Homelessness in the American Psyche

Report back from a recent panel on homelessness in the San Francisco Bay Area.

Posted Oct 09, 2019

"If you want to know what a lifetime of poverty, of discrimination, of abuse, of violence, of no one paying attention to you, no one recognizing your human dignity, looks like on a human being, it’s what you see on the street, and it’s what’s in our housing programs. So compassion, compassion, compassion. Our social workers are doing the best we can, but there’s such a deep level of trauma… we’ve effectively 'done this' to the people on the street.”  —Genevieve Herreria, J.D.

(For more on transforming the web of trauma into a web of healing, see the linked lectures on compassion and self-compassion below.)

Genevieve Herreria, Federal Subsidy Compliance Analyst with the San Francisco Department of Homelessness and Supportive Housing (HSH), moderated a fantastic panel discussion on Homelessness for the Brown Club of San Francisco on October 2nd, 2019. The panelists included fellow Brown University alums Lindsay Haddix, (Principal Real Estate Analyst with the HSH), Michael Santos (Registered Legal Services Attorney with Bay Area Legal Aid's Housing Unit on Eviction Defense), Lara Tannenbaum (Manager of Community Housing Services, Human Services Department for the City of Oakland), and Cody Zeger (former Program Associate for the Chronic Homelessness Initiative at Tipping Point Community, and graduate student at UC Berkeley Goldman School of Public Policy).

You can listen to the entire 90-minute program on the Pacific Heart Podcast at SoundCloud, Stitcher, and iTunes. (Apologies in advance though—interference or an issue with the microphone caused some occasional buzzing.)

Image (c) Ravi Chandra, 2018
Source: Image (c) Ravi Chandra, 2018

Some key takeaways

  • San Francisco has about 8,000 homeless people, about 1 percent of the city’s population, and a dramatic surge in recent years correlated with rapidly increasing costs of housing.
  • The vast majority (two-thirds) of these people are homeless due to poverty and lost housing (not mental health issues) in San Francisco. Getting buy-in for affordable housing, navigation centers, etc., takes work—but the vast majority of San Franciscans want to be a part of solutions, as evidenced in community forums and ballot measures on the subject.
  • There are, of course, many who do need help for mental health and substance abuse issues and sequelae. Mayor London Breed is implementing stronger conservatorship laws recently signed into law by Governor Gavin Newsom to help those with these issues who are cycling through hospitalizations or the criminal justice system.
  • San Francisco is a leader in care coordination (“Co-ordinated Entry”); other municipalities have sought advice from San Francisco, and San Francisco has sought advice from other cities. Homelessness is complicated, and no one “has it down,” so to speak.
  • The main pillar is clearly affordable housing, but sometimes restrictive regulations get in the way. Michael Santos gave an example of a man who was housed, but then understandably chose to go back to the streets, because regulations prevented his long-term partner from staying with him in the housing provided.
  • Connected to the pillars of housing and stable support services is a stable, dedicated funding source—the actualization of society's attention and understanding. The great majority (61 percent) of San Franciscans voted for Proposition C, which would have collected $300 million from the largest corporations in the city. However, the Chamber of Commerce, backed by Big Tech, has blocked the release of these funds, because they believe that this is a new tax that requires a supermajority of two-thirds. San Franciscans will have another opportunity to vote for an affordable housing measure (Proposition A) on November 5, 2019.

It’s certainly a strange paradox that in one of the wealthiest cities in the wealthiest (and perhaps most progressive) states in the wealthiest country in the world, there is such a significant and visible homeless population. A paradox, but also a reminder of how hard it is to care for vulnerability in our society, and how quickly any of us can have our vulnerability exposed.

Los Angeles County has almost 60,000 homeless people in a population of 10.2 million, while New York City has about 63,000 in a city of 8.5 million. There is clearly not a lack of resources to alleviate all points in the pipeline of this predicament.

