Latest news with #BenioffHomelessandHousingInitiative
Los Angeles Times
25-07-2025
- Health
- Los Angeles Times
Criminalization or support? President Trump's executive order on homelessness gets mixed reaction
An executive order signed by President Trump purporting to protect Americans from 'endemic vagrancy, disorderly behavior, sudden confrontations, and violent attacks' attributed to homelessness has left local officials and homeless advocates outraged over its harsh tone while also grasping for a hopeful message in its fine print. The order Trump signed Thursday would require federal agencies to reverse precedents or consent decrees that impede U.S. policy 'encouraging civil commitment of individuals with mental illness who pose risks to themselves or the public or are living on the streets and cannot care for themselves.' It ordered those agencies to 'ensure the availability of funds to support encampment removal efforts.' Depending on how that edict is carried out, it could extend a lifeline for Mayor Karen Bass' Inside Safe program, which has eliminated dozens of the city's most notable encampments but faces budget challenges to maintain the hotel and motel beds that allow people to move indoors. Responding to the order Friday, Bass said she was troubled that it called for ending street homelessness and moving people into rehabilitation facilities at the same time as the administration's cuts to Medicaid have affected funding 'streams for facilities for people to stay in, especially people who are disabled.' 'Of course I'm concerned about any punitive measures,' Bass said. 'But first and foremost, if you want to end street homelessness, then you have got to have housing and services for people who are on the street.' Kevin Murray, president and chief executive of the Weingart Center homeless services and housing agency, saw ambiguity in the language. 'I couldn't tell whether he is offering money for people who want to do it his way or taking money away from people who don't do it his way,' Murray said. Others took their cue from the order's provocative tone set in a preamble declaring that the overwhelming majority of the 274,224 people reported living on the street in 2024 'are addicted to drugs, have a mental health condition, or both.' The order contradicted a growing body of research finding that substance use and mental illness, while significant, are not overriding factors in homelessness. 'Nearly two-thirds of homeless individuals report having regularly used hard drugs like methamphetamines, cocaine, or opioids in their lifetimes. An equally large share of homeless individuals reported suffering from mental health conditions.' A February study by the Benioff Homeless and Housing Initiative at UC San Francisco found that only about 37% of more than 3,000 homeless people surveyed in California were using illicit drugs regularly, but just over 65% reported having regularly used at some point in their lives. More than a third said their drug use had decreased after they became homeless and one in five interviewed in depth said they were seeking treatment but couldn't get it. 'As with most executive orders, it doesn't have much effect on its own,' said Steve Berg, chief policy officer for the National Alliance to End Homelessness. 'It tells the federal agencies to do different things. Depending on how the federal agencies do those things, that's what will have the impact.' In concrete terms, the order seeks to divert funding from two pillars of mainstream homelessness practice, 'housing first,' the prioritization of permanent housing over temporary shelter, and 'harm reduction,' the rejection of abstinence as a condition of receiving services and housing. According to the order, grants issued under the Substance Abuse and Mental Health Services Administration should 'not fund programs that fail to achieve adequate outcomes, including so-called 'harm reduction' or 'safe consumption' efforts that only facilitate illegal drug use and its attendant harm.' And the Secretary of Health and Human Services and the Secretary of Housing and Urban Development should, to the extent permitted by law, end support for 'housing first' policies that 'deprioritize accountability and fail to promote treatment, recovery, and self-sufficiency.' To some extent, those themes reflect shifts that have been underway in the state and local response to homelessness. Under pressure from Gov. Gavin Newsom, the California legislature established rules allowing relatives and service providers to refer people to court for treatment and expanded the definition of gravely disabled to include substance use. Locally, Bass' Inside Safe program and the county's counterpart, Pathway Home, have prioritized expanding interim housing to get people off the streets immediately. Trump's order goes farther, though, wading into the controversial issue of how much coercion is justified in eliminating encampments. The Attorney General and the other federal agencies, it said, should take steps to ensure that grants go to states and cities that enforce prohibitions on open illicit drug use, urban camping and loitering and squatting. Homeless advocacy organizations saw those edicts as a push for criminalization of homelessness and mental illness. 'We'll be back to the days of 'One Flew Over the Cuckcoo's Nest,' 'Berg said, referring to the 1962 novel and subsequent movie dramatizing oppressive conditions in mental health institutions. Defending Housing First as a proven strategy that is the most cost-effective way to get people off the street, Berg said the order encourages agencies to use the money in less cost-effective ways. 'What we want to do is reduce homelessness,' he said. 'I'm not sure that is the goal of the Trump administration.' The National Homelessness Law Center said in a statement saying, 'This Executive Order is rooted in outdated, racist myths about homelessness and will undoubtedly make homelessness worse.... Trump's actions will force more people into homelessness, divert taxpayer money away from people in need, and make it harder for local communities to solve homelessness.' Murray, who describes himself as not a fan of Housing First, noted that key policies pressed in the order—civil commitment, encampment removal and substance use treatment—are already gaining prominence in the state and local response to homelessness. 'We all think if it came from Trump it is horrible,' Murray said. 'It is certainly overbearing. It certainly misses some nuances of what real people with mental illness and substance use are like. But we've started down the path of most of this stuff.' His main concern was that the order might be interpreted to apply to Section 8, the primary federal financial tool for getting homeless people into housing. What would happen, he asked, if someone with a voucher refused treatment? 'It might encourage more people to stay on the streets,' he said. 'Getting people into treatment isn't easy.'
