Public Policy Commons^™

Housing, Community Support, And Homelessness: Emerging Policy In Mental Health Systems, Paul J. Carling

New England Journal of Public Policy

This article summarizes the dramatic changes in public policy through which public mental health systems are attempting to meet the housing and community support needs of persons with severe and persistent mental illnesses, including those who are homeless. It traces the historical approach to meeting these needs through defining people principally as patients and providing some combination of psychotropic medications, outpatient therapy, and structured, supervised quasi-institutional settings such as group homes, shelters, and segregated single-room-occupancy, or board-and-care facilities. A transition phase in public policy has emphasized defining these individuals essentially as service recipients who need greater or lesser amounts of …

The Mckinney Act: New England Responses To Federal Support For State And Local Assistance To The Homeless And Mentally Ill, Danna Mauch, Virginia Mulkern

New England Journal of Public Policy

The Stewart B. McKinney Homeless Assistance Act of 1987 builds on the work of state mental health authorities and the National Institute of Mental Health in the early 1980s. The act and its subsequent amendments are designed to organize, coordinate, and enhance federal support to the states in financing the development of shelter, health, housing, employment, and support services to homeless persons. There is a special focus in the act on assisting homeless persons with handicaps. In the main, the New England states have met the requirements of the act to provide mandated essential services, which include outreach; community mental …

My Life, Thomas Newman

New England Journal of Public Policy

A personal story by Thomas Newman, a resident of Fifty Washington Square, Newport, Rhode Island. His work has appeared in In the Heart of the City, a literary magazine produced by the residents of Fifty Washington Square. He hopes to be a photographer.

Homelessness, Alcohol, And Other Drug Abuse: Research Traditions And Policy Responses, Gerald R. Garrett

New England Journal of Public Policy

Although homeless alcoholics and other drug abusers more often elicit public scorn than sympathy, ironically they enjoy a celebrity status as research subjects. This article provides an overview of research literature on the homeless and their alcohol and drug problems. The evolution of public policies concerning control, rehabilitation, and treatment of homeless substance abusers is also traced with special attention to the interaction between scientific literature and policy responses over the past century. Although homeless populations today are more diverse than their counterparts in earlier decades, the analysis suggests that the policies and programs developed in response to the crisis …

Two Nations: The Homeless In A Divided Land, Shaun O'Connell

New England Journal of Public Policy

The works discussed in this article include: Chain Reaction: The Impact of Race, Rights, and Taxes on American Politics, by Thomas Byrne Edsall with Mary D. Edsall; Why Americans Hate Politics, by E. J. Dionne, Jr.; A Far Cry from Home: Life in a Shelter for Homeless Women, by Lisa Ferrill; Scandal: The Culture of Mistrust in American Politics, by Suzanne Garment; Songs from the Alley, by Kathleen Hirsch; Culture Wars: The Struggle to Define America, by James Davison Hunter; Rachel and Her Children: Homeless Families in America, by Jonathan Kozol; Parliament of …

Shelter The American Way: Federal Urban Housing Policy, 1900-1980, Ronald Dale Karr

New England Journal of Public Policy

American urban housing policy has featured subsidies for the suburban middle class and parsimonious spending for the urban poor. The outlines of this policy took shape during the Progressive Era: acceptance of the capitalistic market economy, support for the deserving poor needing temporary help, toleration of racial segregation, and the designation of overcrowding as the single most important urban problem. Progressive housing reformers championed stricter housing codes and model tenements, but housing conditions for the urban poor showed little improvement.

The U.S. government avoided direct involvement in housing until the early 1920s, when it promoted local zoning legislation. Under the …

Question, Edward Baros

New England Journal of Public Policy

Poem by Edward Baros.

Indemnified In A January Soup Kitchen Line, Ray Hall Jr.

New England Journal of Public Policy

Poetry by Ray Hall, Jr., a contributor to Pile of Papers; Stack of Karma, a collection of poetry published by the Portland Coalition Press. Reprinted with permission.

Classification And Its Risks: How Psychiatric Status Contributes To Homelessness Policy, Anne M. Lovell

New England Journal of Public Policy

This article examines the extent to which psychiatric classification in public policy research contributes to the equation of homelessness and mental illness. Surveys that measure psychiatric status of homeless persons are reviewed to understand whether they contribute to biased rates of mental illness among homeless persons. The relationship between psychiatric classification and the concept of need is examined and alternatives to current classification are proposed. Classification is discussed particularly in relation to policies of segmentation for "single" homeless adults.

Untitled, Kathie Boulanger

New England Journal of Public Policy

Poetry by Kathie Boulanger, who is a member of the Portland (Maine) Coalition for the Psychiatrically Disabled. Her poem first appeared in Pile of Papers; Stack of Karma, a collection of poetry published by the Portland Coalition Press. Reprinted with permission.

