everyone cared a lot about in the 1960s."
One reason the issue faded from dational
view is that the government's housing policies failed. Washington warehoused the
poor in dismal high-rise projects, provided
loans guaranteed to default and wasted
billions in administratively inept programs
that ended up subsidizing middle-class
government paper shuffle-instead
of the poor. Fewer than half
of the 6 million low-income units Lyndon
Johnson believed were needed in 1968 ever
But whileattention flagged, the problem
grew worse. Median rent increased twiceas
fast as income in the 1970s, and low-income-housing construction came to a virtualstandstill. The Department ofHousing
and Urban Development reports construction and renovation dwindled to 203,113
units in 1979 under Jimmy Carter and to
55,120 in 1983 under Ronald Reagan. Yet
census figuresshow about 2 million Americans living in substandard quarters and
hundreds of thousands on mind-numbing
waiting lists for public housing: 20 years in
Miami, 12inNewYork,4in Savannah,Ga.
The Reagan administration's housing
policy revolves around $200 million in
vouchers for low-income people to use for
rent-+ plan that assumesthereisnoshortageofhousing,onlyaninabilitytopay for it.
But a recent Brookings Institution study
suggests that the shortage may reach 1.7
million low-income units by 1990.And the
total housing subsidy for the poor is small
compared to what the middleclass and rich
receive. Their subsidy wmes in the form of
a home-mortgage tax deduction that a p
plies even to summer homes and will cost
theTreasury about $42.8billion in 1984.
Those who benefit from this deduction
are "gentrifying" the cities; they are helping restore the tax base and quality of life
in old neighborhoods. But the side effects
ate devastating. The first buildings to be
abandoned, converted into condomina destroyed are often the flop
houses called single-room occupancies
(SRO's) where many of the very poorest
live. About 1 million rooms-nearly half
the total-were converted or destroyed
nationwide between 1970 and 1980, according to a Columbia-New York Uni-
versity study. New York lost 87 percent
of its SRO's in this period. Cities like
Denver, Seattle and Rochester have lost
more than 50 percent.
Some of the denims of these seedy hotels and abandoned slums go directly into
the streets, but many live 51xtwith friends
and relatives. In fact, thenumberofAmerican families sharing quarters in 1982 was
up 58 percent-thetlrst such increasesince
1950. And that has given rise to a curious
development. In the past, fire tended to be
themost commondirect causeofhomeleasness; now it'softeneviction--evictioninitiated not onlv bv landlords. but increasinnlv
by friends - a h relatives:
crammed into already crowded housing
with an Aunt Louise," says David Park
mi8tmkanly lava that they a n wall
waits for showers, about $3 million a yea]
pays salaries for security officers who arc
more visible on the payroll than in thc
By contrast, private sheltersaround thc
country operate at an average cost of abou
$3 to $6 a person for smaller, more hospita
ble quarters often located in church base
ments or community centers. "There's ;
psychological efect of being in a churcl
that draws respect from guests," says Lu
Martinu, coordinator ofa Chicagoshelte~
Almost all private sponsors argue tha
SmithoftheDallasCoalitionfortheHome- while the government does a bad job c
less. "Pretty soon they wear out their wel- running shelters, its funding help is rc
come and are out on the strats."
1n 1983, ~eafile,a city sympathetic to the
nce the s c m m b g and door slam- homeless, turned down 4,000 familiesming subsides, the only refuge is about 16,000 peopleaeeking temporary
emergency shelter. In New York, housing.
where especially accurate figures are available, 2,300 families, up from 900 last year,
She was called the cellophane lady beare housed in squalid welfare hotels that cause of the woy she wmpped her legs and
charge the city around $1,400 per family fecr to protect them h m the Philadelphia
cold.Itdidn k work lart winterLillian Roseneighbors. The sinnle-sex shelters for indi- borough nearly lost her limbs because oj
rid-& coet the ciiy $24 per "client" per hypothennia. Even so, the 65-year-oldwomnight-most of the money going for per- an refused to be removed from the street
sonnel. In the East New York shelter, where she live-just a block from her
which regularly featuresaninchofwateron daughter's apartment. She insisted that she
a floor where people deep and two-hour was ruled by the spirit of 'Sing-jing " and
THE 'STREET GIRLS'
They scrounge for scraps-and
rom a distance, on the snowy streets of
Chicago, she could be a coed off to a
football game. But get close to the woman
called Teddy Bear-her real name is Dolores-and you see that her long woolen coat,
preppy sweater, dark pants and sturdy
boots have not been donned for a day's
outing.Shehasslept inthem. Herblackhair
hasn't been combed. It is falling over her
dark eyes and onto her bruised face.
Teddy Bear's friend Elizabeth also favors pants and sweaters for Chicago's icy
weather. She has a quilted coat for the
winter but so far has been unable to find
boots wide enough for her feet. So she
sticks to the Trax running, shoes she got
during one of her periodic stays at a Veterans Administration hospital. Elizabeth's
hair is cut tomboy short-a throwback to
her adolescent days. She can still execute a
flying leap, too, the kind she did back in
convent school. Sometimes she does one
just to try lifting herself out of depression.
The social workers call them homeless
women. They call themselves street girlsa motley group scrounging scraps and
small change, bag ladies who carry their
world around with them or stash it at a
friend's home or have nothing left to stash.
They sleep in abandoned buildings, overnight shelters, sleazy welfare hotels or with
men who take them in for the sake of
kindness or sex. They all have one thing in
common: fear. Fear of not finding a safe,
warm placefor thenight, fear of not getting
the meal--or drink-they need, fear of
rape or of losing what little they possess.
live in constant fear.
Even the most deranged bag ladies, who
just want to be left alone, are vulnerable
because of rumors that they keep money in
their bags. On the streets, says Elizabeth,
"you have to have eyes behind your head
and look like you're not scared."
She used to carry a shopping bag with
clothes and soap and a toothbrush, but it
was "too obvious a target," says Elizabeth,
wholooksolder than her 37 years. Now she
keeps clean underwear at the apartment of
adivorced woman friend who lets her takea
shower now and then. "I haven't carried a
purse since I was mugged," she says. "I've
had medication prescribed for my depression, but there's no use carrying that
around-they'll take it." Teddy Bear, 28,
carries nothing; she ends up selling everything for the price of a drink. The hulking
body that earned Teddy Bear her name is
swollen from wine. "A doctor told me my
body is going to give out if I don't stop
drinking," she says. "I was doing OK for a
few months. I have this friend and she
helped me stop drinking and made me
think I could get off the streetsfor good."
But now herwelfarecheck goes for drink
again, whm her sometime boyfriend
doesn't take it from her. She doesn't have
the strength to stay away from him when
she's drinking, even though it means she'll
end up with a black eye. "We fight all the
time," saysTeddy Bear. Soshe wanders the
streets looking for him--or anyone else
Like many street people, Teddy Bear's
past is hazy. She says she is an orphan, but
others say she has a mother and four brothers who keep trying to get her off the bottle
and the streets. Whatever the truth, Elizabeth says she understands Teddy Bear's
drinking problem, because she still carries
the scars from her own heavier drinking
days-like the one on her wrist from putting it through a saloon window. "I was
angry at the bartender for serving me when
I'dalready had toomuch," sherecalls. "It's
the whisky and vodka that makes you so
violent you wind up in jail on a drunk-anddisorderly charge. It feels like there's a
tornado in your stomach and your head
feelslike yougot hit with asledgehammer."
t's only since her divorce in 1979 that
Elizabeth has had to worry about a roof
over her head. "I was married four years to
an electrical-engineering student, but he
was a Pakistani from a strict Islamic upbringing where they didn't like women
going out at night. I've always been a night
person, and when he told me that I was the
camel and he was the driver, that did it.
After the divorce I was too depressed to
work, and after four months of not being
able topay therent, Icame homeoneday to
find the locks changed. So I hit the streets.
It was cold, but I found an open Datsun to
sleep in at night. When the owner saw me
one morning he brought out a blanket and
apologized for not letting me sleep inside,
but five weeks of sleeping in that car landed
mein theVA hospital with pneumonia."
On a recent evening, Elizabeth sought
shelter in the basement of Chicago's Uptown Baptist Church, where Teddy Bear
often spends her nights, but shedidn't stay
long. "I know the shelter is safer than the
streets or the subway," Elizabeth admits.
"But the smell of dirty bodies is like rotting
flesh, and it will get worse by morning. I
worry about getting lice from the blankets
or sores on my mouth ifsomeonespitsin the
coffee." So out into the snow she goes,
hoping that the Cuban guy who sometimes
lets her stay in his room is home and sober.
"I'm kind of scared of him since he pulled a
knife on me a week ago when he was drinking that crazy rotgut vodka. But at least
he's not the typethat would makea woman
work the streets. How am I going.10 get
married again in this predicament?"
Thebest resource for thestreetwomenof
uptown Chicago is Sarah's Circle, a women's drop-in center open five days a week.
It's not only the coffee and snacks and the
Wednesday-afternoon bingo that draws
them. It's the unintimidating, lived-in atmosphere, the tattered sofas and chairs and
the old copies of House and Garden. There
is a kindness at Sarah's, not only from the
Teddy Bear (left) and her
street friend, Elizabetk:'I
never thouaht It would
hapwn to me*
volunteers but also from other women who
have been through whatever you are going
throughand want tohelp. They throw their
arms around Teddy Bear, tell sympathetic
stories about being beaten by their own
"old menw-and talk tough about wanting
to punch them out. And whereas shelters
provide the bare tssentials of existence, a
place like Sarah's also can permit a homeless woman to reorganize her life and perhaps get on her feet again. A young black
woman called Jane is trying to do thatusingasinkat thecentertowash her clothes
regularly and the comfortable lounge to
study books from thepubliclibrary. Unlike
the library, where you're asked to leave if
you're caught dozing off, Sarah's understands how tired a woman can be after a
wary night at acrowded shelter.
For everyoneon thestreet, lifeisa matter
ofimprovising. After breakfast at the Sally
(SalvationArmy), Elizabeth stops at qcity
garagewherethey let you use thebathroom
and just sit in the warmth for a while. Then
it's on to the US Submarine Shop, where
you can get a large cup of coffee in a Styrofoam cup for 50 cents-a much better deal
than at the coffee shop across the street
where you get a seat at a table, a cup and
saucer, but a lot less coffee. "I don't like to
give themmy patronage," harmmphs Elizabeth like the greatest of grandes dames.
ut then the high-strung, fast-talking
extrovert slows down, revealing a
Aash of the severely depressed woman who
still needs medication and periodic hospitalization. The holidays make h a introspective. "I never thought it would happen
tome," b k t h says. "It'sall my faultI can't seem toget my life together. I'm sort
of the black sheer, of a strict Catholic family. Even if I obuldn't k a nun, like I
wanted, I figured at least I'd be married
with a home. But my family hasn't spoken
to me much since 1gave m) why daughter
up for adoption 10years ago. Really, she's
far better off than I am-living in the suburbs with parents who love her-but my
mother always told me that the worst
thing you can do is give up your own flesh
and blood. I should have been strong
enough to keep my daughter. I should be
rtrong enough to get myself out of this
Teddy Bear,meanwhile, is coming off a
binge and hardly notices the holiday season. She wins a Chnstmas tree in a drawing
at Suah'r Circle, and immediately talks
.bout adling it. She's not d y to accept a
missionary's dfer to sleep off her hangover
at an available apartment. "There's too
much pressure there not to drink," says
Dolores. As for the danger that awaits her
intheatreeta, sbesays, "Theonly thingthey
can do to me is itill me. Everything else
they'vedcmetome. I don't f a l i t anymore."
ifshe went inside before the govern-
ment provided shelterfor ail street people,
she would die.
It seemed like a good idea at the time.
Many state mental hospitals were unspeakably inhumane, and new miracle
drugs could control the psychotic without
straitjackets.So starting in the mid-1950s,
the nation's mental hospitals began releasing inmates in unprecddented numbers.
Liberals applauded the new civil rights
granted to the nondangerous mentally
ill; consmatives were happy to find
r seemingly compnssio~teway to cut
state budgets. Between 1955 and 1982
state mental institutions shrank by more
than threequarters-from 558,922 patients to 125,200.
But there is widespread agreement that
efforts to "deinstitutionalize" mental patients have backfired. While some do fine,
kns of thousands end up homeless-if not
right away, then after a few years of
bouncing among families, institutions and
the street. At the same time, it has become nearly impossibleto get the nondangerous mentally ill admitted to state asylums, or to keep them there long enough
to get a grip on themselves. In California, for instance, the median stay is now
only 16 days.
"If a doctor walked away from an opention for an appendicitis, he would k sued
for malpractice," aays New York attorney
Robert Hayes. 'VI'hertateh walked away
Driftin@undor 8 d l r d
bridge now -coon: Tho
homoleu a n younger
from these patients." H a y s felt so strongly
about it that in 1982 he quit the prominent
New York law firm of Sullivan & Cromwell and founded the W t i o n for the
Homeless, which is suing cities for the
right to shelter and coordinating the work
of 40 groups in states across the country.