What is lacking? Perhaps some level of coordinated government-business-public sector consensus and willpower at the local, state and national levels. Unfortunately, to my eyes, there seems to be a lot of partisan finger-pointing and blaming, instead of rational and compassionate problem solving and long-term planning for this predicament that exposes the shortcomings of society writ large. We may not be able to fully help every single person get to housing and wellness, but surely we could work at it a lot better.

As a psychiatrist and citizen, my attention also goes to the underlying psychological factors that impede progress. My experience and observations suggest that the overwhelming majority of citizens are caring and compassionate. I don’t believe that the electorate is as polarized on this or other issues as our leadership or the firebrands on social media would have us believe, to ramp up support at the extremes of the political spectrum. Recent research supports this

I sense that resistance is fueled by these psychological factors:

1. Compassion fatigue or collapse: When we are faced with a high-level challenge to our caring, we might think that “we can’t—we’re unable to—feel compassion for such numbers or this situation,” and/or “we won’t—we choose not to—because it’s overwhelming or ‘pointless.’”

We can face the strain on our compassion by communicating efficacy about our actions to relieve suffering, and also building our reservoir and capacity for compassionate action. (See this Greater Good Science Center article for details as well as my videos below on compassion and self-compassion.) 

2. Our individualistic culture is built on a belief in radical self-reliance, that “anyone can make it on their own.” Thus anyone who falls is “at fault.” Individualism has produced exceptional talent, achievement, and creativity, as we generally feel less fettered by bureaucracy, authority, and tradition to “pursue happiness.”

And there are significant examples of individuals who “pull themselves up by their bootstraps.” Without going into the fallacies of this myth, individualism has several sequelae:

  • The pursuit of happiness becomes a test of individual will and accomplishment, instead of facing the reality that “happiness is love. Full stop,” as George Vaillant stated, summarizing the results of the Grant Study, the longest-running longitudinal study of men’s health and wellness. Happiness is a relationship, not a matter of maximizing individual material gain. What is homelessness but a set of profound disconnections from relationship, sometimes beginning in early life and continuing into disconnection from society writ large? Shifting the balance of interdependence and individualism will benefit us in happiness and addressing problems such as homelessness.
  • Inequity and its psychological consequences are also factors. The concentration of wealth and power in a small number of individuals leaves the rest of the population feeling quite often powerless, angry, caught in blame-rage cycles, insecure, uncertain, inadequate, envious, deflated, defeated, precarious, and so forth. And even the rich and powerful can be prone to these feelings, because of the underlying disconnection from a relationship with others, and the fear of losing wealth and stability. There’s not a great safety net, materially or psychologically, if we’re all supposed to just “make it on our own.” When the rich and powerful act to protect their narrow interests, they further destabilize our psychological ecosystem. Even some well-intentioned young people here in the Bay Area imagine that they first need to strike it rich before giving back to the community.

3. Related to this last point, in an atmosphere of competition for status and stability, there can be an underlying sense of scarcity. “I can’t give to others unless I get enough for myself.” Our emotional attention can go inward and to our devices, rather than to civic engagement and our fellow humans.

We might simultaneously be measuring who “adds to our life,” and who is a burden, and also be worried about our sense of connection with others. This seems the case particularly in my home city over the last decade or so of the “tech boom gold rush.” When financial and cultural stress is high, it can take a toll on relationships.

Our disconnection, insecurity, inadequacy, and shame shows up as bodies on the street, military misadventures, and terrifying White supremacy—another way of framing what Martin Luther King called “the giant triplet” of materialism, militarism, and racism. Only compassion, self-compassion, and mature relationships can tip the balance back to our deepest human roots of caring, strengthened over 100,000+ years of human history.

Compassion is how we do human. There have been tragic shortcomings and massive challenges to our caring capacity, but I have great hope that together, we can turn the tide.   

See also these recent lectures on self-compassion and compassion.

Mindful Self-Compassion

Compassion in Difficult Times 

(c) 2019 Ravi Chandra, M.D., D.F.A.P.A.