Problems with preventing homelessness and substance use disorders

Right opinions matter

The Marysville Globe published an opinion regarding the social epidemic of homelessness and substance use disorder. According to this piece, “A better route would be to stop the problem before it even starts.” It seems quite simple. Find solutions that may work to curtail potential increase in our homeless population. Work toward establishing prevention campaigns to address potential risks associated with active substance use disorder. However, there are certain problems with the ideology of implementing ways to work toward prevention of homelessness and active substance use disorders. Right opinions matter when it comes to public policy associated with supportive campaigns and resources to help prevent rather than work with those already suffering.

Let’s set the record straight

When it comes to those helping individuals experiencing homelessness, who may have diagnosed or undiagnosed mental health related issues, and those suffering active substance use disorders; the Marysville Globe observes:

Places like Marysville, Arlington and Snohomish County are doing a great job dealing with the homeless and opioid epidemic through their embedded social worker programs.

That’s when a social worker goes out with police into the woods and other places homeless people congregate. They talk to them about getting help through various programs. Homeless people can get clean and sober, housing and even jobs.

That is a wonderful program, and there are other programs nationwide – both public and private – that help addicts and homeless.

Metropolitan cities are doing things different, and more proactively, in relation to helping those who are homeless and suffering. Grace Guarnieri published an article on Jan. 21, 2018 for Newsweek regarding how one Texas city pays its homeless to help clean and maintain the streets.

Regardless of these social service outreach programs, the Marysville Globe Opinion piece addresses the lack of educational support for prevention:

However, there has to be a better way. As is often the case nowadays, society is focused on trying to help those in trouble. A better route would be to stop the problem before it even starts. That takes education, at a young age and continuing throughout school.

The Op-Ed article goes into discussing the Drug Abuse Resistance Education that was prominent in all schools nationwide. I grew up with the generation of D.A.R.E T-shirts, bumper stickers and slogans. Not only was this program prominent, most schools had Students Against Drunk Driving. I was not only a member, I served on the S.A.D.D. committee. All of these programs were targeting prevention and awareness to students about the issues related to substance use. Unfortunately, there were no prevention curriculum associated with preventing potential generations of young people from becoming homeless.

Setting the record straight, the Op-Ed article never focused on ways to curtail and implement public policy when it comes to homelessness. Instead, the article appears to mainly focus on addressing prevention of drug use and abuse within the local community by adopting prevention programs and curriculum.

Both social issues deserve appropriate attention and better policy making decisions. Let’s start with addressing ways to prevent homelessness in the first place.

Lack of funding, resources, and discrimination to prevent homelessness

According to the National Alliance to End Homelessness a new 2019 Report shows that Washington State has experienced approximately 22,304 individuals experiencing homelessness on any given night. The report goes on to say that for every 10,000 people in any given general population state wide, are 30 homeless people. In Everett/Snohomish County alone, 858 – or, 10.7 per 10,000 people of the general population – experience homelessness on any given night.

Any individual is at risk for potential homelessness. All it takes is a medical/health crisis, financial crisis, or other types of stressors where an individual, or individual families, may experience homelessness. This is exacerbated by the higher rates of housing, and rental costs to move. For instance, if an individual loses their employment because of downsizing, or any other reasons (whether it is at fault or not), that individual is at a high risk to be evicted.

Imagine losing your main source of income. Imagine lack of financial support to maintain present housing cost. Let us say you are renting an apartment and end up being evicted from that apartment. Despite your best efforts in seeking stable and gainful employment, you are now homeless. Not only are you homeless, you are now having to carry the eviction on your financial record.

Are there programs out there to help people facing evictions? Actually, there is not. Working with individuals who are in treatment for substance use disorder, facing evictions, calling 211 does not connect them with a housing navigator through Volunteers of America. This is because of the policy that:

An individual must actually be homeless. Either living in the bushes, in their car, or other places not designated for human habitations.