Yahoo
27-02-2025
- Health
- Yahoo
Study finds strong link between illegal drug use and homelessness — and unmet need for treatment
Illegal drug use is deeply intertwined with homelessness, both increasing the risk of losing housing and arising or worsening when people find themselves on the streets, a new study has found. But it also found that a large majority of people living on the streets are not drug users. The study, published in the medical journal JAMA by the Benioff Homeless and Housing Initiative at UC San Francisco, gives a complex statistical picture of a topic that has been fraught by conflicting narratives. Against a public perception that drug use is endemic to homeless camps, service providers and advocates see an exaggerated reaction to open drug use on the street that stigmatizes the majority of homeless people who do not use drugs. The Benioff study supports some elements of both viewpoints. Contrary to common perception, only about 37% of homeless people were using illicit drugs regularly, and 25% said they had never used drugs. But drug use is far more prevalent among homeless people than in the general population. Just over 65% reported having regular used at some point in their lives, and 27% had started after becoming homeless. Another twist: 35% said their drug use had decreased after they became homeless. Some were parents worried about losing custody of their children. Others had "just reached that point," said lead author and Benioff director Margot Kushel. That finding highlighted the need for better treatment options, Kushel said. Many told interviewers that had already cut back and would like help to cut back more. "One of the most poignant findings was that 1 in 5 told us they are actively seeking treatment and couldn't get it," Kushel said in an interview. In-depth interviews illustrated their frustration, Kushel said, with respondents saying, "I'm showing up where they tell me to show up, calling where they tell me to call," only to be turned away. Only 7% of those with any lifetime use said they were receiving treatment. "Its hard to get treatment," Kushel said. "It shouldn't be. You shouldn't scrounge to save money to go somewhere and be told you'll be put on a waiting list. That should not happen, but it does." Housing is the solution, Kushel said, but until enough of it is available, there is a need to bring more resources to the street, such as methadone or other medications that treat opioid addiction. Kushel also urged increased access to residential treatment as long as it could lead to housing and that those who relapse in treatment — "very common and part of the natural history of substance use disorders" — would not be returned to homelessness. The report, Illicit Substance Use and Treatment Access Among Adults Experiencing Homelessness, is one of a series of reports based on Benioff's 2023 Statewide Study of People experiencing homelessness. The largest representative sample of homelessness since 1990s, it consisted of 3,200 questionnaires and 365 in-depth interviews. Prior Benioff reports based on the survey have covered intimate partner violence and pathways to homelessness. Unlike the 1990s survey, which included only people using homeless services, Benioff canvassed both shelters and encampments, noting that homeless patterns had changed, with a higher proportion unsheltered, and drug preferences in the general population had shifted from cocaine to methamphetamine and fentanyl. The new report found that methamphetamine was, by far, the most used drug on the street. "People are telling us that it helps them survive," Kushel said. "It keeps them awake and alert. They are using it either because they are traumatized, they have been assaulted, they are afraid or depressed, using it as coping to make it all go away." Only about 10% of respondents said they were regularly using opioids, most mixing them with methamphetamine. But even intermittent use, or unwitting use through contamination, poses a high risk of death. Just under 20% had experienced an overdose in their lifetimes and 10% in their current episode of homelessness. About a quarter reported having naloxone, a medicine that reverses an opioid overdose, but Kushel said it should be in the hands of every opioid user and everyone around them. "What we've heard from a lot of people is, 'I've seen an overdose,'" she said. "You can't often wait for a first responder." Despite the high lifetime use of cocaine, at 58%, only 3% said they were currently using it. "Like a lot of things we talk about in medicine, some things get worse, some things get better, some things stay the same," Kushel said. Sign up for Essential California for news, features and recommendations from the L.A. Times and beyond in your inbox six days a week. This story originally appeared in Los Angeles Times.