Empowerment And The Transition To Housing For Homeless Mentally Ill People: An Anthropological Perspective, Norma C. Ware, Robert R. Desjarlais, Tara L. Avruskin, Joshua Breslau, Byron J. Good, Stephen M. Goldfinger

New England Journal of Public Policy

Often lacking in scholarly and policy-oriented discussions of homelessness are contextualized understandings of the problems faced, and the values held, by homeless mentally ill people. This article, using an anthropological perspective, examines issues that arise for homeless mentally ill individuals in making the transition from shelter living to permanent residences. The transition occurs as part of a housing initiative driven by the philosophy of consumer empowerment. Project participants are placed in independent apartments or evolving consumer households (ECH) — shared, staffed residences designed to transform themselves into consumer-directed living situations over time. The effects of an empowerment paradigm on the …

Victimization And Homelessness: Cause And Effect, Pamela J. Fischer

New England Journal of Public Policy

The literature on the contemporary homeless population is reviewed to examine the association of victimization with homelessness. Although few studies have specifically focused on victimization, findings derived from studies investigating pathways to homelessness, prevalence of health, mental health, and substance-use disorders, and demographic profiles and life histories suggest that victimization both causes homelessness and is an outcome of losing housing. Causal sequences ending in homelessness most frequently involve domestic violence, which mainly affects women, although other types of abuse may extrude individuals from their established housing. Once they become homeless, the risk of violence escalates for people living on the …

Subgroups Of The Homeless: Street Kids, Bruce Clary, James Harrod, Rachel Olney

New England Journal of Public Policy

Street kids are a feature of many cities, but only recently have they been included among the homeless. They were defined as runaways, throwaways, or youth in crisis. They had a place to live, even if it was a foster or group home or an institutional setting. However, many are without shelter at one time or another and face the same problems as the chronic homeless: the need for food and shelter, avoidance of victimization, and help for personal problems. In 1988, the National Institute of Mental Health funded three national demonstration projects on adolescent homelessness. We report findings from …

From Lemons To Lemonade: An Ethnographic Sketch Of Late Twentieth-Century Panhandling, Louisa R. Stark

New England Journal of Public Policy

A rise in the number of panhandlers on the streets of this country has given rise to the promulgation of ordinances outlawing this activity. Although there has been a great deal of press and litigation revolving around such public policy, little is known about homeless panhandlers. This article reviews the rather limited information about what is known of the sociodemographics of panhandling. Strategies used by panhandlers in pursuing their occupation are described, along with their own perceptions of their occupation. Services available to this population are discussed, along with some suggestions for resolving the problems associated with panhandling on America's …

Homelessness In Massachusetts: Perception, Policy, And Progress, Milton Argeriou

New England Journal of Public Policy

Homelessness is not a new phenomenon in Massachusetts, nor are the "new" homeless of the 1980s and 1990s that different from the "old" homeless of previous decades. What is new is the societal response to the burgeoning population of homeless men, women, and children. Massachusetts's response to the problem of homelessness in the 1980s, as outlined in the Massachusetts Comprehensive Policy Approach, is examined and found to reflect commitment and creativity. However, the problem of homelessness in Massachusetts remains, the community appears frustrated, and current budget cutbacks do not augur well for future services to the homeless.

State Government's Response To Homelessness: The Massachusetts Experience, 1983-1990, Nancy K. Kaufman

New England Journal of Public Policy

When Governor Michael S. Dukakis reentered the State House in January 1983, he focused his inaugural address and priorities for his incoming administration on solving the problem of homelessness. This article describes the policy approach taken during his two successive terms as governor from 1983 to 1990, outlines the various steps taken to rally public and private support and resources on preventing the problem and on finding long-term, permanent solutions designed to solve it, and points to some of the lessons learned during these years of experimentation and innovation.

Circle, Dean Hamlin

New England Journal of Public Policy

Poetry by Dean Hamlin, a member of the Portland (Maine) Coalition for the Psychiatrically Disabled. His poem first appeared in Pile of Papers; Stack of Karma, a collection of poetry published by the Portland Coalition Press. Reprinted with permission.

Let Them Have Housing, Wendy Quinones

New England Journal of Public Policy

Does eliminating homelessness primarily require social services or affordable housing? Research done among former guests of the family shelter operated by Wellspring House, Inc., suggests that, at least for one group of homeless mothers, the provision of secure and affordable housing enables them to function and even to flourish. This article explores both the research and its philosophical underpinnings.

Anger, A. E. S.

New England Journal of Public Policy

Poetry by A.E.S., a member of the Portland (Maine) Coalition for the Psychiatrically Disabled.

The Grassroots Home: How Local Communities Are Fighting Homelessness, Sheila Rauch Kennedy

New England Journal of Public Policy

In the 1980s federal policy combined with market forces to produce the American tragedy of homelessness. Since that time influential policymakers have debated every aspect of the issue, but avoided the large-scale commitment needed for solutions. Locally, however, grassroots efforts have made these commitments and forged the coalitions needed to address the issue. The solution to homelessness lies in harnessing these same successful public and private resources on the regional and national levels.

