Nancy Baglietto: Adverse childhood experiences linked to homelessness
When we encounter homeless men and women, or hear about homelessness issues, it’s very common for those of us working with homeless people to be asked why so many folks end up in the shelters or out on the streets.
We’ve previously discussed some of these causes in this column, including the lack of affordable housing, difficulties with consistent healthcare, increasing levels of mental illness, and substance abuse.
Another major cause of homelessness is less visible but affects the vast majority of the homeless people we encounter. It’s known generally as Adverse Childhood Experiences, or more simply ACEs. These include emotional, physical and sexual abuse, violence, drug abuse, and mental illness in the household, general neglect, parental incarceration and more. Adverse Childhood Experiences are unfortunately more common than we would like and can affect families at various times; the effects can be further exacerbated for those also struggling with financial stress.
There have been quite a few studies of the correlation between ACEs and homelessness. Due to the difficulties in surveying transient populations, the numbers are hard to pinpoint, but most studies agree that 60-85% of adult homeless individuals report neglect, abuse, household dysfunction, and adversity as children.
In a San Jose study, homeless patients in a homeless health care clinic were 10 times more likely than folks in the general population to have experienced the following ACEs: a family member going to prison, living with someone who was using street drugs, and living with an adult who “often or very often pushed, shoved, grabbed or slapped them.”
ACEs cause a wide variety of negative outcomes. Studies show that children raised with one or more adverse childhood effects have significant increases in future violence victimization and perpetration, substance abuse, sexually transmitted infections, delayed brain development, reproductive health problems, involvement in sex trafficking, non-communicable diseases such as cancer, diabetes, and severe obesity, lower educational attainment, and limited employment opportunities. Naturally, ACEs also correlate with anxiety disorders, depression and antisocial behavior.
Sadly, these outcomes contribute to homelessness. It’s a vicious cycle.
Worse, homelessness can be a dangerous experience itself. Other studies show that approximately 35% of homeless men, women and children report incidents of physical or sexual violence within the previous year. For homeless youth, the numbers are grim: 70% report experiencing some form of violence.
January’s Point In Time count here in Nevada County found over 400 homeless people, though that number doesn’t reflect many young people, couch surfers, people living in cars, or folks who simply couldn’t be found. There is shelter space for fewer than 100 people, meaning the bulk remain unsheltered day and night, summer and winter.
Homelessness is almost never a choice. It’s dangerous, uncomfortable, degrading, and, quite honestly, hard work. Homeless people are frequently sick or injured. In fact, 43% suffer from a disability of some kind. Without a home or a place to stay clean, it’s nearly impossible to get a job, receive disability payments, collect Social Security, attend school.
These folks are our neighbors. Somebody’s grandfather, who served in Vietnam. A 16-year-old boy whose parents are hooked on heroin. An abused mother of two in a safehouse. Most had abusive upbringings, many cannot afford housing, most slip into homelessness while struggling to pay medical bills, rent, car payments on minimum wage.
Fortunately, our community provides a network of care. Community Outreach Liaisons from Hospitality House regularly investigate the camps and streets. Our Homeless Access Transport van offers free rides to medical appointments, DMV, Granite Wellness Centers (formally CoRR), grocers and related service providers. Sick or injured people receive treatment at the hospital, and if necessary, can be transferred to one of four long-term recuperative care beds at Hospitality House for in-house recuperative care, thanks to a partnership with Dignity Health Sierra Nevada Memorial Hospital and County of Nevada.
Once a homeless person is reached, we in the broad community of caregivers can help them receive shelter, food, clothes, apply for MediCal, provide referrals for mental health counseling, residential rehabilitation and help them make plans to return to housing.
The social service network, both public and nonprofit, is kicked into high gear. When people are struggling with substance abuse, PTSD, mental or physical illness, it is always best to get them into housing (emergency, transitional, supported, permanent) so that wraparound services can be used effectively and efficiently.
Housing allows folks to begin the journey back home.
Nancy Baglietto serves as executive director for Hospitality House, with previous executive experience for agencies focusing on homeless people, homeless animals and the parks they use.
Start a dialogue, stay on topic and be civil.
If you don't follow the rules, your comment may be deleted.