Members of The Guilford County Task Force to End Homelessness are reading “Million Dollar Murray: Why problems like homelessness may be easier to solve than to manage,” by Malcolm Gladwell (published in the March 2006 issue of the New Yorker.) It’s one of the best and most exhaustive articles that I’ve read about the problem of homelessness in our society, the specific issue of chronic homelessness, and the current efforts to end homelessness through the use of permanent supportive housing. I urge you to read it. It is educating, thought-provoking and challenging.
Some quotes:
The costs of chronic homelessness to a community:
“…if you totted up all his hospital bills for the ten years that he had been on the streets — as well as substance-abuse-treatment costs, doctors’ fees, and other expenses — Murray Barr probably ran up a medical bill as large as anyone in the state of Nevada. ‘It cost us one million dollars not to do something about Murray,’ O’Bryan said.”
The distribution of homelessness:
“Homelessness doesn’t have a normal distribution, it turned out. It has a power-law distribution. ‘We found that eighty per cent of the homeless were in and out really quickly,’ [Culhane] said.”
Chronic homelessness:
“It was the last ten per cent of the group at the farthest edge of the curve that interested Culhane the most. They were the chronically homeless, who lived in the shelters, sometimes for years at a time. They were older. Many were mentally ill or physically disabled, and when we think about homelessness as a social problem — the people sleeping on the sidewalk, aggressively panhandling, lying drunk in doorways, huddled on subway grates and under bridges — it’s this group that we have in mind.”
The fruitlessness of efforts that simply “manage” homelessness:
“There is no end to the issues. We do this huge drill. We run up big lab fees, and the nurses want to quit, because they see the same guys come in over and over, and all we’re doing is making them capable of walking down the block.”
We have the solution and we’re already spending the money:
“It’s a matter of a few hard cases, and that’s good news, because when a problem is that concentrated you can wrap your arms around it and think about solving it. The bad news is that those few hard cases are hard. They are falling-down drunks with liver disease and complex infections and mental illness. They need time and attention and lots of money. But enormous sums of money are already being spent on the chronically homeless, and Culhane saw that the kind of money it would take to solve the homeless problem could well be less than the kind of money it took to ignore it.”
Philip Mangano:
“The leading exponent for the power-law theory of homelessness is Philip Mangano, who, since he was appointed by President Bush in 2002, has been the executive director of the U.S. Interagency Council on Homelessness, a group that oversees the programs of twenty federal agencies… [Mangano argues that you] build a shelter and a soup kitchen if you think that homelessness is a problem with a broad and unmanageable middle. But if it’s a problem at the fringe it can be solved.”
(Mr. Mangano visited Greensboro in February, for our Ten Year Plan Task Force Kickoff.)
The old rules don’t apply:
“The current philosophy of welfare holds that government assistance should be temporary and conditional, to avoid creating dependency. But someone who blows .49 on a Breathalyzer and has cirrhosis of the liver at the age of twenty-seven doesn’t respond to incentives and sanctions in the usual way.”
Tough choices:
“There isn’t enough money to go around, and to try to help everyone a little bit — to observe the principle of universality — isn’t as cost-effective as helping a few people a lot… Power-law problems leave us with an unpleasant choice. We can be true to our principles or we can fix the problem. We cannot do both.”
Something for everyone to reject:
“Power-law solutions have little appeal to the right, because they involve special treatment for people who do not deserve special treatment; and they have little appeal to the left, because their emphasis on efficiency over fairness suggests the cold number-crunching of Chicago-school cost-benefit analysis.”
Both the “right” in me and the “left” in me reject the proposed “power-law” solution to homelessness for the very reasons he states, but if I disconnect my head from my heart for a minute, I admit that it sounds good on paper. (However, I can’t live long with my head and heart detached, so….)
