Ending Homelessness: Conference Emphasizes Solutions

By Rebecca A. Clay

About 20 percent of homeless people spend more than 2 or 3 weeks on the streets, according to the SAMHSA-funded National Resource Center on Homelessness and Mental Illness. Although the lack of affordable housing obviously plays a key role in chronic homelessness, so do mental illness and substance abuse.

Approximately 800 service providers, consumers of mental health and substance abuse treatment services, and policymakers gathered in Washington, DC, in December to learn more about serving this vulnerable population. Hosted by SAMHSA's Center for Mental Health Services (CMHS), the conference was cosponsored by all three SAMHSA Centers, the Health Resources and Services Administration's Bureau of Primary Health Care, the U.S. Department of Veterans Affairs, and several nonprofit organizations. "We Can Do This! Ending Homelessness for People with Mental Illnesses and/or Substance Use Disorders" was the first national training conference of its kind. In addition to tours of local programs, the conference featured workshops on topics such as mental health and substance abuse treatment services, supportive housing, Federal initiatives, and advocacy efforts. A special preconference institute offered participants training in "Homelessness 101: At the Nexus of Mental Illness and Substance Use Disorders."

"For too many years, too many people considered homelessness the result of individuals' character flaws rather than treatable illnesses going untreated," said SAMHSA Administrator Charles G. Curie, M.A., A.C.S.W., in welcoming the participants. "I'm gratified to see the tremendous response to this conference. It tells me that people are really committed to doing something about homelessness."

Sister Mary Scullion

Sister Mary Scullion, M.S.W., of Project HOME in Philadelphia, delivered the keynote address. She noted that the field had made remarkable progress over the last 25 years. For example, CMHS has identified effective strategies for integrating homeless people back into the mainstream. Grassroots activists have built housing, lobbied Congress, and won courtroom battles against discrimination. And homeless people themselves have left the streets and become productive members of society in jobs such as nurses, teachers, administrators, and organizers.

Three key elements remain in the fight against homelessness, said Sister Mary. First, there's an urgent need for affordable housing. Providing services to people with mental illness living on the streets costs just as much as providing them with supportive housing, she said, citing a recent study by Dennis P. Culhane, Ph.D., of the University of Pennsylvania. Providing such housing also has a positive effect on everything from residents' employment prospects to neighborhood safety.

Second, all levels of government need to address the problem of discrimination in health care and housing. Third, the Nation must commit to ending poverty.

"We will never end homelessness unless we really struggle to end its root cause," said Sister Mary. "That is poverty." To achieve these goals, she added, activists will have to expand their coalitions, engage the media, educate policymakers and the public, and combat apathy.

Luncheon speaker Nan Roman, M.S., president of the National Alliance to End Homelessness, said that current approaches to ending homelessness aren't working. She noted that the number of homeless people has actually been increasing along with the amount of money spent on serving them.

In response, the Alliance has developed a plan for ending homelessness within the next decade. The Alliance wants to "close the front door" into the homeless assistance system and stop prisons, hospitals, and other institutions from discharging people into shelters. The Alliance also wants to "open the back door" by getting homeless people the affordable housing and higher incomes they need to get off the streets. In the meantime, the goal is to create 200,000 units of permanent, supportive housing across the Nation—a challenge that will require obtaining more public support, enhancing the capacity of nonprofit and community development organizations, and using incentives to get the private sector involved.

"Ending homelessness is a doable proposition," Ms. Roman said. "We can turn the tide."

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