Those patients sent back to what the
professionalscall "independent living" are
truly on their own. According to Dr. John
Talbott, presidentclect of the American
Psychiatric Association (APA), fewer
than a quarter of the patients discharged
from state mental institutions remain in
any mental-health program at all. When
they crack up, the lucky ones are taken to
hospital emergency rooms, .where they
routinely wait hours---sometimes tied to
c h a i e f o r a temporary bed. One out of
every five patientsat New York City public
hospitals is homeless.
ollow-up treatment has kenscarce
partly because many psychotic
street people mistakenly believe
they are well, and grow fearful that any
contact with authoritiswill lead to getting
locked up again. Large numbers have serious delusions. One woman wandered Hollywood aeowing passers-by that &hewas
Linda Darnell, r movie star of the 1940s
Arizona and Massachusetts represent the extremes.
iking her designer slacks above her
ankles, Sandy Cowen crouched,
made a face and gnarled her hands in imitation of a man she used to see from the
window of her advertising agency in downtown Phoenix, Ariz. This particular gentleman was a bit odd-a street bum who
carried around a bucket of soapy water and
washed everything in sight, from his feet to
the sidewalks. But Cowen is the brains
behind "Fight Back"-a
Phoenix leaders to wipe out the "unacceptable behavior" of the area's 1,500 street
people-she knew how to handle the nuisance. Police weresummoned, and thebum
was forced to moveon.
The homeless are not welcome in Arizona. Many of them, residents argue, are
outsiders looking for a sunny place to
sponge off the state. The mayor of Tucson
was recently elected to his 13th year in
office on a platform that included a vow to
get "the transients the hell out of town,"
and beefed-up patrols of police officers
prowl the streets looking for suspicious
transient behavior. By contrast, the state
of Massachusetts is in the midst of an
ambitious effort to help the homeless help
themselves. It's more than the difference
between Barry Goldwater and Ted Kennedy; Arizonaisn't allconservative, and Massachusetts isn't all liberal. But the two
attitudes toward the homeless.
"We're tired of it. Tired of feeling guilty
about these people," says Cowen, who designed an ad campaign that features a
sketch of a man sleeping on a bench with a
red line drawn through it (like an international traffic sign). Posted around town,
these signs echo the official view of Phoenix, which in 1981 adopted an Anti-Skid
Row Ordinance that discourages blood
banks, bars, soup kitchens and flophouses.
Since 1981 four missions-including two
sponsored by the Salvation Army-have
closed their doors under pressure. After
one of his assistants had her fingers broken
by a drunken drifter, newly elected Mayor
Terry Goddard, a relative liberal, helped
found a task force dedicated to coping with
the transient problem and protecting Arizona's image as a sunny paradise.
s homelessness worsens across the
Southwest, a game of finger pointing
hasbegun. Skeptics in Phoenix andTucson
believe that Los Angeles, trying to clean up
before the 1984 Summer Olympics, will
soon send its problem across the desert.
Some Arizonans think they should try the
same thing themselves.
Tucson residents are divided, but the
prevailing ittitude seems to be that "Love
thy neighbor" should apply not just to the
needy but to the family down the street
alarmed by thesometimes violent vagrants.
Policescour homeless haunts with German
shepherd dogs, and one church soup kitchen will be sued as a public nuisance. "These
transients are urinating on the sidewalk,
sleeping in doorways and frightening shoppers," says Mayor Lewis Murphy, noting
that crime by the new amvals is up. "The
last thing we want to do is publicly provide
That isone of the first things that Massachusetts wants to do. After regaining the
governorship last year, Michael Dukakis
announced that homelessness was his No. 1
social-service priority. "Homeless" plays
better politically than "poor" as a way
to win approval of state social programs,
and Dukakis, who lost his bid for re-election in 1978 in part because he alienated
liberals, had in recent years growngenuinely alarmed about the growth of the problem. Despite its frigid winters, Massachusetts has roughly the same number of
homeless as Arizona--estimated between
5,000 and 10,000.
75-25 basis with the community groups
that run them. It has also opened a 24-hour
hot line for referrals, assigned more state
caseworkers and changed welfare rules so
that people without permanent addresses
can receive benefits. Over the objections of
real-estate interests, Dukakis rammed
through a tough condominium-conversion
bill that requires that certain tenants get as
much as four years' noticebeforea building
can be converted. In mid-December, the
Massachusetts Legislature approved.Sl96
million for low-income housing, which will
translate into 2,500 new units and 2,000
ne example of how the public-private
cooperation can work is Jessie's
House, a new family shelter located in a big
white house in Northampton. The city,
home of Smith College, has several hundred homeless people-some of them mental patients from a nearby hospital or victims of gentrification downtown. About 20
guests stay at Jessie's House for four to six
weeks under strict house rules. Staff members make a determined-and often successful-effort to find them jobs and housing, and friendly neighbors pack the
shelter's refrigerators and cupboards with
food. A city councilman who opposed the
idea was overruled by his constituents.
"Our philosophy," says Priscilla Braman, director of Jessie's House, "is to put a
lot of energy into people once and do it
right." Arizona's approach, says Tucson's
Rev. Dave Innocenti, is often "a traditional
Western-cowboy mentality-if you can't
pull yourself up by your bootstraps andbea
man, get out." There could hardly beclearerproof oftheold saw-"cold hands, warm
heartn-and vice versa.
JONATHAN ALTERwith JERRY BUCKLEY
in Nonhampton, MARILYNTAYLOR
in Phom~xand SHAWN DOHERTY
Down and out In Tucson:
'H you canY pull yourself up
by your bootstrap. and bo
a man, get O W
who died in 1965. Another rejected food
and water for days because she thought she
was aplant and could soak up nourishment
from the rain. A man with his possessions
in garbage bags told travelers he had seen
the Ayatollah Khomeini in the basement
of a train station. When wealthier people
have mental or drinking problems they
often rely on counseling; the poor have it
harder. Navigating the bymutine mentalhealth bureaucracy, says Talbott, "would
drive even the normal person insane."
But the main reason mental-health care
has left so many homeless is that funding
iidn't follow the patients out of the hospitals and into the community. A 1963 goal
3f starting 2,000 community mentalhealth centers nationwide by 1980 is still
1,283 short. Some community-based care
is actually decreasing. Colorado, for in~tance,has released 1,172 patients since
1981, but the number of halfway houses
has fallen from 60 in 1975 to about 10
today. Even the mentally ill themselves
recognize the irrationality of the situation.
"It's amerry-go-round," says one 48-year,Id schizophrenic in New York. "You go
to the horpital, then they dump you into
thee h t e Inferno shelter8 and then you
go back again. This system doesn't make a
nan go up. It makes him go down."
Some of this results from budget squeezP, but much is the fault of administrators,
egislatore and civil-service unions. When
noncyis available,it often doesn't go to the
wmdcb8 mentally ill. In 1979,43 percent
of the $8.8 billion in total mental-health
expenditures was spent by state hospitals,
and only 17 percent by federal outpatient
clinics serving the homeless. Some state
officialsclaim that hospitals have to keepso
much of the money in order to maintain
specificstaffing ratiosrequired by the Joint
canmission on Accreditation of H
o sr ~- i --.tals. But the JCAH saysthat's untrue.
While homeless psychotics wander the
streets without care, most statecmployed
doctors and staff are back at the nearly
empty asylums. In the last 20 years the
average patient-staff ratio in state mental
hospitals has dropped from 5 to 1 to 1 to 1.
And civil-service unions prefer to keep it
that way. Efforts to cut or transfer maintenance and support staff in favor of more
community effortsareusually straitjacketed. When New York Gov. Mario Cuomo
a n n o d budget cuts for the state mental-health system, for instance, the huge
Creedmoor PsychiatricCenter cut itscommunity outreach staff-and protected hospital workers who maintain a 315-acre
complex that houses one-fifth as many patients as it once did.
A brother and sister on
the streets of Hourton:Many
have hazy baokgroundsand no roots left
of these people are defined as clinically
employable by the government, but in the
real world can't possibly get jobs. Among
those rejected for benefits in 1982, according to community workers, were an incontinent man who wore seven pairs of pants
at once and a woman who thought she was
a Vietnam War orphan.
For the nonmentally ill homeless, welfare isn't always much better. In many
states it won't pay the rent. A New Mexico
family of four is expected to get by on $66 a
month in rent allowance. In Indiana, it's
$100 a month for rent, regardless of family
size. And these states aren't exceptions.
Last year Pennsylvania Gov. Richard
Thornburgh and the state legislature
moved to restrict all able-bodied men to 9C
days of welfare a year. Instead of lessening
dependency, as conservatives hoped, il
simply made many of them homeless and
thus still dependent. William Wachob
chdrmm of the welfare subcommittee
eanwhile, citing past welfare of the Pennsylvania State Legislature
abuses, the Reagan administra- charges that "Thornfare," now being re.
tion has tightened the review vised, is "directly responsible for the in,
process so that Awer people qualify for crease of homeless."
benefits. Since 1980 more than 200,000
have km dropped from the rolls of S u p
The counselinn service in downtow,
plemental Security Income h e , a major Houston is called-ampass and it's run b~
sourceof income for the mentally ill. Many
who helps street people get anchored. The Helpinghomeleu familiesin
approach avoids "quickfixes and rice-bowl Texar: Volunteers must
Christianity. " she says, and attracts 600 a make a leap of faith-and
month. "I listen to them, accept what they sometimes courage
have to say and also ask myself if they 're
trying to rip me oB;" Whitesays ''Some do ors and two foundations now sponsoring a
and I tellthem to leave." Greater numbers $20 million effort to treat the ghastly array
don %-and leave with help: a bus token, an of diseases that afflict the homeless.
apartment lead, aphone numberforajob.
There are success stories of public-private cooperation: last month a Memphis
Coping with homelessness requires pilot project opened 10 HUD-owned
melding public and private efforts in ways houses for under $100,000. Still, roadthat help street people but don't hurt tax- blocks remain. On White House orders, the
payers. After all, most people take what Pentagon has offered 500 locations, mostly
Jane Malone, an activist on behalf of the unoccupiedmilitary-reservecenters,but so
homeless in Philadelphia, calls a "mini- far only a few have been put to use-largely
malist" approach to the problem-+senbecause cities and local groups would have
tially, "not in my neighborhood." That is to pick up most of the tab needed to make
understandable; the homeless do drive the places inhabitable. The Federal Emerdown property values, and it isn't pleasant gency Management Administration has
to find that someone has urinated in your distributed $140 million over two years in
doorway. Some argue that the more that is shelteraid, but admits it's aone-time effort.
done on behalf of the homeless, the more Margaret Heckler, secretary of Health and
comfortable they willbewith their plightHuman Services, says the Reagan adminisand the worse the problem will become.
tration is now studying ways to cut the red
But if government and the community tape, and NEWSWEEK
has learned that
helped worsen the problem, they can work HUD will decide soon whether to subsidize
together to ease it. As GeorgeOrwellwrote sheltersdirectly.
in "Down and Out in Paris and London,"
"the 'serve them damned well right' attiermnent housing is a taller order.
tude that is normally taken toward tramps
One reason it's so expensive for the
is no fairer than it would be toward cripgovernment to build low-income
ples." Sister Gay of Houston, who has units is that government contracts usually
adopted 10 homeless children and tended must pay the so-called prevailing wageto their families, believes that. So docs a whichalmostalwaysmatchesthe top union
consortium of the U.S. Conferen& of May- scale in any given region. Andrew Raube-
son, director of the Burnside Consortium,
which has renovated 450 SRO units for use
by poor people in Portland, Ore., says that
his costs are $6,000 to $9,000 a unit, less
than a fifth the expense of many government projects.
That's a big difference, and some lowincome-housing advocates suggest that
waiving the prevailing wage onlow-income
projects may be the only way to bring the
federal government into a partnership to
build more housing. Doing so would require amending the Davis-Bacon Act, a
sacred cow for most Democrats that even
the Reagan administration has not challenged. More flexible wages might also allow unskilledlaborersto help in the workof
renewing their own neighborhoods. Private tenant organizationsaround thecoun-
try have already begun this. Some, in cities
like San Francisco, have also won agreement that when developers tear down flop
houses, they will help pay for some new
Solutions to the mental-health riddle
are following a similar logic of publicprivate cooperation. Some mental-health
professionals and government officials argue that providing community care is
~rohibitivelve x w i v e . But that assumes
It is done k~ what might k called the
"'pmailing" way--that is, with highly
paid psychiatrists and other union-scale
mental-health professionals. What homeless mental patients need first, their advoC a t S Say, i
s Simply a phce to stay and
some supervision by compassionate peopie. Many private halfway houses now
provide stable environments for former
mental patients for as little as 36,000 per
person a year, compared with about
540,000 in state hospitals. With more
charitable and government funding, these
places could make a major dent in the
number of mentally ill homeless without
sending them back to asylums.
or mental health, as for shelter and
permaaent housing, the answer
oeans to lie in the novernment's
Ktting aside its inclination-to solve the
problems itselfin favor of helping the cornmunity do its natural work. That rquiresa
leap of faith. But it is much the same leap
volunteers take as they ovacome enough
of thek nervousness about America's lost
mula to pitch in and help.