Massachusetts At The Crossroads, Richard E. Ring

New England Journal of Public Policy

Massachusetts is at a critical juncture in its care for homeless individuals. In the face of a charged political climate and with a governor bent on the "downsizing" and "privatization" of government services, decisions are being made that are of major importance to the welfare of homeless individuals in this state. Based on the choices of the state administration, Massachusetts can either solve its homelessness problem in the near future or relegate its homeless population to a lifetime spent on the streets or in shelters. In comparison to other states, Massachusetts has been relatively successful in caring for homeless people. …

Private-Sector Funders: Their Role In Homelessness Projects, Nancy Roob, Ruth Mccambridge

New England Journal of Public Policy

As the problem of homelessness escalates, private funders struggle to define the most appropriate role they should play in addressing one of our nation's most pressing and visible social problems. Through surveying and compiling the opinions of Massachusetts funders, this report documents funding trends in homelessness throughout the state. By examining government policies and spending patterns, the report attempts to place these trends in context. The analysis and the questions that conclude this report are designed to help develop an appropriate future role for funders in addressing this problem.

Homelessness: The Politics Of Accommodation, Kip Tiernan

New England Journal of Public Policy

This article considers the problem of poverty, with homelessness as the centerpiece. A survey of the problem and its roots and ancillary branches includes (1) a description of poverty in Boston (and America) from 1974 to 1991, its effects, its victims, and its predictable effects on the economy; (2) a description of displacement and of the homelessness that results from it; (3) a description of the immediate response to displacement and homelessness, that is, shelters; (4) a description of the institutionalization/professionalization/ossification of the response (more shelters); and (5) an outline of the terms of the new debate and suggestions for …

A Visit To The Vet Hospital, D. B.

New England Journal of Public Policy

D.B. is a member of the Portland (Maine) Coalition for the Psychiatrically Disabled. His poem first appeared in The Portland Coalition Advocate. Reprinted with permission.

The Needs Of Hartford's Homeless Mentally Ill, Steven Kessler

New England Journal of Public Policy

A state budget deficit in Connecticut threatens the closing of state mental hospitals and holds the potential of displacing chronically mentally ill patients into homelessness. This article explores the historical association between deinstitutionalization of patients from mental hospitals and subsequent homelessness. One third to two thirds of homeless individuals are mentally ill and require intensive, specific, and targeted responses by the community to end their homelessness. Trends in the care of the chronically mentally ill and the conditions of those who are homeless in Connecticut are explored. Model treatment programs are discussed to suggest possible actions, and recommendations that would …

Winds Curse, Robert Pavel

New England Journal of Public Policy

Robert Pavel is a member of the Portland (Maine) Coalition for the Psychiatrically Disabled. His poem first appeared in Pile of Papers; Stack of Karma, a collection of poetry published by the Portland Coalition Press. Reprinted with permission.

Aggressive Outreach To Homeless Mentally Ill People, Ellen Nasper, Melissa Curry, Elizabeth Omara-Otunnu

New England Journal of Public Policy

Historically, people with chronic mental illnesses have been particularly at risk for homelessness. In 1984, the Connecticut Department of Mental Health (DMH) articulated policy to insure housing for mentally ill persons. One facet of that policy is to increase mental health services to homeless people. The Greater Bridgeport Community Mental Health Center has addressed this need through the formation of the Homeless Outreach Team (HOT). This article describes the development, organization, clinical work, and future of HOT. The team is run jointly by the Mental Health Center (funded through DMH) and Family Service-Woodfield, a United Way-funded agency that provides case …

In Search Of Safety: Double Jeopardy For Battered Women, Pamela H. Zappardino, Deborah Debare

New England Journal of Public Policy

Battering is the single most common cause of injury to U.S. women. Its myriad consequences affect every aspect of the lives of its victims and its children. In their search for safety, many battered women and their children find themselves homeless not because they do not have homes, but because their homes are unsafe. They are homeless because to go home would invite further injury or even death. This article discusses the unique issues and implications of double jeopardy for battered women, including the crisis components of their homelessness, the economic and emotional impacts, the child custody issues, the inadequacy …

Counting The New York Homeless: An Ethnographic Perspective, Kim Hopper

New England Journal of Public Policy

Significant ambiguities inhere in the operational definitions of "site" and "selected components of the homeless population" used in the 1990 S-Night Count. Ethnographic methods offer a useful corrective. This article, covering research that was part of a larger project evaluating the S-Night count, describes a brief ethnographic inquiry into the ecology of public spaces occupied by the homeless poor in New York City. Problems in implementation, surprising ease of access, patterns of mobility and prevailing norms from site to site, and the tenuous character of the street sites are reviewed, as are implications for future enumeration efforts.

Medicare Supplemental Insurance: Today's Crisis, Health Care For All, Gerontology Institute, University Of Massachusetts Boston

Gerontology Institute Publications

The purpose of health insurance is to spread risk. The system works under the assumption that, at any given point in time, only a percentage of the people in a given group will be sick. Regardless of health status, all members of the group will be paying premiums in order to cover the cost of care for those who need it.

As a group, however, seniors represent a high-risk population. They are more likely than younger people to need health care services and tend to require longer hospital stays. Yet, while their expenses are greater, their financial resources are generally …