It is only when the individual spends one night homeless are they able to access housing navigator. Even then, depending on the individuals situation, depends on whether or not they are appropriate for Rapid re-housing. For instance, a single mother with a young child has a greater chance of utilizing rapid housing resources than a single man with medical issues. This latter goes into the nature and conversation of who has the greater need and more specific: addressing underlying discrimination through housing resources to address homelessness.

Not only is there apparent discrimination in resources designated to assist individuals who are facing potential homelessness. There is underlying discrimination perpetuated by society toward homeless individuals:

The homeless are a vulnerable population in many respects. Those experiencing homelessness not only experience personal and economic hardship they also frequently face discrimination and exclusion because of their housing status. Although past research has shown that identifying with multiple groups can buffer against the negative consequences of discrimination on well-being, it remains to be seen whether such strategies protect well-being of people who are homeless. We investigate this issue in a longitudinal study of 119 individuals who were homeless. The results showed that perceived group-based discrimination at T1 was associated with fewer group memberships, and lower subsequent well-being at T2. There was no relationship between personal discrimination at T1 on multiple group memberships at T2. The findings suggest that the experience of group-based discrimination may hinder connecting with groups in the broader social world — groups that could potentially protect the individual against the negative impact of homelessness and discrimination.

Therefore, to work toward preventive strategies that may help individuals sustain housing is paramount to decreasing homelessness. In addition, the National Alliance to End Homelessness recognizes that creating a Coordinated Care Strategy is proven instrumental in reconnecting individuals through rapid rehousing programs. This requires collective and collaborative work through citizenship and business owner participation. Adequate funding, increase access to affordable housing, assistance with rental deposits and move in costs, employment resources and job coaching, and connecting family’s and individuals to available mental health and supportive case management social services. All this regardless of race, ethnicity, sexual identity, religious preference, or political affiliation.

Preventing substance use disorder

There appears a sense of detachment in the Op-Ed article of the Marysville Globe. I say this because substance use disorder is a more complex issue and social epidemic where simple solutions of preventive strategies are not going to be helpful. No matter how well intention they are. This is based on the following factors associated with the nature of how substance use disorder is developed:

Complex contributing factors associated with active substance use disorder

Some of the most prominent contributing risk factors are associated with development of adolescent substance use disorder. This also corresponds with potential mental health/trauma related issues that adolescents may carry into adulthood:

  • Abuse, including childhood mistreatment and sexual abuse.
  • Social problems, including dysfunctional peer relationships.
  • Individual variables, including genetics and the presence of mental health issues.
  • Family problems, including divorce and parental substance use.

Addressing these complex and contributing risk factors require more than just simple educational programs and curriculum. It involves developing and implementing comprehensive case management to address extensive bullying (in person and online). Working with those who are developing social problems and are feeling isolated from any family and peer support and connection. Understanding how genetics play a role in potential risk factors. Active substance use in the home and it’s impact on adolescence emotional and spiritual growth.

This latter part address parental permissiveness of allowing their kids to experiment with alcohol and marijuana use. As well and good such intentions are: parents who are permissive in allowing their kids to try alcohol or marijuana is like giving them a loaded gun without any understanding of its harmful effects.

Finally, family stress of financial issues, relational conflicts, divorce, and other issues have significant impact on the well-being and health of a child. Working to address these issues will need to be implemented in any prevention and educational program.

What is the right solution to prevent homelessness and active substance use disorder?

Unfortunately, with all the best programs, education, support, and comprehensive case management – homelessness will continue to be a social issue and epidemic. Active substance use disorder is going to be problematic and extensive in our communities.

With that said, the most prominent solution is both – prevention and proactive social services. Prevention to help educate and work to establish core strategies to address risk factors associated with homelessness and substance use. And, more proactive funding campaigns to support active social services, bring together coordinated community care services to connect individuals with housing resources, employment services, and actively promote better treatment assistance for mental health services and substance use disorder.

Homelessness and Substance use disorder is not just an individual issue and problem. It is a family and community issue as it inevitably impacts all people.

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