' . all
have the urn. nodmeal, warm clothes,
oomeplace to sIa.pD
In Denver, a takered group of men liner
warehouse ramp, waiting in the snowy dusk
to enter the Salvation Army Survival Shel,
ter. John Destry, 22, a navy stocking ca)
rolled on his head, describes his homeles.
life. "The streets a n dongemus, " he says
"But, vw know, we all do the same thinas
haw-;he same -needhot meal, some
warm clothes, someplace to sleep. "
JONATHAN ALTER slirh ALEXANDER
GREENBERG in Wvhin n, SUSAN AGREST
in PhiLdelpbi& VERPE. SMITH in Atlanu,
GEORGE RAINE Seattle,DARBY JUNKIN
ud butau rrponr
~ r l f t e n ~to
t ykeep warm on a steam Orate durlng a anowfall In -on,
Behind Swelling Ranks of
jobless and broke. Lacking the fixed
address required for welfare, they cannot obtain food stamps or other benefits:
Untouched by the economic recovery,
these are the socalled new poor who
once had homes, jobs and hopes.
"If you're an alcoholic or a drug
abuser, there are beds available
through specialized agencies," notes
Jarrie Tent, director of a shelter in an
Episcopal church in Detroit. "If you're
a victim of spouse abuse, there are designated beds. But if you're just poor,
broke and out of work, it is much harder to find bed space."
Take Tom Pittson, an ahgular 301 year-old former Kentucky coal miner
seated in Lafayette Square across from
the White House. "After two years on
the street, I'm near giving up," he says.
Coatless in 25-degree cold, he was clad
in an old Army surplus sweater, torn
tennis shoes and light cotton trousers
with a long rip down the right leg. His
a half-empty pack of cigarettes.
"After my benefits played out back
ty died in New York City alone last
year. Many more homeless will perish home, I come to Manassas, Va., looking
of pneumonia, tuberculosis or other ill- for work, then here," recalls Pittson.
nesses. For those who manage to sur- "Bad mistake. For a while, I had me a
vive, the blessings of life are debatable. big cardboard box to sleep in beneath a
How does a person sink to this rock- bridge. Another guy, he took it, along
Harsh winds of winter blowing bottom point? Many are drug addicts with my coat. Can't work now because
through streets of the nation's proudest and skid-row alcoholics, beyond any I'm sick a lot. My job now is to get by.
cities are calling fresh attention to a hope of recovery. There is grizzled, 64- It's a sorry way to live."
rapidly worsening social problem-up
year-old Ned, who relates fi familiar
Courtsrdered rebares. Even more
to a half-million Americans living and story while awaiting dinner in San troubling than people like Pittson and
sometimes dying as homeless outcasts. Francisco's St. Anthony Dining Room: Ned is the swelling number of mentalDressed in tatters, scavenging for "I thought I had it all--a wife, a job, ly ill among the homeless. Rescue-misfood and often suffering from severe some kids, a house and a car. Then my sion workers say up to a third who seek
emotional problems, these street peo- wife died, the plant closed down, my help are former mental patients with
ple are becoming an increasingly dis- kids got sassy and they took the house nowhere else to turn.
tressing part of the urban scene.
away. At my age, ain't nobody wants
Thousands of disturbed patients
The destitute are being found in ev- you. I got real discouraged and started have been released by court orders alery sizable city and in even greater drinking. That's what done me in."
lowing mental hospitals to keep only
numbers than a year ago before the
Others are simply down on their luck, those judged a threat to themselves or
economic recovery got rolling.
others. Nationwide, the number in psyIn Chicago and Cleveland, jammed A t o n m t e Nab at a garage In New Vork chiatric wards has been halved since
emergency shelters each night must Clty provides temporary ehelter.
1970. In some states, two thirds of the
turn away dozens of homeless women,
beds have been emptied--and not besome with small children in.tow.
cause patients have been cured.
An estimated 18,000 show up at New
"There's absolutely no doubt people
York's dormitorylike shelters each
are wandering around Denver today
night4ouble last winter's number. A
who, 20 years ago, would have been in
Salvation Army soup kitchen in Salt
an institution," says Dr. Frank Traylor,
Lake City is serving 11,000 free meals a
executive director of Colorado's Demonth, compared with 9,000 a year ago.
partment of Institutions. New York's
The same is true in Miami and Atlanta.
Mayor Edward Koch, whose city has at
The homeless huddle in frigid temleast 40,000 homeless, complains that
peratures on steam grates a block from
many neighborhoods have been turned
the White House, beg for handouts in
into "outdoor psychiatric wards."
Chicago's Loop and wander San fianDr. Rodger Farr of the Los Angeles
cisco's tough Tenderloin district.
County Mental Health Department esNo one knows how many street peotimates that the number of homeless in
ple there are, but even conservative
the city's downtown district doubles to
estimates put the figure at half a milmore than 15,000 in winter, many of
lion. This much seems certain: Dozens
them chronic mental cases. F a n says
will freeze to death this winter. %ensome of these drifters, called "sun
Sick, homeless, hungry and
often mentally ill, they
are growing by the thousands
despite an economic upturn.
1984 US. News 8 World Report, Inc. Reproduced by the Library of Congress,
Congressional Research Service with permission of copyright claimant.
they can do to help such people. "You
can nm a ahelter with love and corn.
passion," says the Rev. C. B. Woodrich,
who assists the homeless in Denver.
"But when you get into mental problems, you're tnlking about medication
and therapy. And you've got to have
money to deal with that."
The burden of providing for the
homeless has fallen most heavily on local governments and charities. The
federal contribution consists mainly of
50 million dollars for health care, surplus food and limited shelter space in
unused federal buildings.
Prodded by courts in some instances,
city officials now are becoming more
food at the Star of Hope Minion In Houston b one ot many nowkes p r o v W by involved. But they, too, are far from
private rgoncles illling r gap ktt by govemnnnt fund cut$.
able to help everyone. Chicago, with as
many as 25,000 homeless people, probirds." are given a one-way bus ticket to
Left on their own, many of the men- vides housing vouchers to fewer than
Southern California as part of a "Crey- tally ill drifters do not last long. Police 4,000 and can sleep only 100 in its lone
hound therapy" practiced by several say women often are raped by street municipal shelter.
communities around the nation.
thugs, and both men and women freDenver budgets $400,000 for the
When hospitals began mass dis- quently are beaten and robbed of their homeless but gives no help to single,
charges, the plan was to support patients possessions. If they do succeed in finding employable people. San Francisco set
with a network of communitycare cen- refuge in an abandoned building, others aside $750,000 for the year, but it was
ters and halfway-house residences. But may drive them out.
gone in five months. New York now
with government budgets slashed at all
In Philadelphia, a fragile 50-yearold spends SO million dollars annually for
levels, there has been little to spend on woman named Ellen, formerly a mental emergency housing and other services.
follow-up care for ex-patients. Most of patient in Buffalo, N.Y., tearfully re"The help they &."
the money available goes for hospital counts being robbed and attacked by generous help has come from private
winos twice in one week. "They took and church groups, whose expenses
treatment of acute cases.
Two other factors compound the everything I had--even my cough run at least 500 million dollars a year.
problem-bitter public resistance to medicine," she says. "Didn't leave me The Salvation Army alone provides
opening group homes in residential ar- nothing." Ellen was one of the lucky more than 44,000 beds.
"Every one of us needs two or three
eas and a shortage of low-rent housing. ones, however, finally finding hot meals
"If you can't hold them in hospitals and and a place to sleep at a church mission. arms to pick up these people and give
'These are very vulnerable people," them the rest of the help they need,"
no space is available in the community," says a District of Columbia official, explains Mendal Kemp of the Mississip says Frances Swartsfager, a volunteer
"you have no alternative. They must pi Health Care Commission. "People in a Houston food-distribution center.
Both private charities and governwho have been institutionalized for
fend for themselves."
mica) is the scene in the Detroit years are very subservient. If you tell ment officials are bracing for the probRescue Mission, where a tall young man them to go sit in the corner, they will. lem of the homeless to get worse.
The practice of quickly releasing
with vacant eyes, a former mental pa- You can do almost anything to them."
tient whose family would not take him
Private 0 o u- ~ are
s limited in what mental patients only now is coming under serious question by
in, explains: 'T;e been
down on my luck for the Homeleu women on r street In &n Frmcl.co. Most dtba do not have health experh, and no
change is likely for years.
past three years. There enough shelters to house the thousands wlth no place to go.
The -steadily shrinking
have been some whackedsupply of cheap housing
out people around here."
will force many more on
Another man, named
the street before t h e
Richard, sits in Houston's
crunch is over.
Star of Hope Mission
And there will always
chuckling to himself and
be people like Paul Jim h g his head from side
minez, a recovering dcoto side. Nearby, a young
holic who, before he hit
man suffering brain damthe skids, often rode past
age from sniffing glue
the Detroit Rescue Mis#tares into space saying
sion in the city's mean
nothtn He disappears peCprs COmdor.
riodic y, only to return a
"I UlCd to thtnk, man, I
week or so later. "We take
never want to end u p
people to t h e hospital
there," says Jiminez, 24.
three times a week, but if
"Well, here 1 am."
they aren't suicidal or homicidal, they're turned
out on the street," says mpervisor B i . Reed.
U.S.NEWS &WORLD REPORT
F e b r u a r y 1984
O 1984 b y t h e A m e r i c a n P s y c h o l o g i c a l A s s o c i a t i o n
Reproduced by the Library of Congress, Congressional Research Service
with permission of copyright claimant.
Runaway children, immigrants, bag
ladies, displaced families, a growing
number of unemployed, alcoholics and
drug abusers and the mentally illthese are the homeless persons who
live on the mean streets of our cities.
Every winter, their plight is dramatized by the media, and every winter,
groups investigate the causes of and
possible solutions to this age-old
Approximately onethird to onehalf
of the homeless are believed to be
mentally ill and on the streets primarily because of a process known as
deinstitutionalization, which was initi-
the care of unprepared community facilities and the development of a policy
of more restrictive admissions require
ments. Almost anything was seen as
being more benevolent than putting
people in state hospitals. And to an extent, this is still the feeling.
The restrictive admiasion policies
and continuing funding and personnel
cutbacks a t state hospitals make it unlikely that many of the deinstitutionalized will be reinstitutionalized. In addition, because of these restrictive
admission policies, there is a fastgrowing population of young, chronically mentally ill persons who have
never been admitted to an institution
and are living on the streets.
The results of the massive depopulation of the state mental hospitals are
only now being realized.In 1955, there
were more than 550,000 patients in
ated more than 20 years ago, when
thousands of patients began to be released from state mental hospitals. At
the time, the idea was a noble one.
Deinstitutionalization was supposed to
bring new hope, freedom and a second
chance to those living behind the walls
of overcrowded mental institutions.
Instead of being cut off from the real
world, they would be placed in the care
of community mental-health centers,
where they could continue their treatment in more humane social settings.
The deinstitutionalization movement
was spurred on by advances in the development of psychotropic drugs
(tranquilizers) that could be used to
treat the more serious cases of mental
illness and by landmark legal decisions. In 1971, deinstitutionalization
changed from policy to law Bs a result
of the Wyatt v, Stickney suit in Alabama, which guaranteed the right to
treatment in the least restrictive setting. Other cases expanded the rights
of patients to community care. The result was hasty release of patients into
state institutions. Today the figure is
roughly 125,000, a reduction of 75 percent. Where did these people go?
Many found places for themselves in
the community, but many others ended up homeless. In Illinois, for instance, more than 30,000 patients have
been deinstitutionalized within the
past 20 years. Many were released into
the care of underfunded and understaffed community facilities that could
not provide the extensive care and follow-up treatment they needed. An
abyss of bureaucratic red tape, holes
in the treatment system and ineffective case management left many of
the mentally ill with little or no continuity of care.
Judi Berry, a senior planning specialist at the New York State Department of Social Services, offers an example of how the system can fail to
meet adequately the needs of the deinstitutionalized. One of the more common types of street person likely to be
found begging on the upper West Side
of New York, she says, can be d e
strangers. Quietly, you gather your
belongings, and forsake this place of
rest to begin another long day as one
of the nation's more than 2,000,000
scribed as an alcoholic schizophrenic
mle. Early in his life, he was diagnosed as schizophrenic and sent to a
state hospital, where Re spent anywhepe between two and 10 years before being discharged. Upon release,
he was given a subway token to the
welfare office, a disability check, if he
was lucky and a, bed in a public shelter. Eventually he dropped out of the
system-perhaps he didn't even make
it to his first psychiatric appointm e n t a n d began drinking on the
street with other outcasts in similar
predicaments. Soon he developed
drinking pattern so close to those of
an alcoholic that when he gets picked
up off the street and taken to the
emergency room of a hospital, the intern can't tell whether he is an alcoholic or a schizophrenic. A human pinball
game follows, with this person being
bounced back and forth between the
psychiatrist and the alcoholic wards,
getting no coordinated service from either. He ends up on city comers,
The presence of numerous mentally
ill persons on the skid rows of the
United States is further testimony to
the failure of the private and community mental-health systems to treat
deinstitutionalized patients successfully, says Rodger Farr, head of Adult
Psychiatric Services in Los Angeles.
