It took seven years for Abigail Judge to see what success looked like for one Boston homeless woman. If Judge was going to help her, trust had to come first. She gets better, stops, gets re-engaged with the trafficker and pulled back into the lifestyle. A December report by the U. Department of Housing and Urban Development said , Americans experienced homelessness, tallied on a single night in January last year. That figure was the highest since HUD began reporting on the issue to Congress in Scholars, healthcare workers, and homeless advocates agree that two major contributing factors are poverty and a lack of affordable housing, both stubbornly intractable societal challenges.
But they add that hard-to-treat psychiatric issues and substance-use disorders also often underlie chronic homelessness. It requires an interdisciplinary effort for success. Katherine Koh, an assistant professor of psychiatry at HMS and psychiatrist at MGH on the street team for Boston Health Care for the Homeless Program, traced the rise of homelessness in recent decades to a combination of factors, including funding cuts for community-based care, affordable housing, and social services in the s as well as deinstitutionalization of mental hospitals.
There are a number of countries with more robust social services but similar prevalence of mental illness, for example, where homelessness rates are significantly lower. We do not have to accept current rates of homelessness as the way it has to be.
Success stories exist and illustrate that strong leadership, multidisciplinary collaboration, and adequate resources can significantly reduce the problem. Prevention, meanwhile, in the form of interventions focused on transition periods like military discharge, aging out of foster care, and release from prison, has the potential to vastly reduce the numbers of the newly homeless. Experts say that means interventions have to be multidisciplinary yet focused on the problem; funding for research has to rise; and education of the next generation of leaders on the issue must improve.
We need increased investment in public health services, in the public health workforce, such that, for people who are unhoused, are unsheltered, who are struggling with substance use, we have a meaningful answer for them. A recent study of 60, homeless people in Boston recorded 7, deaths over the year study period.
