Substance abuse

Californians often struggle with health, trauma, poverty before losing homes: research

Homeless Californians are often victims of violence and have mental health and substance abuse issues before losing their homes, according to new research from the University of California San Francisco.

The study released Tuesday spoke with a representative sample of 3,200 homeless people in California, the largest number for a study since the 1990s, authors said. California is estimated to have more than 170,000 homeless people, about one-third of the country’s total count.

Nearly two-thirds of California’s homeless have severe mental health issues, the study found, and more than a quarter had been hospitalized as a result. Another two-thirds also reported substance abuse issues including drug or alcohol addiction.

Black and Indigenous people are significantly overrepresented in the homeless population. Indigenous people make up 12 percent of homeless people but only about 2 percent of the overall California population.

The study was requested by Gov. Gavin Newsom (D), who has made homelessness a focus of his administration. California has spent more than $22 billion combatting homelessness since Newsom took office.

About three-quarters of California’s homeless population said they had been victims of physical violence, and about 40 percent of cisgender women and three-quarters of transgender and nonbinary people said they had been victims of sexual violence.

High rents or mortgage costs forced most people into homelessness, the study found — with the average person spending 50 percent of their income on housing in the six months before they lost their home. California also has one of the country’s highest housing costs in the U.S. High costs leave many people with little time to prepare, and the median renter has just one day’s notice before losing their housing.

More than 90 percent of respondents said that a housing choice voucher — which allows entry into public housing — would have prevented their homelessness, and 70 percent said a $300-$500 rental subsidy would have been enough to stay in their homes, the study found.

“People are homeless because their rent is too high. And their options are too few. And they have no cushion,” survey lead Margot Kushel told The Associated Press. “And it really makes you wonder how different things would look if we could solve that underlying problem.”

Most of California’s homeless population, about 78 percent, spend most nights without shelter. That can create worse health outcomes for a population of which 60 percent reported a chronic disease and more than 20 percent reported a form of disability, according to the research.

While more than 80 percent of unhoused people have access to health care, mostly Medicare, just less than half have ready access to nonemergency health care. Access to treatment was found to be even worse for mental health, with two-thirds of respondents reporting mental health issues but only 18 percent receiving treatment.

From these findings, researchers made many recommendations including expanding housing assistance like housing choice vouchers and rent subsidies to keep people off the streets. The authors also argued for increased mental and physical health support and access for the homeless population.

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