Many of these patients end up on skid
row, Farr explains, because of a practice known as "bus therapy." Farr has
documented cases of public institutions releasing patients and giving
them bus fare to another city as their
only form of therapy. Los Angeles,
with its mild climate and a social atmosphere that tolerates their presence, is
a natural magnet for many of these
patients. Once they get off the bus-in
the worst part of town-they lack the
resources and abilities necessary to 1e
cate the existing care facilities. They
end up as denizens of skid row. "These
people," Farr says, "have changed the
homeless population of L.A.'s skid row
over the past 15 years from the alcoholic derelict population we used to
see to a repository of chronically and
seriously mentally ill people. Because
of its allure, California is becoming a
dumping ground for what is a national
The population of skid row may
have changed in the past 15 years, but
that is a result of deinstitutionalization and economic conditions, not be-
An estimated 36,000persons make their homes on the sidewalks of New York.
cause alcoholism is no longer a cause
of homelessness. It is estimated that
alcoholics and drug abusers represent
up to 40 percent of the homeless population. Because of addictions, they cannot get or keep jobs, they cannot afford adequate housing and they
usually can't get organized enough to
take advantage of the services that
In addition to suffering the prob
lems associated with alcohol, drug
abuse and mental illness, many of the
homeless suffer from a wide range of
physical disabilities. A recent study by
Philadelphia psychiitrist A. Anthony
Arce and hie colleagues found that 22
percent of those who sought refuge in
the city's emergency shelters had evidence of physical illness. Their ailments ranged from frostbite to heart
problems to drug withdrawal. And as
if life on the street weren't hopeless
enough, there is also the everpresent
danger of personal violence. In Los
Angeles, Farr says, "the chances of
spending n fourhour period on Fifth
Street, or The Nickel, without being
stabbed or beaten or robbed are almost nil."
A few months ago, the president of
the Philadelphia Committee for the
Homeless, Robert E. Jones, cited additional causes of homelessness in an ar
ticle in the Journal of Ho8pitsl and
Community Psychiatry (Vol. 34, No.
9). He blamed deinstitutionalizationas
the major cause, but he also mentioned, as significant contniutora, economic recession, high unemployment
rates and cutbacks in federal p m
grams. In addition to blaming cutbacks in aid to individuals, he cited the
cutbacks in programs for medical
care, aging studies, alcoholism and
drug abuse, families and children and
employment training. He also cited ur
ban renewal for severely cutting into
the number of available lowcost housing units and for increasing the number of evictions.
For years, the downtowns and inner
cities of our large metropolitan areas
have been the havens of the homeless.
It was in these places that they found
church miesions, shelters, SRO's (singleroom occupancy hotels) and some
sense of community support. However, urban development is changing this
picture. In Chicago, 5,000 lowcost
room have been lost since 1970. In
Phoenix, 27 residence hotels in the inner city have been torn down in the
past 10 years. In downtown Washington, D.C.,housing and services used
by the homeless were lost when a new
convention center and hotels were
The buying up and remodeling of innercity houses and changing them
from inexpensive rooming houses into
singlefamily dwellings and expensive
condos, ia also contributing to
homeles!ness. New York, for instance,
has lost +ouaands of such unita in the
Increased unemployment has also
contributed to the homeless problems
in recent yean. In New York, for instance, the unemployment rate among
young black males is running between
40 and 60 percent. The job situation is
similar and equally serious in most
major cities in the Northeast.
Many of the unemployed, frustrated
with the lack of job opportunities
where they live, migrate from the
Northeast, making the homeless prob
lem worse for Sun-Belt cities. According to anthropologist Louisa Stark of
the St. Vincent De Paul Shelter for the
Homeless, in Phoenix, Arizona, 60 per
cent of those using the shelter have
been homeless for six months or less.
These include many Mexican nationals
who fled a ruined economy and Native
Americans who left their reservations,
where unemployment approaches 60
The employment picture is bleak
for the mentall,, ill. E. Fuller Torrey, a
clinical and research psychiatrist, rays
in his book Swviving Schhphmais
that vocational rehabilitation efforts
in the United Staka have, for the most
part, excluded the mentally handicapped. The major focus of programs
of the Labor and Health and Human
Services departments, he says, hm
been the poorly educated members of
,society, especially minority groups.
Consequently, there is no program especially designed for those &imphrenia who are able to return to the
work force on a t least a parttime basis. This is not the case, however, in
other parts of the world. Sweden and
England have both job opportunities
and housing units for the mentally ill.
This includes sheltered workshops for
long-term, partial employment of psychiatric patients. In the Soviet Union,
employment of schizophrenia in sheltered workshops is "the rule and not
the exception," Torrey says, "and such
workshops work closely with psychiatric hospitals."
"Homelessness probably has been a
way of life for a certain segment of
the human population since before Old
Testament times," says William
Mayer, administrator of the Alcohol,
Drug Abuse and Mental Health Administration (ADAMHA). One of the
reasons that homelessness continues
to be a problem is that our society has
tolerated it. In a round-table discussion sponsored by ADAMHA last
spring, professionals who work with
the homeless cited this tolerance as an
important reason that homelessness
has never been resolved or effectively
dealt with. And when tolerance is lacking, some localities simply try to hide
or get rid of the problem.
Phoenix has been especially inventive in its dealings with the homeless.
In 1982, the city decided to rid itself of
the homeless population because it felt
these people were scaring away tourists and potentially lucrative business
prospects. So, Phoenix began a dispersal policy. The thinking went that if
the city had no facilities, no social-service agencies and no private voluntary
organizations, then the homeless
would all leave-take the next bus to
L.A. or Salt Lake City. Consequently,
is falling fast. Bundled up, you hit the '
AS DNERSE AS THE CAUSES,
PUBLICSECTORSAS WELL AS
THE LEGAL S
M PLA HNG
a lot of anti-transient, or "anti-bum,"
legidation was paseed. For example,
anyone found scavenging through a
full dumpster looking for recyclable
cans or food could be accused of stealing city property.
The city also managed, through zoning, to shut down most of the food p m
grams and shelters for the homeless.
Between January and June 1982, the
city condemned two missions that
were providing shelter and two food
programs. In August of that year, the
Salvation Army shut down its shelter
and food program because of mounting pressure from the city. (It reopened this winter.)
You're standing in line, waiting for
a lunchtime meal at Martha's Table, a
soup kitchen for the needy in Washingtonl D.C.m e line is long, extending two blocks past the storefront c a r
ry-outs and liquor stores. Your feet
are aching from walking all day-the
public bathrooms and soup kitchens
are few and far between. Ww'thg with
you are the city's poor, some sitting
because they are tired' others pressing
together in an attempt to shield each
other from the rain and sleet with b m
ken umbrellas, rags and tattered
coats. You don't feel safe on this
street, where drug traffickingand vie
lence are not uncommon.
Inside, it's warm and the chicken
soup is surprisingly tasty. A w s s
from you is an elderly man who has
been drinking and has problems
spooning his soup. At the table to your
left, an angry young woman is shouting obscenities to no one in particular.
Most of the people, though, are quiet.
With the soup eaten, you're pressed to
go out again' where the temperatue
Solutions t o the problem of
homelessness are likely to be as diverse as the causes, and in the next
few years, all of us are going to become actively involved, whether we
want to or not. The kind of involve
ment could vary anywhere from casting a vote for a specific housing initiative to fighting for or against the
opening of a soup kitchen near where
we live or work. For example, for
years the D.C. government has been
burdened with the homeless residents
of surrounding counties. It is only r e
cently that the states of Maryland and
Virginia have acknowledged that they
have a homeless problem. And only recently have local advocacy groups
pressured those s t a t e s into
Because of the efforts of these
groups, county facilities for the needy
are now being opened-but not without opposition. In Bethesda, Maryland,
argument still rages among the local
merchants and the county government, the Salvation Army and an advocacy group called Threshold AM1 over
a soup kitchen and a shelter for home
less men. Liz Farrell, a clinical social
worker employed by Threshold AMI,
says this type of hoopla is nothing
new. "Part of the problem with opening this kind of kitchen," she says, "is
community acceptance. There is still
the old problem of what is called the
criminal element-thinking all of the
homeless are criminals. Most of the
people coming to eat here," she stresses, "will. be families and local
The merchants of Bethesda have expressed several concerns in their series of meetings with the county. Fore
most on their list is the fear that the
kitchen, along with its group of indigent men, will disrupt business during
the day and create a safety problem at
night. They are also worried that the
kitchen might attract undesirables or
"a bunch of drifting criminals," as one
of the merchants put it. Similar fears
were expressed when a soup kitchen
was opened in affluent Westport, Connecticut. But Ted Hoskins, a minister
of the church that helps run that kitchen, says that since the kitchen opened
last year, crime in the neighborhood
has gone down more than 20 percent.
In Fairfax, Virginia, proposals for
Homeless %now bimls" flock to utim like Miami to e s c a p e h e cold winters of the'~ortheastand Midwest.
shelters or special housing for any disadvantaged group have spawned protats of all sorts from neighboring residents. Many cry that the homeless
would bring property values down.
Others say that they would cause an
increase in crime.
Despite the negative images associated with the homeless problem, their
cause is by no means hopeless. There
are several aggressive groups acting
and focusing on this issue. One of the
most prominent is the Coalition for the
Homeless, whose legal advocate R o b
ert M. Hayes successfully sued New
York City on behalf of the homeless.
The suit forced city officials to provide
emergency shelters for the needy and
to provide dining areas, lockers, toilets
Mitch Snyder, of the Community for
Creative Non-Violence (CCNV), based
in Washington, D.C., is familiar with
this type of litigation. His group has a
suit in the Supreme Court that is set to
be decided upon early this year, Two
yeare ago, to protest President Reagan's domestic program cuts, members of CCNV, along with many of the
District's homeless, set up tents in Lafayette Park, where their large number became a vieible, but silent, p m
test in front of the White House. The
group, after beingeodered out of the
park, claimed violation of its First
Amendment rights and sued, saying
protest by sleeping is permitted and
protected by the Constitution. The
case is to be argued this month or
CCNV is also trying to place an initiative on the November ballot of this
year's D.C. elections. The question
this initiative raises ii whether shelter
should be a legally guaranteed right.
If it does make the November ballot,
and wins, then all of the District's
homeless will be required by law to
have shelter. Snyder hopes this type of
initiative will set a precedent for other
cities, so that no citizen will ever be
On a federal level, Rep. Stewart B.
McKinney, R-Conn., hm introduced
legislation aimed a t correcting the defects of deinstitutionalization. The Me
Kinney bill, offered M an amendment
to the Public Health Servicas Act,
would replace the requirement for
"least restrictive setting" in the standard care for a mental patient to one
of "optimum therapeutic setting." The
bill is specific in stating that a hospital
or other form of institution may be optimum for some patients, while cornmunity living is most desirable for others. The bill also puts responsibility on
the states for insuring that the chronically mentally ill receive appropriate
care, tying that responsibility to eligibility for federal block-grant funds.
The needs of the homeless are many
and varied, but they can be met in effective ways. The participants of last
year's ADAMHA round-table discussions and the Coalition for the Home
less of New York agree that this could
be done with an aggressive outreach
program that moves the homeless off
the streets into emergency facilities,
from there to transitional shelter and
finally into permanent housing.
Outreach involves meeting t h e
homeless on their own ground and
making initial contacts that allow for
the time and care necessary to develop
trusting relationships. These first
PSYCHOLOGY TODAY / FEBRUARY 1984
meetings should offer easy access to
basic needs and should be used to increase gradually the willingness of the
homeless person to take advantage of
food services, dropin facilities and
emergency shelter. The Midtown Outreach Project in New York City is actively involved in finding street people
who frequently avoid treatment and
administering on-thespot medical and
psychiatric therapy. Along with finding those who avoid the available
treatment facilities, the Midtown
project locates people who show signs
of mental illness and those who cannot
fend for themselves without interven,tion by psychiatric professionals. Marsha Martin, director of the project,
says that they also provide information on the nearest shelters and psychiatric centers, and that they will
sometimes even take people to their
the "street pee
are an acute embarrassas ordinary middle-class or
ORGANrnTIONS HAVE B r n
SUCCWFUL LN M O W G SOME
OF THE HOlwlZms OFF
appointments a t clinics.
In 1981, social researchers Ellen
Baxter and Kim Hopper published Private Lives/Public Spaces, about home
less people. The authors described the
Pine Street Inn of Boston, the city's
of the big state "insane asylums"
in favor of "community treatment"-which is one source of the
present problem. (There are clearly
others,) After taking part as officers of the Joint Commission on
Mental Illness and Health, which
laid the basis for the deinstitutionalization that followed, Nick Hobbs
and I drafted the position paper on
The Community and We Community Mental Haalth Ceoter, in which
we placed special emphasis on the
importance of "continuity of concern" for people in trouble and on
"reaching those most in need of
help." In retrospect, "community
treatment" of the deinstitutionalized never dealt adequately with
the problems that were shoved off
on it. Since the excellent report of
President Carter's Commission on
Mental Health came to nought in
the general retrenchment of human
services under President Reagan,
unwanted incompetents have been
nobody's problem-until by sheer
numbers and intrueive visibility
they are making thermelvee every
blue-collar types. I am still uneasy
as I remember how I felt about the
street person, seemingly an alcoholic schizophrenicin his 308, who was
sleeping in the entryway of our u p
per East Side walk-up in Manhattan
last winter--until the other tenants
insisted on a new lock on the outside door. I t is disturbing to have to
step over such a stinking person,
and it is more disturbing to feel utterly baffled about how to help.
Back home in Santa Cruz, I see
many more street people, who are
attracted by a mostly benign climate and by a civic culture that is
very tolerant, for the time being,
but is strained almost to the breaking point by the desire of the conservative business community to
must the unwelcome visitors out of
town. The situation is getting humanly intolerable.
Here is an emerging focus of
public concern where psychology
obviously has no ready, anawere,
but where psychologiets have a
special responsibility all the same.
Psychologists participated in the By M. Breweter Smith, a psychole
movement of deinstitutionaliza- gist st the University of CPlifom's st
tion-cleaning out the back wards Srrota h.
oldest and largest emergency shelter.
for men and women, as a model three
tier shelter program. The inn offers
security, meals, counseling and nursing services to more than 500 men and
women a day.
A program b:a,aed on the threetier
model has been proposed recently in
Phoenix by the Consortium for the
Homeless, a coalition of more than 30
public and private groups.
Each tier is designed to provide a
step toward complete independence
and stabilization of the homeless person. Under Tier I, armories, church
basements and school buildings could
serve as shorbterm (up to 72 hours)
emergency shelters where the basic
needs of homeless people could be met
until they are ready to move to Tier 11.
Tier I1 is transitional shelter, where
more demands are made on residents
and more services provided. The goals
of Tier I1 are independence and normalization of lifestyle. Services would
include job training, the securing of
entitlements (such as welfare or disability payments) and providing links
with clinical services.
Unlike Tier 11, which would allow
people to stay up to six months, Tier
I11 is long-term. The residences would
have lowcost housing, food services
and other services built in as part of
the structure of everyday life.
For example, Rodger Farr's Los Angeles Skid Row Project has been s u e
cessful in taking advantage of existing private community and volunteer
agencies in the area and piggybacking
mental-health treatment programs
onto them. The Salvation Army, like
other agencies in the skid row area,
Farr explains, welcomes the involvement of mental health professionals to
their program. "Our most valuable
service as a mental health department
to these nonprofit groups," he says,
"is to act as consultants, educators
and expediters to the various mentalhealth problems of their clients." The
Salvation Army has an adult rehabilitation center in Los Angeles with 180
beds. They are self-supported by their
satellite Salvation Army thrift stores.
The residents deep, eat and work in a
fowstory building donated by a local
private industry. The repair and rebuilding of various items that have
been donated to the Salvation Army
constitute the bulk of the rehabilita.
tion services. This includes such things
aa electrical and television repair and
The needs of the homeless and indigent vs. the fears of local
residents: Shelters ahd soup kitchens, like this one in Bethesda, Maryland,
remain a source of public controversy.
wood refinishing. Farr believes that
the combined effort. of the public and
private sectors of our society are needed to alleviate this reservoir of human
The not-for-profit sponsorship and
operation of such residences, like the
St. Francis Friends of the Poor Residence in New York, exemplify the humanity of this approach. Similar p r e
grams in other cities have shown that
private and voluntary organizations
can be successful in moving some of
the homeless off the streets, sometimes permanently.
Increased federal funding, however,
will be necessary to further such efforts. With regard to dein$titutionalization, for instance, Charles Kiesler of
Carnegie-Mellon University and his
colleagues recommend in the American Psychologist (Vol. 38, No. 12) that
federal funds be used to improve existing methods of collecting data on men-
tal-health services. Too often, they
say, there are conflicting conclusions
drawn by different groups, making
the quantifying of any data nearly impossible. The report also suggests that
the government be more supportive in
the funding of basic behavioral and
biomedical research in the area of
mental health, and that it assist in the
development of guidelines for a minimally acceptable level of mentalhealth care as a national policy.
There is little doubt that the problem of homelessness will continue to
exist and will be dramatized again
next winter as more people freeze to
death on the streets. If the problem is
ever to be solved, if people are to stop
living and dying on the streets, there
will have to be a reduction in the public's willingness to tolerate the situation and a concerted, coordinated effort, involving the courts, lawmakers
and public and private organizations.
It's night, the northern winds are
snapping hard at your fingers and toes.
It's the k t day of a cold wave, the kind
that killed your buddy, Freddy, last
year. The papers are warning pe t owners to bring theiranimals inside. As you
turn the comer of L and 15th, you are
met by a screaming siren. Looking up
into the windows that icily reflect
swinging yellow andgreen streetlights,
you see the red blur of a speedingambulance. The streets are slick and suddenly vacant. Your feet are aching. Frightened, you pick up the pace. The warm
grids are far away and probably crowded, but you're sure there's a spot for
you somewhere. And so you walk your
endless walk, occasionally wandering
into dark corners, always moving, forever homeless.
Steven Fustero is on the staff of Psychology Today.
P S Y C H O L O G Y T O D A Y
F E B R C ' A R Y 1984
The Emergence of the Homeless as a Public
Mark J. Stern
University of Penn.iylvaniu
Using the model of social problems developed by Herbcn Bluma, this &de examines
the recent public attention directed at homelessness. B w d on this analysis, the
articbplaces the homeless issue in historical perspective, arguing that it is an element
of the recent reemergence of conservative political practices and the traditional style
of American sodai welfare.
During the past century the primary goal of social welfare has been
to provide for the needs of individuals within our society. The provision
of the most basic needs, such as food, shelter, and warmth, has been
seen as the minimum goal of the welfare state. We are shocked when
we realize our failure to provide these needs. Indeed, a popular slogan
of the early 1980s, concerned with the forced choice between 'heating
and eating," gained notoriety precisely *because it exemplified the failure
to provide two things that we believe all persons should have.
Although our failures to provide warmth and food have been much
in the news in the past few years, a third basic need-shelter-has
received the most public attention. During the early 1980s, homelessness
emerged as a significant public problem. It attracted a great amount
of news coverage and became the target of public and private efforts
at the national, state, and local levels. Yet, much confusion exists about
the nature of the problem, who the homeless are, and what can be
done about them.
In this article, I wish to address these questions from an unusual
perspective. Rather than getting to the 'faas" about the homeless, I
want to ask how the 'homeless" have been conceptualized in the public's
mind and what this tells us, not about the homeless, but about ourselves,
our officials, and our society. Thus, rather than holding the homeless
under the microscope of public and professional enquiry, I want to
use the homeless as a means of loqking at ourselves.
Reproduced by the Library of Congress, Congressional Research Service
with permission of copyright claimant.
Social Service Review
First, I will examine the past two years to see how the homeless have
become a public problem at the national level, and as a local issue in
the city of Philadelphia. Second, I will place the homeless in a historical
perspective and speculate about the historical significance of the emergence of this issue. Here I will make the case that the homeless as a
public problem reflect the conservative drift in public policy symbolized
most graphically by the Reagan administration's attack on the poor.
The Anatomy of a Public Problem
The starting point for my examination of the homeless is Herbert
Blumer's seminal essay, 'Social Problems as Collective Behavior."' Blumer's essential point is that 'social problems are fundamentally produas
of a process of collective definition instead of existing independently
as a set of objective social arrangements with an intrinsic makeup."2
Thus, rather than using the common geological metaphor of social
problems-their "discovery" or 'uncovering"-it is more appropriate
to use a construction metaphor: How do we build social problems?
As much as any other element of reality, public problems are socially
This insight has a number of impy-tant implications. Fitst, it suggests
that public problems are selective; not all phenomena become public
problems. (For example, although by objective measures poverty was
more extensive in the 1940s and 1950s, it was not until the 1960s that
we 'discovered" poverty.)' Second, once we agree that a social problem
exists, there is competition over what the natu-e of the problem is.
For example, Joseph Gusfield notes in the Cultwe of Public Problnns
that for most of the postwar period the issve of automobile casualties
was seen as a problem of individual c o m ~ e t e n c eThen,
in the late
1960s, thanks to the efforts of Ralph Nader and his. suppyters, a
competing definition emerged that stressed problems of automobile
design and manufacture as the source of the p r ~ b l e m . ~
Blumer specifies five steps that comprise the career of a social problem:
its emergence (through agitation, Y~iolence,interest groups, o r political
attention); its legitimation (when the explanation of the problem is
agreed upon); the mobilization of forces to attack the problem; the
development of an official "solution"; and the implementation of the
plan. Of these steps, perhaps the most interesting is the legitimation
stage, for it is there that the issue of who "owns" a problem is decided.
Only when a paradigm of the cause of the problem emerges can we
Nobr oa Policy and Pnctice
be sure who has a right to 'know" about the problem, Again, uring
the automobile example during the 19b08, psychologirtr and doctor8
were the expert8 who explained the origins of the 'drunk driver," In
the post-Nader era, however, the ownership of the problem parred
to reporters and other investigators of the unsafe automobile.
A final point: at any time in its career a social problem can be
sidetracked from its course, When this happens, it recedes from public
notice and becomes part of the accepted order of things. Here again,
the example of the War on Poverty comes to mind,
The Homeless as a Public Problem
Emcrgnce.-The homeless slowly emerged as a public problem between 1980 and 1982. A combination of activism, publicity, self-interest,
and timing account for the power with which homelessness burst upon
the public consciousness.
The initial factor in the emergence of the homeless as a public
problem appears to have been the legal action undertaken by attorney
Robert Hays on behalf of vagrants in the Bowery section of New York
City. As early as 1979, the city had agreed to provide more beds for
the homeless on Ward's Island.' Howevq, it was only the consent
decree in the Callahan case signed by the city and the state in August
1981 that brought the issue forcefully to the public conscio~sness.~
The decree committed the city to provide clean and safe shelter for
every homeless man and woman who sought it and set standards
against overcrowding in the shelters.
At the national level, this legal action was supported by direct political
action. During the Democratic Convention in 1980,a coalition formed
by the Community Services Society of New York, Catholic Workers,
and other groups held a vigil at St. Francis of Assisi Church near
Madison Square Garden in New York City. This demonstration was
followed the next year by a veritable publicity blitz as first Ann Marie
Rousseau's Slwpfnng Bag Ladks and then Ellen Baxter and Kim Hopper's
Private Lives, Public Spaces were r e l e a ~ e d The
. ~ Baxter and Hopper
study, a combination of ethnographic observation and advocacy research,
was widely publicized and served to focus public attention on the issue.
In Philadelphia, local businessmen aided in pushing the homeless
forward as a public problem. In November 1981, the Inquirer reported
that businessmen in the area of the city most frequented by homeless
men were complaining that the men on the street were hurting business.
They demanded that the city take action to relieve the problem.J0At
Social Service Review
the same time, other cities, including Washington, D.C., began to pay
attention to the problem.
The culminating event in the emergence of the homeless as a public
problem, however, was the severe winter of 1981-82. As the newspaper
filled with grim stories of the homeless freezing to death, they gained
a kind of "newsworthiness" that made them accessible to the television
Legztzmation and mobilization.-The legitimation of the homeless is
an example of the contestable character of public problems. As I have
noted, the goal of legitimation is to forge a paradigm to explain the
nature of a problem and to suggest its solution. The resolution of this
issue determines who "owns" it. Thus, when there are competing
groups interested in "owning" an issue, as has been the case with the
homeless, there are competing paradigms to explain and legitimate it
as a public problem.
The most successful attempts to legitimate the homeless as an issue
point to the deinstitutionalization of mental patients during the 1970s."
According to this theory, most of the homeless are severely disturbed
individuals who in earlier decades would have been safely warehoused
in state facilities. However, because of deinstitutionalization they have
been dumped on the street, where they maintain a marginal existence.
As with the emergence of the homeless as a problem, this proposed
paradigm had its roots in self-interest, resulting from the overlapping
responsibilities of various levels of government. As early as 1980, for
example, New York City Mayor Edward Koch was resisting state pressure
to open more shelters, while-in turn the governor of New York reacted
angrily to city officials' attempts to link the homeless to the state's
release of psychiatric patients."
