Sunday, February 07, 2010

Homelessness Doesn't Have to Be a Death Sentence by Noah Jennings

Homelessness Doesn't Have to Be a Death Sentence
by Noah Jennings

categories: Health, Innovation, Stories From The Streets

Published February 02, 2010 @ 04:24PM PT

As I write this post, I spot a client across the street who will likely die soon. All the signs point to this possibility: the substance abuse issues, an absent network of support, a fear of shelters and closed spaces because of trauma, being HIV positive, the cold winter -- the list goes on. All this fits with what we know about homelessness: for many people, it's fatal.

If that's not shocking, please read it again: when you see the chronically homeless, you're very likely looking at someone who's dying. That's not melodrama. It's fact.

Because of this, I was positively thrilled to read about new efforts in Hartford, Connecticut. There, as in an increasing number of cities, outreach workers have made use of the Vulnerability Index, a method of strengthening support for the homeless by targeting those who need help immediately.

What's happening in Hartford is inspiring. There, armed with questionnaires and a willingness to make real contact with their clients, outreach workers set out to find homeless people and ask about health history, resources, times homeless and so on. All of this is done with an eye toward determining how dangerous it is for each individual to be on the streets. This evidenced-based approach can influence the number of nights a client is offered at a given shelter, or may even result in the homeless person securing housing more quickly.

Those utilizing the Index have discovered that many of their homeless are without housing "comma-but." In other words, there are resources available to them (comma but) they don't know about them. Some of the examples might include a veteran who only needs transportation to the Veterans Affairs office to complete that final interview, or a disabled woman who, with the right advocacy, could get her benefits and a housing voucher more quickly. Imagine it: more homeless could get housed if we put resources into finding out what precisely they need to stay alive.

And that's what's revolutionary about the Vulnerability Index. By placing homelessness within the context of public health, it makes the need to strengthen communication with street communities one of dire consequence.

If you're surprised this isn't already implemented everywhere, I share your disbelief. The truth is that much of what we do for the homeless isn't based on evidence or direct feedback from clients. It's best guesses all around. That plus the lack of awareness among the general population that homelessness is in large part a public health issue means that the people who need help most are the people most often left behind. But if we're to believe the statistics, use of the Vulnerability Index is a reform we can't afford to ignore. One study notes that the average age of death for those without shelter is just 48.

What this means is that if you're homeless for too long in America, you can expect to die about 30 years before your time. Whether that remains a reality is up to us.

If you're interested in introducing the Vulnerability Index to your community, please check out the resources at Common Ground here: