How to Help the Homeless

June 20, 1993|By MARY FARINHOLT

We are used to homeless people turning up nightly at shelters, queuing at soup kitchens, living in cars or in the open. Visible in cities, more hidden in the rural places, they have come to be ignored or accepted as part of the landscape.

Over more than a decade, vast effort across the nation has mobilized faithful workers to operate food pantries and serve meals for the homeless. Yet providers in Maryland and other areas, while serving whom they can, turn away increasing numbers. Lately they speak of more children coming to the door. Have we merely been applying band-aids to an ugly social wound that is not healing?

Now a book by Alice S. Baum and Donald W. Burnes, ''A Nation in Denial: The Truth About Homelessness,'' asks us to take a new look at the condition. Ms. Baum and Mr. Burnes think we have been making the wrong moves, that short-term handouts do not touch the crippling handicaps that have left these people unable to serve their own needs.

There are rippling consequences to becoming homeless: It means more than lacking keys to a space of your own. Without a private abode, one has few possessions; no control over diet; little regular means of bathing, laundering, medicating, toileting and transport. Many unfortunate people, even in deep poverty, still manage their lives, assisted or partnered or taken in or taken care of by people they know. But as Ms. Baum and Mr. Burnes point out, a person who is homeless for long tends to lack or shun such a network, to be disconnected from any community and feel quite alone.

More than those multiple consequences of homelessness, ''A Nation in Denial'' stresses multiple causes, which the authors believe afflict the large majority of the homeless population. Since these causes are deep rooted, long-term and often tangled together, they have been ''denied'' by a public that wants simple answers.

The authors cite research estimating that one-third of the homeless are mentally ill; two-fifths are alcoholics; two-fifths suffer disabling physical disorder, and a tenth use drugs. They believe that up to 83 percent may be seriously impaired by mental illness, alcoholism and/or drug addiction. Such figures are stunners. If valid, they imply that even instant windfalls of house keys and steady incomes would not magically enable most homeless people to cope with their own lives.

Statistics are always questionable, especially assessments of the homeless population. An accurate census, or even reliable estimates, are impossible because of typical doubling up, temporariness, transiency and concealment. That said, Ms. Baum and Mr. Burnes alert us to the likelihood that a significant portion of our citizens are afflicted with complex ailments that seem intractable because they have been totally neglected. And short-term acts of charity cannot relieve long-untended disorders.

Meantime, all around us, substance abusers change their habits, and the mentally ill benefit from careful medication, when restorative health care and rehabilitative training are available and affordable.

An alcoholic manic-depressive familiar with cocaine, whose only chance of getting clean is with treatment, can get services if able to pay; this person is in no danger of losing the comforts of home, as long as a steady income pays the rent. A poor or homeless person in the same situation is often out of luck. Treatment services are scarcely available to the homeless, and budget cuts to state-funded addiction-treatment programs and the medical assistance program for single adults have made things worse.

Rather short shrift is given by ''A Nation in Denial'' to current emergency services, which are treated as useless activities that perpetuate national ''denial.'' Similar is the implication that public protest against widening poverty and the scarcity of low-cost housing is irrelevant. Conscientiously concerned about homeless people enmeshed in a desperate situation that seems out of control, the authors recommend a new look and a new approach. But their single theme -- that treatment of severe disorders and disabilities is the only care worth offering -- all else being ''denial'' -- frequently counters common sense.

Emergency facilities are needed just because human survival requires food and fluids, shelter from the weather and predators. In short, first aid is preferable to no aid.

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