Changing the paradigm of family homelessness

ABSTRACT

Policymakers have used the same basic paradigms year after year with minimal success in preventing family homelessness. This policy brief promotes the view that child and family homelessness can overwhelmingly be prevented but only if a different paradigm is employed. The new paradigm would focus on the integration of public health, human rights, human dignity, and trauma prevention.

KEYWORDS:

• Family homelessness
• paradigm
• policy
• human rights
• dignity
• trauma

Introduction

The way the United States is dealing with family homelessness isn’t working (Biello 2016). Despite efforts and millions of dollars, policymakers, government leaders, and organizational administrators keep trying to tweak current programs to be more effective, rather than accepting the fact that the existing paradigm simply does not and will not prevent family homelessness or ensure that it is a one-time experience.

How we think about family homelessness and poor people is at the crux of the issue. Underlying assumptions are shaped by, and in turn shape, the response to social policies such as family homelessness. Many policymakers promote solutions without considering why they are advocating for a certain position instead of researching and selecting better alternatives that exist (Erwin 2019). Shifting to people-first language (“people who are homeless” rather than “homeless people”) takes our heads and hearts to a different place. We then see individuals with faces, names, personal histories, and stories, who both struggle and have possibility. Homelessness is totally preventable. If we don’t change how we look at it and how we are treating those who suffer, more suffering is predictable and inevitable. We are all being hurt by the way family homelessness is currently being addressed. It’s time to change this trajectory.

The definitional dilemma

Part of the problem of finding the right paradigm for family homelessness is the lack of a systematic, coherent, universal definition of homelessness (Vissing, Hudson, and Nilan 2020). Definitions vary widely; with the main two coming from the U.S. Department of Housing and Urban Development (U.S. Department of Housing and Urban Development 2019; National Alliance to End Homelessness 2012), and the U.S. Department of Education. (National Center for Homeless Education 2020a, 2020b). They are not the same. HUD’s definition focuses on chronically mentally ill and substance-abusing adults, whereas the Department of Education’s definition, derived from the McKinney-Vento Act, has a more fluid understanding of housing situations that are likely to include children and families.

Definitions are important because they influence how homelessness is measured in research studies as well as how — or whether — programs are funded. For instance, HUD (2019) takes a research approach using local Point-In-Time (PIT) counts obtained annually on one night in January, whereas the Department of Education uses numbers based on school homeless liaisons’ identification of students experiencing homelessness throughout the school year. HUD’s model is designed to focus on visibly homeless adults living on the street and takes a census only of people staying in shelters, residing in transitional housing, or sleeping rough on the streets. The organization thus fails to identify most homeless children and families, who are likely to be doubled-up with others or hunkered-down in cars or nontraditional spaces where they can keep their children warm and safe. The result is that the federal counts of homeless children and families vary widely. For instance, HUD’s 2019 Annual Homeless Assessment Report to Congress counted 53,692 homeless family households, while the Department of Education (DOE) counted 1,508,265 homeless students in School Year (SY) 2017–2018 (HUD 2019; National Center for Homeless Education 2020b; Vissing, Hudson, and Nilan 2020). Curiously, because of differing methods of tallying, HUD’s count of homeless children went down from 2016 to 2019, while the DOE’s went up. As the Bassuk Center (2018) observes in a letter to the Boston Globe, HUD’s methodology doesn’t account for hundreds of thousands of children or their parents who have become invisible to the system. The McKinney-Vento figures include only children old enough to attend school, so families who are experiencing homelessness according to the DOE’s definition but not according to HUD’s definition and whose oldest children are infants or toddlers will not be captured by either count. Furthermore, the HUD count does not detail age bands of minors under 18, making it difficult to assess the number of children nationwide who are experiencing homelessness at the youngest ages (Fernandes 2019). Some localities, like New York City, for example, do group children into different age brackets, such as 0­–5, 6–13, and 14–17 (New York City Department of Homeless Services 2019), though even greater exactitude is warranted given the particular vulnerabilities of infants and children under three years of age. It is difficult to know how to best help families experiencing homelessness if we have only a tenuous grasp on their number and composition.