Los Angeles Times
27-02-2025
- Health
- Los Angeles Times
Study finds strong link between illegal drug use and homelessness — and unmet need for treatment
Illegal drug use is deeply intertwined with homelessness, both increasing the risk of losing housing and arising or worsening when people find themselves on the streets, a new study has found. But it also found that a large majority of people living on the streets are not drug users. The study, published in the medical journal JAMA by the Benioff Homeless and Housing Initiative at UC San Francisco, gives a complex statistical picture of a topic that has been fraught by conflicting narratives. Against a public perception that drug use is endemic to homeless camps, service providers and advocates see an exaggerated reaction to open drug use on the street that stigmatizes the majority of homeless people who do not use drugs. The Benioff study supports some elements of both viewpoints. Contrary to common perception, only about 37% of homeless people were using illicit drugs regularly, and 25% said they had never used drugs. But drug use is far more prevalent among homeless people than in the general population. Just over 65% reported having regular used at some point in their lives, and 27% had started after becoming homeless. Another twist: 35% said their drug use had decreased after they became homeless. Some were parents worried about losing custody of their children. Others had 'just reached that point,' said lead author and Benioff director Margot Kushel. That finding highlighted the need for better treatment options, Kushel said. Many told interviewers that had already cut back and would like help to cut back more. 'One of the most poignant findings was that 1 in 5 told us they are actively seeking treatment and couldn't get it,' Kushel said in an interview. In-depth interviews illustrated their frustration, Kushel said, with respondents saying, 'I'm showing up where they tell me to show up, calling where they tell me to call,' only to be turned away. Only 7% of those with any lifetime use said they were receiving treatment. 'Its hard to get treatment,' Kushel said. 'It shouldn't be. You shouldn't scrounge to save money to go somewhere and be told you'll be put on a waiting list. That should not happen, but it does.' Housing is the solution, Kushel said, but until enough of it is available, there is a need to bring more resources to the street, such as methadone or other medications that treat opioid addiction. Kushel also urged increased access to residential treatment as long as it could lead to housing and that those who relapse in treatment — 'very common and part of the natural history of substance use disorders' — would not be returned to homelessness. The report, Illicit Substance Use and Treatment Access Among Adults Experiencing Homelessness, is one of a series of reports based on Benioff's 2023 Statewide Study of People experiencing homelessness. The largest representative sample of homelessness since 1990s, it consisted of 3,200 questionnaires and 365 in-depth interviews. Prior Benioff reports based on the survey have covered intimate partner violence and pathways to homelessness. Unlike the 1990s survey, which included only people using homeless services, Benioff canvassed both shelters and encampments, noting that homeless patterns had changed, with a higher proportion unsheltered, and drug preferences in the general population had shifted from cocaine to methamphetamine and fentanyl. The new report found that methamphetamine was, by far, the most used drug on the street. 'People are telling us that it helps them survive,' Kushel said. 'It keeps them awake and alert. They are using it either because they are traumatized, they have been assaulted, they are afraid or depressed, using it as coping to make it all go away.' Only about 10% of respondents said they were regularly using opioids, most mixing them with methamphetamine. But even intermittent use, or unwitting use through contamination, poses a high risk of death. Just under 20% had experienced an overdose in their lifetimes and 10% in their current episode of homelessness. About a quarter reported having naloxone, a medicine that reverses an opioid overdose, but Kushel said it should be in the hands of every opioid user and everyone around them. 'What we've heard from a lot of people is, 'I've seen an overdose,'' she said. 'You can't often wait for a first responder.' Despite the high lifetime use of cocaine, at 58%, only 3% said they were currently using it. 'Like a lot of things we talk about in medicine, some things get worse, some things get better, some things stay the same,' Kushel said.
