Abstract This paper examines racialized encounters with the police from the perspectives of people experiencing homelessness in San Diego, California in 2020. By some estimates, homelessness doubled in San Diego during the first year of the COVID-19 pandemic. We conducted a survey of (n = 244) and interviews with (n = 57) homeless San Diegans during initial shelter-in-place orders, oversampling for Black respondents, whose voices are often under-represented despite high rates of homelessness nationally. Our respondents reported high rates of police contact, frequent lack of respect; overt racism, sexism, and homophobia; and a failure to offer basic services during these encounters. Centering our Black respondents’ experiences of criminalization and racism in what Clair calls “criminalized subjectivity,” we develop a conceptual framework that brings together critical theoretical perspectives on the role of race in the governance of poverty and crime. When people experiencing extreme poverty face apathy, disrespect, and discrimination from police—as our data show—the result is a reluctance to seek services and to engage with outreach when offered. This reinforces stereotypes of unhoused people as not “wanting” help or “choosing” to be homeless. We reflect on these findings and our framework for envisioning a system of public safety that supports and cares for—rather than punishes—the most vulnerable members of our society.

Black Lives Experiencing Homelessness Matter: A Critical Conceptual Framework for Understanding How Policing Drives System Avoidance among Vulnerable Populations

Under what conditions will the public accept homeless-serving housing and social service facilities in their neighborhood? In this paper, we answer this question through a basic descriptive statistical analysis of a brief survey (respondent n=251) and a thematic analysis of seven focus groups with residents of San Diego, California (participant n=34). We find that although residents were not categorically opposed to such facilities, their support was contingent on a particular approach to addressing homelessness, often rooted in misperceptions of the causes of homelessness. Participants classified people experiencing homelessness (PEH) into “deserving” and “undeserving” groups based on these perceptions. Attitudes towards homeless-serving facilities were also shaped by a belief that what is needed most are services such as substance abuse treatment, mental health services, or job training; they focused less on the need to house people who are currently unsheltered. Study participants also took a paternalistic approach to policy design, focusing on rules and regulations to force PEH to make “good” decisions. Participants recognized homelessness as a pressing social problem and were willing to consider homeless-serving facilities in their community. However, their attitudes and beliefs limited which facilities they would support, and under what circumstances.

/pdf/community-acceptance-of-and-opposition-to-homeless-serving-3b41758a.pdf

Community Acceptance of, and Opposition to, Homeless-Serving Facilities

A pervasive barrier to preventing, reducing, and ending homelessness is the stigmatization of and discrimination towards persons experiencing homelessness (PEH), termed “homeism.” To date, there has been no systematic review of the experiences and outcomes of stigmatization and discrimination among PEH or interventions to reduce this discrimination. To fill this gap in the literature, we conducted a scoping review to identify the ways in which PEH have been stigmatized and discriminated against, the results of these experiences, and interventions that have been used to reduce stigma and discrimination. We reviewed results from 12 databases with no date restrictions; 205 studies met our inclusion criteria. Thematic data analyses resulted in the identification of 12 categories. Using community consultation, the scoping review themes were reviewed and validated with 25 PEH or service providers in the homelessness sector and their feedback integrated into our results. Thematic categories included discrimination and stigmatization in healthcare, social services, workplaces and employment, and public spaces by the general public; discrimination and stigmatization from landlords, police and security guards, informal social networks, and by PEH toward PEH; discrimination and stigmatization linked to intersectional domains; PEH feelings about discrimination and stigmatization; outcomes of discrimination and stigmatization for PEH; and interventions to reduce stigma, discrimination, and prejudice towards PEH. Based on findings from this review, we argue that homeism serves as a social determinant of health as PEH confront multiple barriers to housing, income security, and healthcare due to interpersonal, institutional, structural, and intrapersonal stigmatization and discrimination. 

A Scoping Review of the Experiences and Outcomes of Stigma and Discrimination towards Persons Experiencing Homelessness

Service providers and researchers often describe people affected by homelessness as hidden. This study aims to study social relationships and implications for outreach services through a qualitative content analysis of reports written by field investigators for the New Mexico Office of the Medical Investigator that involve people affected by homelessness who died between 2014 and 2019 across the state (N = 512). Findings describe variation in what is newly conceptualized as the aspects of the visibility framework, which organizes people as most engaged and surveilled, most visible and exposed, or most hidden. Recommendations include facilitating greater engagement with hotel/motel management and staff about harm reduction and engaging more with local business communities and first responders (including the criminal-legal system). This research also conceptualizes subsistence ties, acquaintances that both provide longer-term support and further hide people who are precariously housed. Future research and policy recommendations are described.

Hidden to Whom? Aspects of Visibility among People Who Died While Affected by Homelessness and Implications for Outreach

Homelessness is one of the most significant humanitarian, policy, and public health issues in the United States. People experiencing homelessness are at a heightened risk of various health issues, including severe mental illness, and face a life expectancy up to 30 years shorter than those with stable housing. The US Department of Housing and Urban Development (HUD) defines homelessness as lack of a fixed, regular, and adequate nighttime residence and reports that there has been a steady rise in the number of individuals with mental illness lacking stable housing, far outpacing the capacity of available services. Despite the importance of housing for mental health, psychiatrists are often ill-equipped to intervene on this key social determinant of health. This article reviews underlying factors contributing to homelessness for individuals with mental illness, details clinical ramifications of homelessness, and outlines evidence-based interventions for supporting people experiencing homelessness and psychiatric illness. [ Psychiatr Ann. 2024;54(7):e202–e208.] 

Housing, Homelessness, and Mental Health

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Black Lives Experiencing Homelessness Matter: A Critical Conceptual Framework for Understanding How Policing Drives System Avoidance among Vulnerable Populations

Community Acceptance of, and Opposition to, Homeless-Serving Facilities