Homelessness paradigms

Most traditional paradigms of family homelessness are reactive rather than proactive. They are treatment-oriented rather than prevention-focused. They assume a causal sequence that identifies personal problems as the cause of homelessness, rather than reversing the causal sequence to see how homelessness creates personal problems. But, as shown in Figure 1, there are many social, economic, psychological, familial, situational, and support factors that intertwine in a complicated multivariate analysis format to create and perpetuate homelessness. To focus on a limited few, such as affordable housing or minimum wage salaries, rather than an interactive, systemic model, dooms programs to fail (Beck and Twiss 2018). Many policies require that government or the private sector wait to provide assistance to people until after they have fallen into homelessness. (Blumberg 2019; Booker 2018; Carroll 1991; Cohen 2015; Da Costa Nunez 2017; Delaney 2019; Desmond 2017; Edelman 2017; Ehrenfreund 2017; Eskes 2017; Filipovic 2018; Finn, Muyeba, and Brigham 2018; Fontenot, Semega, and Kollar 2018; Gans 2012; Gustafson 2009; McLeod 2018; Morris 2008; Rae 2018; Reich 2010; Robb 2009; Roosevelt Institute 2011; Rosenburg 2013; Ryan 1971).

Figure 1. Factors influencing creation of homelessness.

A public health framework is more proactive, data-driven, and prevention-focused (Centers for Disease Control 2020). A public health model would be more personally effective and less problematic socially if the conditions underlying the journey into homelessness were addressed much earlier (Duffield 2016). Prevention is always less costly and more wellness-promoting when done early. Treatment and rehabilitation are always more costly, challenging, time-consuming, and less effective than prevention (O'Connell, Boat, and Warner 2009).

The book Changing the Paradigm of Homelessness (Vissing, Hudson, and Nilan 2020) argues that a Human Dignity Paradigm should supersede commonly used paradigms, shown in Figure 2, that are currently guiding family homelessness policy in most U.S. localities. Traditionally used approaches to helping families who are homeless often have policy directives that contradict each other and inflict a sort of bureaucratic trauma on families who try to navigate the complex, convoluted “assistance” systems. Policymakers keep tweaking existing program components, thinking that small modifications will result in bigger, better outcomes. This is unlikely. These paradigms are primarily transactional in nature and do not take a holistic view of how to support and empower families experiencing homelessness. The Human Dignity Paradigm does.

Figure 2. Homelessness paradigms. Originally appeared in Changing the Paradigm of Homelessness (2019) by Yvonne Vissing, Christopher G. Hudson, and Diane Nilan (Routledge), Figure 6.1: “A Visual Diagram of the Paradigms and Sub-components That Will Be Provided in the Remainder of Part II.” Reproduced with permission of The Licensor through PLSclear.

Human dignity paradigm

A systematic approach to the conditions contributing to poverty and homelessness requires not just doing things differently, but thinking about things differently. We recommend starting with a paradigm that focuses on ensuring that every individual’s human rights are addressed. Developing policies that honor each individual’s human dignity and human rights will help them to rise to their potential. This shift will be a challenge for those who view poor people according to the drift theory, assuming they sink to the bottom of the stratification ladder because they are defective (Bloom 2019; Milligan 2019). It is essential to dismantle the view that homelessness and poverty are intergenerational; they do not have to be. Homelessness is a product of social construction, and it is particularly detrimental to children.

All children are born with potential to change the world. Labeling children as lesser than others merely because they are born to parents who have the misfortune to be poor can send them into a downward life trajectory starting when they are very young. A public health, trauma-prevention approach can mitigate the long-term impacts of family and child homelessness. Scientists and medical experts have collected data that support the long-term benefits of a comprehensive child wellbeing model. Preventing trauma — of which poverty and homelessness are but two examples — will have huge payoffs in the long run for both individuals and society.

The Adverse Childhood Experiences (ACES) model illustrates how housing distress among children can pose lifelong preventable challenges for their physical, social, emotional, cognitive, educational, and economic wellbeing into adulthood (Felitti et al. 1998). Trauma is regarded as both a cause and a consequence of homelessness. As shown in Figure 3, trauma exposure can have long-term impact on people’s physical and mental health (Dickrell 2016; Harvard Center for the Developing Child 2020; Muller 2013).

Figure 3. Adverse childhood experiences. Source: Materials developed by CDC

Note: Use of this graphic was free and done with the consent of the CDC. It does not constitute its endorsement or recommendation by the U.S. Government, Department of Health and Human Services, or Centers for Disease Control and Prevention.