The source of this controversy was not simply disinterested social
research, but the division of responsibility between the state and city.
If the homeless were considered a welfare problem, the city had ultimate
responsibility. If they were considered a mental health problem, the
state needed to act. The deinstitutionalization theory was again voiced
repeatedly by the Koch administration, leading to the mayor's call for
legislation to allow the city to involuntarily commit the homeless."
The Callahan case rendered the issue moot by holding both the city
and state equally responsible for providing shelten.
In Philadelphia, a similar use of the deinstitutionalization issue took
place. During the winter of 1982, the city's Department of Public
Welfare attempted to draw a distinction between the "homeless" and
"street people." Department officials claimed that street people were
deinstitutionalized mental patients and should be the responsibility of
the health department, while the homeless were their responsibility."
Interestingly, the recession in the winter of 1982-83 changed the
paradigm of legitimation. More and more news reports and 'experts"
Notes on Policy and Plrctice
linked the homeless explicitly to unemploy~nentand fore~losures.'~
Thus, as the economic situation of the 'normal" population declined,
the homeless were portrayed as more normal.
The official plans ultimately agreed upon to fight the problem exemplified the conservativism that characterized the homeless as a public
problem. Rather than entering into a complex analysis of the multiple
causes of homelessness-housing shortages, gentrification, unemployment, mental problems, and other social and individual problemsalmost all agreed on the most simple answer to the problem: providing
food and shelter. New York City, under its commitments in the Callahan
decision, led the way, and other localities followed.
The official plan had a number of important features. First, there
was a central reliance on traditional voluntary agencies like the Salvation
Army and church groups. The new shelter that opened in New York
City in 1980 was under the authority of the Volunteers of America,
and Mayor Koch was constantly calling on or berating the city's religious
institutions to do their share. In addition, the efforts of the city were
restricted to the provision of food and shelter. In the emergency of
1982, for example, the city of Philadelphia paid Giffre Hospital $22
per day to shelter those homeless who could not be housed in existing
voluntary shelters. By that summer, the city council had passed a bill
to provide annually for shelters."
Although in 1983 the activist groups that had originally drawn attention to the homeless were still calling for more sweeping actions
to get at the root of the problem, the evidence seemed to suggest that
from a social perspective, the problem had been solved. Although the
number of homeless had not diminished, they had become part of the
accepted order of things. Much like the poor of the eighteenth and
nineteenth centuries, the homeless (outcasts, psychotics, and physically
impaired) would be with us for the foreseeable future. The only solution
was palliative: keep them from freezing or starving and keep them
out of fashionable areas where they might provide discomfort for those
who were better off. As former Haverford College President John
Coleman noted while he was 'underground," 'Watching people come
and go at the Volvo tennis tournament at Madison Square Garden,
I sensed how uncomfortable they were at the presence of the homeless.
Easy to love in the abstract, not so easy to [love] face to face."t8
A Public Problem for the Age of Reagan
The emergence of the homeless as a public problem is relatively easy
to document. A far more difficult question is why the homeless struck
Social Service Review
such a responsive chord in our culture in the early 1980s. Although
there was some evidence that the problem was getting worse, the increase in attention was totally out of proportion with the increase in
the phenomenon. I propose that the emergence of the homeless was
an element of the conservative reaction that brought Ronald Reagan
to the presidency and, in Pennsylvania, led to Governor Thornburgh's
proposals for the cutoff of welfare to "ablebodied" recipients.
The conservative nature of welfare policy in the 1980s has been
widely commented on elsewhere.lg In its first two years, the Reagan
administration took steps to reduce the federal government's role in
most of the major welfare programs, including Aid to Families with
Dependent Children, Food Stamps, federal housing and education
programs, and legal services. At the state level, in Pennsylvania, these
reductions were echoed in the governor's proposals to eliminate adult
men from the state's general assistance program.
These developments had a complex impact on our society. On the
one hand, they represent a return to a "uaditional" American approach
to poverty. Yet, at the same time, they go against fifty years of government
action flowing out of the New Deal. Thus, they present those in control
with a delicate issue of legitimation. The response to the homeless
emerged as an issue that suited the situation by allowing the better
off in society to affirm their continued belief in the New Deal tradition,
while reimposing an older vision of the relationship of the poor to
What is the basis for such a proposal? It rests on a historical perspective
of the relationship between the well-off and the poor in America, and
the changes that that relationship underwent in the postwar period.
Traditionally, the relationship of charity was meant to underline the
social position of both parties. The giver was able to confirm his benevolence and the legitimacy of his position, while the poor were
expected to understand their inferiority, the stigma attached to their
position, and the docility and' appreciation they should feel toward
the giver. As Gareth Stedman Jones has noted in his under-read Outcast
London, 'In all known traditional societies, the gift has played a central
Stedman Jones, following Marcel Mauss, associated the gift relationship with three conditions." The gift implies the idea of sacrifice;
it is a symbol of prestige; and it serves as a method of social control.
In Jones's words, 'To give, from whatever motives, generally imposes
an obligation upon the receiver. In order to receive one must behave
in an acceptable manner, if only by expressing gratitude and humiliation .w22
Jones goes on to note that these three conditions imply that the gift
entails a personal relationship. 'If it is deprsonalized, the gift loses
Notes on Policy and Practice
its defining features: the elements of voluntary sacrifice, prestige, subordination, and obligati~n."~~
He claims that much of the motivation
of the British Charity Organization Society in the 1860s and 1870s
was to reestablish this set of relationships that urbanization had 'deformed."
The United States, too, has traditionally used charity as a means of
reinforcing the virtue of the rich and the immorality of the poor. As
Michael Katz has recently noted, part of the "identifiable stylewof
welfare policy and practice in America is the "individual and degraded
image of the
Indeed, the often-used distinction between the
worthy and unworthy poor has had much to do with issues of deference
to authority. The worthy poor-widows, children, the insane, and
disabled-were expected to be grateful for the beneficence of the
welfare ladies, whiie the unworthy-the shiftless vagrants and other
ablebodied recipients-were sly, ungrateful, and mendacious.
These images of the poor and the rich held up through the Great
Depression. Indeed, the reports on the psychological impact of unemployment by Kamarovsky and Bakke suggest that self-blame, not
anger, was a typical response to the great social crisis of the 1 9 3 0 ~ . ~ ~
Yet, the dynamics of the Great Depression did set off forces that led
The spread of welfare in the 1940s and 1950s and the spark of
'community action" of the War on Poverty set off a new posture toward
welfare that was symbolized by the welfare rights movement. Rather
than seeing welfare as a gift, the National welfare Rights Organization
and like-minded groups attempted to cast it as a right or entitlement,
the product of structural, not individual, breakdown.
More important than the NWR? itself during the 1970s was a
perceptible change in the stance of welfare recipients. The use of food
stamps was no longer a stigma. A new, assertive attitude began to
characterize the actions of welfare recipients. As James Patterson noted,
'Despite the hostility of the middle classes to increases in welfare, poor
Americans refused at last to be cowed from applying for aid. Despite
the continuing stigma attached to living on welfare, they stood firm
in their determination to stay on the rolls as long as they were in
need. . . . Compared to the past, when poor people-harassed and
stigmatized by public authorities-were slow to claim their rights, this
was a fundamental change."26
This change in the attitudes of the poor had an immense impact
on the beliefs of nonrecipients. Among conservatives, there was little
need for change, since they had been preaching the moral inferiority
of welfare bums for decades. Among liberals, however, a greater discomfort set in.
Although liberals, like members of the welfare rights movement,
Social Service Review
had been preaching the structural origins of welfare, when the poor
actually came to believe them, they were not happy with the results.
First, the failurc of the programs of the 1960s and 1970s to reduce
poverty made it more difficult than ever to cxpose its 'roots." The web
of causality seemed too dense to penetrate. Furthermore, overlaid with
issues of race, the new attitude of welfare recipients did not include
gratitude or deference to their liberal 'friends." In short, by the end
of the welfare revolution of the 1970s, liberals no longer felt appreckted,
the poor were no longer deferential, and the gift relationship, with
its affirmation of the virtue of the rich, had broken down.
The way in which the issue of the homeless came to public consciousness in the early 1980sbroke with this pattern in three decisive
ways. First, it reestablished a direct relationship between the giver
and receiver. Second, it was based on exacting "proper" behavior
from the recipient. And finally, it simplified the web of causal attribution and strategy formulation that had so frustrated liberals
during the 1970s.
The outstanding feature of the official plan to fight homelessness
was its reestablishment of the bond between giver and recipient. Although the activists, like the Coalition for the Homeless, promoted
the 'entitlement" of the homeless to shelter and worked for government
action to achieve this, the vast majority of action was directed at voluntarism and individual responsibility. Always in the forefront of the
movement to evade governmental responsibility, Mayor Koch called
for New York City's 3,500 houses of worship to take in ten homeless
people each, and then berated synagogues for not doing their part."
Indeed, one notable feature of the homeless problem was the extent
to which churches, lay organizations, and individuals did respond to
the need by carrying out food drives, setting up shelters,and providing
One of the reasons for this response was the comportment of the
recipients. Although much attention was paid to their negative physical
characteristics (bad smell, ulcerated sores), this was contrasted with
their almost saintlike spirits. Docility and gratitude, not anger and
suspicion, were the general images of the homeless. Thus, even for
those who did not consciously advocate it, the reestablishment of a
'properw gift relationship was one element of the popularity of the
Finally, the homeless cut through the tangled web of causality that
was typical of poverty policy in the 1970s. Although advocates attempted
to draw continuities between the homeless and the explanations of
poverty in the 1970s, the massive response of the public simplified
the situation. For example, in my experience, a discussion of whether
a shelter was a degrading form of aid for the homeless could be cut
off with the claim, 'People are hungry and cold. That's all there is to
Notes on Policy and Practice
it." Although true enough, the homeless may have actually functioned
to reduce the willingness of Americans to explore the complexities of
need in the 1980s.
After two decades of guilt and worry, the framing of the homeless
issue served to reestablish the gift relationship of a bygone era. Indeed,
a particular irony emerged as the old "worthy"and "unworthywdistinction
took on a new meaning. As I have noted, in the nineteenth century,
the symbol of the worthy poor was the single mother (assumed to be
widowed), and that of the unworthy poor was the vagrant and tramp.
By the 1970s, the images had been reversed. It w8s the single mother
(assumed not to be married), like those who came to Washington to
denounce President Nixon's Family Assistance Plan ('You can't force
me to work. . . . You better give mi something better than I'm getting
on welfare"), who came to symbolize the unworthy,2' while the docile
and appreciative homeless, like Bernice Martin, who asked Mayor
Koch, "Can I go to the one [shelter] on Lafayette Street?" became the
image of the worthy
The implications of this reversal are important. The distinction between worthiness and unworthiness is often seen as locked in demographic characteristics,while others have argued that it has fluctuated
with the needs of the labor market. The experience of the homeless,
however, suggests that a key element is comportment. Those poor
who are willing to be polite and quiet, grateful and guilty, have a much
better chance to be seen favorably than those who are assertive and
loud, nondeferential and unbowed. The gift relationship, with all of
its complexity, still haunts our welfare system. The American style of
The development of the homeless as a public problem poses a severe
dilemma for advocacy groups, such as the Coalition for the Homeless,
that have been instrumental in drawing attention to the issue. Although
the public prominence the problem has been given will undoubtedly
provide more alternatives for those who wish to avail themselves of
the services, the way the issue has been cast will frustrate the longerterm goal of activists: to use the homeless as an example of the general
inequities of the American social welfare system.
In a sense they share an old radical dilemma. As long as radical
activists clearly enunciated their position, they remained isolated from
the mainstream of American politics. Only in those times when their
concerns converged with those of a wider political sphere-the Socialist
Party's antiwar stand in 1917, the Unemployment Councils in the early
1930s-have radicals broken out of this isolation. In the end, they
have either had to face repression or surrender their issues to those
who had different goals in mind." One hopes that advocates for the
homeless will not face this choice; however, events of the past two
years do not provide much ground for optimism.
Social Service Review
This paper was an outgrowth of a student project that 1 directed at the Lniversity
of Pennsvlvania School of Social Work. 1 would like to thank mv coadvisor on the
project, Dr June Axinn, and the students ~nvolted Ctnth~aArmstrong. Ruth Bronzan.
Catherine Clark, Anne G~bbons,kchard Koch. Sallt Stephens, and S~sterloanne W~ll~ams
I would also like to thank the ~azarus-Goldrnan'~e&rfor the stud; of Social Work
Practice and its director, Dr. Joseph Soffen, for providing research assistance. Michael
Katz and Susan Davis provided cpmments on an earlier draft.
1. Herbert Blumer, 'Social Problems as Collective Behavior," Social Problems 18, no.
3 (Winter 1971): 298-306.
2. Ibid., p. 298.
3. Peter L. Berger and Thomas Luckman, The Social Conrhuction ofRealrfy: A Treatise
in the Sociology of Knowledge (Garden City, N.Y.: Doubleday & Co., 1967).
4. On poverty in the immediate postwar period, see James T. Patterson. Amerzca'c
Struggle agaimt Poverty 1900-1980 (Cambridge, Mass.: Harvard University Press, 1981).
pp. 78-8 1.
5. Joseph R. Gusfield, The Culture ofPublic Problems: Drinking, Drtvzng, and thr Sjmbolrc
Order (Chicago and London: University of Chicago Press, 1981).
6. This leads to an important aside: the limited role of social science in the process
of problem definition. For example, in spite of its prevalence during the 1950%poverty
was practically ignored by social researchers during that decade. Only after popular
writers such as Michael Harrington and Dwight McDonald focused public attention on
it did professional social researchers begin to 'discover" poverty (Patterson, p. 99).
7. New Ymk Times (January 4, 1980).
8. New York Times (August 27, 1981); Kim Hopper et al., One Year Latn: The Homel~ss
Poor in New Ymk City, 1982 (New York: Community Service Society, 1982), pp. 20-23.
9. New York Times (February 15, 1981), (March 21, 1981); A. M. Rousseau, Shopping
Bag Ladies: Homeless Women Speak about Their Lives (New York: Pilgrim Press, 1981);
Ellen Baxter and Kim Hopper, Private LiueslPublic Spacrs: Hom~lessA d u b on thr Stre&
ofNew York Cify (New York: Community Service Society, 1981).
10. Philadelphia Inquirer (November 11, 1981).
11. New Ymk Times (January 27, 1982).
12. N m Yorh Times (November 24r 1983).
13. New Yolk Times (December 30. 1980).
14. New Ymk Times (March 28, 19811, (March 25, 1983).
15. Cynthia Armstrong et al., 'Homeless Adults: A Participant ObSe~ationStudy"
(M.S.W. project, University of Pennsylvania, 1982), pp. 65-66.
16. NCW York Times (December 15, 1982).
17. Armstrong et al., p. 65.
18. John R. Coleman, 'Diary of a Homeless Man," New York (February 21, 1983), p.
19. See, e.g.. Alan Gartner, Colin Greer, and Frank Riessman, eds., What Reagan Is
Doing to Us (New York: Harper & Row, 1982).
(London: Oxford University Press, 1971),
20. Gareth Stedman Jones, Outcast Lon&
21. Marcel Mauss, ThP Gqt: Form and Functionr of Exchange In Archic S O C ~ (Sew
York: W. W. Norton & Co., 1967).
22. Ibid., p. 253.
24. Michael B. Kau, Poverty and Policy in Amm'can H u t q (New York: Academic Press.
1983), pp. 239-40.
25. Frances Fox Piven and Richard Cloward, Poor Peopk's Movements: Why Th? S U C C P P ~
and How They Fail (New York: Pantheon Books, 1977).
26. Patterson, p. 179.
27. NCW York T k s (December 11, 1981), (January 20, 1983).
28. Patterson, p. 195.
29. New York T k s (March 25. 1983).
Notes on Policy m d Practice
30. See Katz, chap. 1, for a discussion of the charity organization movement's view
31. Hopper ct al., pp. 51 -55; Aileen S. Kraditor ( ' h d c a n RadM Historians on
Their Heritage: Part and Prcsenf, no. 56 [August 19723, ,136-53) p m u a provocative
theory of the role of radicals in the American politic!?syswm.
J u l y 1984
The Homelessness Problem
Many of the homeless people wandering the streets ofAmerican
cities and crowding into emergency shelters are mentally ill.
They require adequate housing and appropriare psychiatric care
by Ellen L. Bassuk
ore Americans were homeless
last winter than at any time
since the Great Depression.
Estimates of the size of the vagrant population vary widely. The National Coalition for the Homeless puts the figure
at 2.5 million for 1983, an increase of
500,000 over the preceding year. The
Federal Department of Housing and
Urban Development (HUD) estimates
that only 250,000 to 350,000 are homeless nationwide. Whatever the number
is, everyone agrees it is growing.
Particularly in the past five years government officials and private groups in
cities around the country have responded by opening emergency shelters to
try to meet the immediate needs of the
homeless. Beds in these shelters fill as
soon as they become available, and still
only a fraction of those in need are provided for. Some of the rest seek temporary refuge elsewhere, for example
in hospitals, but most probably fend
for themselves on the streets, huddling
in doorways or over subway ventilation grates. When the weather turns cold,
At night in New York City 18 public
shelters house some of the thousands of
men and women who roam the streets
during the day; 16 of these shelters did
not exist before 1980. Private groups
in New York have also stepped up their
efforts. In ,1982, 10 churches offered a
total of 113 beds to homeless people; by
the end of 1983, 172 churches and synagogues were providing a totai of 650
beds in 60 shelters. In Boston two large
shelters recently doubled their capacity.
Nevertheless, on a snowy night in January, Boston's largest shelter, the Pine
Street Inn, reported a record number of
"guests": the 350 beds were filled, as always, and 267 people crowded onto the
Inn's bare cement floors.
, Who are these people? Unfortunately
there are no reliable national data on the
homeless, even though they have always
been numerous in American cities. Anecdotal evidence suggests that in the
decades before 1970 most of the homeless were unattached, middle-aged, alcoholic men-the denizens of Skid Row.
Since about 1970 the population appears to have been getting progressively younger. Moreover, the sparse literature on the subject and my own experience as a psychiatrist working with
homeless people in Boston leads me to
believe a more important change has
taken place: an increasing n u m b e r 4
would say a large majority-of the
homeless suffer from mental illness,
ranging from schizophrenia to severe
homeless are mentally ill does not in
itself explain why their number is growing or why a particular individual joins
their ranks. Without reliable data it is
difficult to answer the first question, but
several factors may have contributed to
the recent swelling of the homeless population. The most obvious one is the re-
t a time when the accepted solution
to the homelessness problem is to
establish more shelters, this finding has
disturbing implications. Shelters are invaluable: they save lives. The trouble is
that many shelters d o little more, and
the mentally ill need more than just a
meal and protection from the elements.
Those whose disorders are treatable or
at least manageable require appropriate psychiatric care; which they d o not
get at shelters. The chronically disabled
people who will never be able to care
for themselves deserve better than to
spend their lives begging on the streets
and sleeping on army cots in gymnasiums. Shelters have been saddled with
the impossible task of replacing not
only the almshouses of the past but
also the large state mental institutions.
At this task they must inevitably fail,
and thus American society has failed in
its moral responsibility to care for its
The statement that a majority of the
1984 by S c i e n t i f i c American. Inc.
Reproduc.ed by the Library of Congress, Congressional Research Service
with permission of copyright claimant.
HOMELESS PEOPLE sleep in mn armory in
New York City. As the number of homeless
cession. Unemployment reached a peak
of 16.7 percent in November, 1982, its
highest level since the 1930's. Some of
those who lost their jobs and incomes
undoubtedly lost their homes as well.
The effects of unemployment are intensified by another problem: the dearth
of low-cost housing. According to an
analysis of the Federal Government's
Annual Housing Survey by the Low Income Housing Information Service, the
number of renter households with incomes below $3,000 per year dropped
by about 46 percent, from 5.8 to 2.7
million, between 1970 and 1980; at the
same time, however, the number of rental units available to these households
a t 3 0 percent of their income fell by 70
percent, from an estimated 5.1 to about
1.2 million (excluding dwellings for
which no cash rent was paid). As the
"housing gap" widened, the median rent
paid by households in the lowest income bracket rose from $72 a month
in 1970 to $179 a month in 1980.
That works out to 72 percent of an annual income of $3,000 and leaves $71
a month to cover all other household
needs. A family devoting such a large
fraction of its income to rent is in a precarious position: it may easily be dislodged by a drop in its income or by a
further rise in its expenses. Unemployment and the lack of low-cost housing
help to account for the increasing number of homeless families (as opposed to
individuals), which once were rare.
Recent cuts in government benefit
payments may also have thrown some
people onto the streets, although the evidence is inferential. One of the Federal
Government's most controversial measures in this area has been its effort to
reform the Social Security Disability Insurance program, which in 1983 provided monthly benefits to a total of 3.8
million disabled workers and their dependents. T o receive payments a worker must be physically or mentally unable to perform any kind of "substantial
gainful work" for which he is qualified, regardless of whether such work is
available where he lives. Following a report by the General Accounting Office
that as many as 20 percent of the beneficiaries might be ineligible under the law,
the Reagan Administration launched a
"crackdown on ineligibility" in March,
1981. Between 150,000 and 200,000
people lost their benefits before the Administration halted its review of the
beneficiary rolls in April, 1984, amid
charges that truly disabled people, including some who were too mentally
disabled to respond to termination notices, had been stricken from the rolls.
Again, a lack of data makes it impossible to draw definite conclusions. but it
i~ ~ d l oc vda the prst few y a r s govwnmeats and private group
have responded by providing emergency shelter& AMbeugb the food
seems not unreasonable to infer that
the loss of disability benefits reduced
some people to not being able to pay for
more important, however, in its
on the homeless poj-ulation
has been the long-term c h a n g ~in the
national policy for dealing with the
mentally ill. A little more than 20 years
ago state and county mental institutions
began releasing large numbers of patients, many of whom suffered from
severe illnesses. The "deinstitutionalization" movement followed the widespread introduction in the 1950's of psychoactive drugs, which seemed to offer
the possibility of rehabilitating psychotic people within a community setting,
under better living conditions and with
greater respect for their civil rights. It
was also thought the "community mental health" approach would be cheaper
than operating large state hospitals. The
movement was launched in 1963 when
Congress passed a law promising Federal funding for the construction of community mental health centers.
Deinstitutionalization was a well-intentioned and perhaps even enlightened
reform, but it has not proceeded according to the original plan. The first step has
been accomplished: the patient population at state and county mental hospitals
and refuge they offer save lives, most of tbese shelters offer no psychiatric care and thus do not meet the needs of many of tbe homeless.
ANNUAL LESS THAN $3,000
MEDIAN RENT paid by low-income households increased between
1970 and 1980, as did the fraction of income tbey devoted to rent
hallucinations, they have trouble coping with the demands of daily life.
A 42-year-old man, at one time a
talented artist, is an extreme example.
When he was 24, he killed his wife with
a baseball bat because she had been unfaithful to him. At the time he believed
he was Raskolnikoff, the protagonist
in Dostoevski's Crime and Punishment.
The court psychiatrist diagnosed him as
schizophrenic, and he was hospitalized
in an institution for the criminally insane for the next 16 years. Since being
discharged more than two years ago,
he has lived both in shelters and on the
streets; not long before we saw him he
had been arrested for trespassing in a
cemetery, where he was living in a tomb
he had hollowed out. He says he receives messages from spirits who speak
to him through spiders.
The story of an 18-year-old shelter
guest is less striking but no less tragic.
Until he became psychotic he was enrolled in an Ivy League college. He was
hospitalized briefly in a state institution,
where he was given antipsychotic.medication, but when we saw him, he was
receiving no treatment. For a while after
his discharge his mother cared for him;
eventually, however, she became too
depressed to continue. Frightened and
too confused to care for himself, he
now wanders the streets by day, muttering incoherently and responding to
voices he alone hears. At night he goes
to a shelter where the staff are too busy
feeding and clothing people to devote
themselves to individual problems.
Many of the people we interviewedwe estimated 29 percent-were chronic
(colored wedges). The 1980 figures indicate tbat tbe bwsebolds with
higher income generally spend a smaller fraction of it on housing.
alcoholics. One 33-year-old man had
lived on the streets of Boston for 20
years and like many homeless alcoholics
had been in and out of hospitals, detoxification centers and various treatment
programs. In the past year he had made
several suicide attempts, and he had
recently been treated for pulmonary
tuberculosis. (About 45 percent of the
study group reported serious physical
problems, including heart disease and
cancer, in addition to their psychological difficulties.) Finally, about 21 percent suffered from personality disorders
that made it hard for them to form and
maintain relationships or to hold a job.
hronic mental illness, even when it is
severe enough to impair the ability
to function in society, does not by itself
cause homelessness, any more than unemployment does. For the great majority of shelter guests lack of a home
is symptomatic of total disconnection
from supportive people and institutions.
Consider for a moment what would
happen if a crisis were to strike your
life-if you were to lose your job, say,
or contract a serious illness. Most likely you are surrounded by family and
friends, by co-workers and even by professional caretakers at various social
agencies whose help you could call on to
prevent a downward slide You are Insured, both in the literal sense of having
coverage against financial loss and in the
figurative sense of having a reliable support network.
T o talk with homeless people is to be
struck by how alone moat of them are.
The isolation is most severe for the men-
tally ill. Family and friends grow exhausted or lack the ability to help; overburdened social workers may be less responsive; the homeless themselves may
be unwilling or unable to communicate
their needs and to make use of the support available. Some 74 percent of the
shelter residents we interviewed said
they had no family relationships, and
73 percent said they had no friends,
even within the shelter community.
Those who had been hospitalized before
for psychiatric reasons (about one-third
of the group) reported even less social
contact: more than 90 percent of them
had neither friends nor family. About
40 percent of all the guests said they had
no relationship with anyone or with
any social institution; although only 6
percent worked steadily, only 22 percent received any financial assistance.
There is usually no single, simple reason for an individual's becoming homeless; rather, homelessness is often the final stage in a lifelong series of crises and
missed opportunities, the culmination
of a gradual disengagement from supportive relationships and institutions. A
final example illustrates the point. A 45year-old man whom I shall call Johnny
M. has lived on the streets and in the
shelters of Boston for four years. The
youngest of four siblings in a lowermiddle-class family, Johnny spent most
of his adolescent years in an institution
for the mentally retarded. He remembers washing dishes, going to classes
and looking forward to the visits of his
mother and older sister. When he turned
16, he moved back home and spent time
watching television and puttering in the
garden. Ten years later his older sister
died suddenly and Johnny had a "nervous breakdown." He became terrified
of dying, he cried constantly and his
thoughts became confused. Because he
was unable to care for himself, he was
involuntarily ~omrnittedto a state hospital, where he remained for the next
eight years. He became very attached
to a social worker whom he saw twice a
week for therapy.
Although the hospital had become
Johnny's home, he was discharged at
the height of deinstitutionalization into
a single-room-occupancy hotel. His father had died, his mother was in a nursing home and neither his remaining siste; nor his brother could afford to support him. Within six months he had lost
contact with the hospital. Johnny was
forced out of the hotel when it was
converted into condominiums; unable
to find a room he could afford, he
roamed the streets for several months
until an elderly woman and her daughter took him into their rooming house.
When the daughter died unexpectedly
of a stroke, Johnny became depressed,
thought the other residents were trying to harm h i m and grew increasingly
belligerent. His. landlady evicted him.
Without resources or supports and with
an incipient psychosis, he ended up
homeless. Resigned to street life, he now
spends his days walking endlessly, for-
aging in dumpsters. Occasionally he collects bottles, sells his blood for transfusion or takes part in medical experiments to make pocket money, Itching
from lice, wearing tattered clothes and
suffering from cellulitis of one leg, he
feels lucky that he can depend on an
ellening meal at the shelter and that on
most nights he has access to a bed.
helters help to keep Johnny M. and
his companions in misfortune alive.
That is a shelter's function: to provide
food, clothing and a bed. At a typical
shelter guests line up outside until the
doors bpen in the early evening. A security guard checks each person for alcohol, drugs and weapons. New guests are
also checked for lice. At some shelters
volunteers cook hot meals; at others dinner consists of soup, sandwiches and
coffee. Some guests spend the evening
socializing and playing cards, but most
are too weary or too detached and go
directly to sleep. The dormitory is typically a barren auditorium-size room
with rows of cots or beds and one or two
cribs. Sometimes groups of six or more
beds are separated by partitions. Shelter
guests usually have few opportunities to
wash during the day, and so at night the
bathrooms at the shelter are generally
overcrowded. By 10:OO P.M. the lights
are turned out, and the next morning
the guests are awakened early, given
JOHNNY M. (a pseudonym) w u one of the shelter guests intervlewd by the author. He L seen here in line waiting to check into a
coffee and a doughnut and sent out, even
if the temperature is below zero.
The atmosphere in a shelter is sometimes volatile, and occasionally violent
fights erupt that have to be broken up by
the staff or the police. On the other hand,
the anonymity and invisibility fostered
by shelters is comforting to many of the
guests, who spend their days as highly
visible social outcasts. Shelter providers
try to treat their guests with dignity and
respect, asking n o questions and attaching no strings to the .help they offer.
D o they offer enough? In my view
they do not. Shelters would be the appropriate solution if the homeless were
simply the victims of unemployment, or
of disasters such as floods or fires. Although these factors undoubtedly con-.
tribute to the problem, the overriding
fact about the homeless is that most are
mentally disabled and isolated from the
support that might help to reintegrate
them into society. Moreover, many are
chronically, permanently ill and will
never be able to live independently.
Although various innovative model
programs exist, including one sponsored by Sl. Vincent's Hospital in New
York City, shelters as a rule offer only
minimal medical, psychological and
social services. They are generally understaffed and have few personnel specifically trained to care for the severely disabled. Because they are open only
Boston shelter (I@) and waiting for dinner to start at the shelter on
Easter Sunday (right). Treated in an institution for the mentally re-
at night, they cannot offer the continuing support and supervision that many
chrortically ill people need. People
whose condition might improve with
properly supervised treatment (for example the 18-year-old student I mentioned above) do not get it at the shelters. And it hardly needs saying that
shelters are not a humane solution to the
problem of providing a place to live for
those who suffer from permanent mental disabilities.
The precise extent to which mental
illnesses are prevalent among the homeless remains a matter of controversy.
Recent clinical-studies-atshelters in Los
Angeles, New York and Philadelphia
support my contention that a majority
of the homeless suffer from psychiatric
disorders, but other estimates have put
the incidence of mental illness among
shelter populations as low as 20 percent.
All these studies, including our own,
have been largely descriptive and have
been plagued by methodological problems. Differences in results can be attributed to the different theoretical biases of the various investigators, to the
use of different standardized scales as
the basis for psychiatric evaluation and
most of all to the difficulty of obtaining
a representative sample of a constantly
shifting population. In addition, there is
no reason to expect the characteristics
of the homeless population to be con-
stant throughout the country when mentkl health policies and economic conditions vary regionally.
he public debate on .homelessness
would undoubtedly be enlightened
by more rigorous research into the causes of the problem. It can already be said,
however, that at the very least a significant fraction of the people who frequent
shelters have diagnosablemental disturbances. Public servants of all ideologies
have failed .to recognize the imptications of this fact. Many political conservatives seem to believe the Government has little.obligation to care for.the
homeless: this attitude is w r h a ~ sbest
exemplifi'ed by President ~kagan'soften
quoted remark that "the homeless are
homeless, you might say, by choice."
For political liberals the plight of the
homeless serves as ammunition in their
attack on the Administration's economic policies, but the solution they tend
to support is the expansion of emergency shelters: simply putting a temporary
dressing o n what has become a large,
festering.wound in the social body.
There is no mystery about the nature
of a more appropriate solution. Essentially it would call for carrying out the
aborted plans of the 1963 community
.mental health law by providing a spectrum of housing options and related
healthcare and social services for the
1.rldas a cbild, Jobnay M. was h t s commffld to s meMd Lapit.I
w h a k bad s .mom kakdowm. He w n d k b r g e d at tk -1
mentally ill. These would entail living
arrangements with varying degrees of
supervision, from 24-hour care at therapeutic residences for patients with severe psychoses'to more independent living at halfway houses for patients with
less severe disorders. Some patients
would receive counseling and therapy
with the goal of rehabilitating them and
even getting them jobs in the community. The one major change needed in
the community mental health program,
however, is a greater recognition of the
limitations of psychiatry: given the current state of the art many chronically
disturbed people simply cannot be rehabilitated, and the goal in these cases
would be to provide the patient with
comfortahle and friendly asylum.
The community mental health movement failed primarily because the Federal and state governments never allocated .the money needed to fulfill its
promise. American-society is currently
trying to solve the problem cheaply, giving the mentally ill homeless at best
emergency refuge and at worst no refuge at all. The question raised by the
increasing number of homeless people is
a very basic one: Are Americans willing
to consign a broad class of disabled pcople to a life of degradation, or will thcy
make the commitment to give such people the care they need? In a civilized society the answer should be clear.
of d ~ s l i z a l i o m
a d la( Lh room w b a t k boiUiacrmconr w t d bto doahbar H e Lu hd om tbe rbnb for foor y e a n
Taking Aim at Panhandlers
ust billowed in thick, acrid clouds unD
der the viaduct above Alaska Way
when they broke up Dave Deppen's camp.
As Deppen and his pals watched sadly and
police stood by warily, city crews dragged
mattresses, bundles of clothing and boxes of
food to a dump truck. "We lived here out of
necessity," sighed Deppen, stripping laces
from a pair of boots left by one of dozens of
drifters who passed through his compound
on a ledge overlooking Puget Sound. "The
missions are full of people who talk to walls
and don't remember what a shower is for.
We did what we could as honestly as we
could. It's all over now."
Growing up around the original Skid
Road, Seattle has long cast a tolerant eye on
the growing number of poor who sleep under its bridges and beg in its streets. But here
as elsewhere in Reagan's America, tolerance is eroding as the gap between rich and
poor grows. When merchants in Washington, D.C., complained that the homeless
were turning a small park outside the State
Department into an eyesore, the government built sheds over heating grates to keep
derelicts from sleeping on them, In laidback Santa Cruz, Calif., a civic stew is brewing over violence against trolls-indigents
who live under bridges and in parks. Even
sophisticated San Francisco has targeted
punks and drunks who roam Market Street
and hang around Civic Center. The operative approach to urban poverty these days
seems to be out of sight, out of mind.
Coafrontariolland Contempt: In Seattle,
society's failures litter the steep, mile-long
stretch from Pike Place Market to Pioneer
Square, cadging spare change, eating in missions, sleeping under the bridges and via-
- - -
ducts that lace the city. Gentrification is
eating relentlessly into their turf, turning
cheap hotels and warehouses into condominiums and trendy restaurants. And confrontation breeds contempt, on both sides.
After a workout at a -new Pike Place
health club, two young executives turn onto
Lenora Street and run into a sullen line of
people outside a food bank. They retreat
uneasily. "Let's go another way," says one.
"I feel out of place here."
In Market Park, office workers lunch on
croissant sandwiches and white wine while
Tolerance for street
people is eroding in
Reagan's America as
the gap between rich
and poor widens.
red-eyed drifterspassabottle in a paper bag.
At a nearby ice-cream shop, a young couple
buy macadamia-nut ice-cream cones with a
hundred-dollar bill while bums rummage
through street receptacles for aluminum
cans. "There's never been a homogeneous
community here," says Laurie BeckerKiner, who chats with a friend while their
children romp in the sun. "That's always
been one of its attractions. But lately it's
been a problem." Dining recently at a fashionable fish restaurant that adjoins the
park, she was startled by a drunk spreadeagled against the window, his tongue
rased against the nlass. Less-fortunate
diners in the area have been treated to impromptu strip shows by drunks who stand
outside, undulate suggestively, and drop
"If you sit on the south side of the dining
room," says restaurant manager Rick
Boller, "you can see everything from breakdancing and clowns to people urinating and
fighting." One night a man sleeping in the
park was doused with kerosene and set on
fire. One restaurant's art-deco elegance was
shattered when a man who had been
stabbed reeled in the front door and fell
bleeding in front of the pasta chef. "We've
been hounding the police to move these
people," says Boller. "They have no place to
go, but that's not really my concern."
Chmgiq Atdtude: Sitting on a stool in
The Rose and Thistle, shopkeeper Karen
Howe has seen a decade of change in Pioneer Square and takes a different view. "The
area has changed," she says. "They'vealways been here. Now we're here." Philip
Showstead, who runs a county alcoholabuse program, agrees: "When poor people
hassle poor people, no one cares. The attitude is changing because of the people who
frequent these areas." While all poor people
suffer from eroding services and disappearing housing, the most visible of them, the
public drunks, panhandlers and hustlers,
inspire little public sympathy.
Too often, official efforts to help only
make things worse. A local alcohol program provides $300 a month, food stamps
and medical care to almost anyone who
wanders into town, gets loaded and shows
up at a detox center. "It's like being paid to
drink," complains Brad Edstrom, a clerk at
the Union Gospel Mission. Steve Burger,
who runs the mission, longs for the older
bums who shared traditional values even if
they violated them. "The young guys come
in demanding help," says Burger. "They
think they have a constitutional right to be
taken care of." It's a new "me generation"
of indigents. Downwardly mobile and aggressively amoral, the worst of them turn
panhandling into a form of extortion, sell
their bodies to buy lunch, roll the older
drunks and even steal from the missions.
As gentrification increases conflict between urban haves and have-nots, the havenots are bound to lose. "As society becomes
more conservative," says Showstead, "concerns about providing services are given a
back seat to social control." Seattle may
pass apanhandling law, as many cities have,
but it won't go as far as Phoenix, which
adopted a tough anti-skid row ordinance in
1981. Indeed, as the winter rains begin, the
climate will solve some of Seattle's problems. And creative street people will get by.
City crews were still picking up the oddments of his former home as the 26-year-old
Deppen and his pals sunned themselves on a
knoll in Market Park. "We done relocated
already," he grinned. And where will he
spend the night? "1'11 just go stay at my
O 1984 Newsweek, lnc.'~eproducedby the Library of Congress, Congressional Research
Service with permission of copyright claimant.
GERALD C. LUBENOW in Seattle
NEWSWEEK~OCTOBER 29, 1 9 8 4 ~