A public heath model helps re-conceptualize the benefits of providing primary, secondary, and tertiary homelessness prevention strategies. Primary prevention refers to preventing homelessness in the first place. Primary prevention is the cheapest, most effective strategy to ameliorate major societal problems, from obesity to substance abuse to homelessness. It means making sure we have affordable, available, accessible housing for everyone. It means adequate wages. It means having good physical and mental health care, education, childcare, transportation, and access to supportive services — items identified in Figure 1. Secondary prevention involves shelters, safe spaces in which to reset and figure out what interventions need to be put in place to keep people from remaining in housing distress. Another example of secondary prevention is the McKinney-Vento requirement to provide transportation for students to travel between their school of origin and shelter, even if the shelter is zoned for a different school or district. Tertiary prevention focuses on rehabilitation; for instance, if frequent moves have prevented children from mastering required, fundamental schoolwork, providing remedial education or tutoring is essential for their academic success.

It is possible to prevent trauma in the first place or reduce its impact when it occurs if we develop public health and human dignity programs that protect human rights. Research indicates that early exposure to trauma can contribute to the development of substance abuse, mental illness, diabetes, heart problems, and other diseases (Brasher 2020; Brown, Duffield, and Owens 2018; Culhane, Metraux, and Byrne 2011). From a cost-benefit analysis at both the macro and micro level, preventing trauma can yield positive results.

Consider the following example of how using a public health, trauma-prevention paradigm can shape positive realities for children. One day Martha and her two children, Tanya, 4, and Andrew, 3, became homeless the way so many families do — following a spate of physical violence by Martha’s husband after years of emotional abuse. Martha and her children sought refuge in a motel in Newport, Oregon, a coastal town ravaged by economic decline as lumber and fishing industries crumbled. Martha spotted a poster in the motel lobby that offered an encouraging message — help for families in their situation.

First thing the next day, she contacted Newport’s Lincoln County School District, which has a history of strong compliance with the McKinney-Vento Homeless Education Act. Their countywide Homeless Education and Literacy Program (HELP) provides an array of essential services for the approximately 1,000 students experiencing homelessness served each year. The district recognizes that families and youth experiencing homelessness will rebound from their trauma and housing crises much better if their basic human needs are met. The district tries to provide as many of the “extras” as possible, to ease the pain of homelessness.

HELP staff contacted their extensive network of community partners and found safe respite housing for the family where they could shower and sleep. Accessing available, affordable long-term housing is a problem in the county, so staff helped Martha navigate the application and waitlist process at several potential locations. Staff also worked to make sure the family could access food assistance, including SNAP, soup kitchens, and food pantries. HELP’s clothing distribution program and furniture resources helped the family feel more rooted.

The school helped Tanya enroll in their bilingual early childhood center “LIFT: Learning is Fun Together!” This kindergarten-readiness center involves parents, recognizing that they will be their children’s most important teachers. HELP staff found daycare for Andrew so Martha could attend social service meetings and counseling sessions and obtain support services. Realizing that Martha could benefit from improved job skills, they also helped her access community college courses and parenting classes as well as transportation to get to them.

HELP staff have been trained to deal with trauma in children and parents. The district removes barriers to success for those struggling with the many psychological and physical challenges that accompany poverty and homelessness. Before long, Martha and her children experienced the kind of stability they had forgotten was possible. The children thrived at school. Martha’s college internship turned into a real job, and she was able to afford their own apartment and used car. Stigma evaporated as they were treated with dignity, respect, and opportunity.

We hypothesize that refocusing public policy efforts to prioritize child wellbeing and prevention will result in a significant reduction in homelessness; poverty; and various other physical, emotional, and social problems. As Lisbeth Schorr (1989) observed decades ago, we know what works: investment in the future, in prevention, in services, in equality, and in our children. All this is within our reach. The question she, and now we, pose is — do we have the will to do what we know needs to be done?

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes on contributors

Yvonne Vissing is a Professor of Healthcare Studies at Salem State University and the Founding Director of the Salem State University Center for Childhood and Youth Studies. She was appointed Policy Chair for the United Nations Convention on the Rights of the Child Policy Center; is a former National Institute of Mental Health Post-Doctoral Fellow, Whiting Fellow, and UConn Democracy and Dialogue Fellow; and was a long-term board member of the National Coalition for the Homeless. She is the author of the book Out of Sight, Out of Mind (University of Kentucky Press), which focuses on hidden family homelessness.

Diane Nilan is the founder and president of HEAR US Inc. She has spent the last 15 years traveling backroads chronicling family and youth homelessness. She has three decades of experience running and managing homeless shelters and advocating for improved state and federal homeless policies. She has filmed and produced two award-winning documentaries — My Own Four Walls and On the Edge: Family Homelessness in America — and wrote the book Crossing the Line: Taking Steps to End Homelessness.