A solution that makes sense for the homeless and the city

November 16, 2007|By Kevin Lindamood

Sheila Dixon is no longer homeless. Sick and tired, she slept for years on stone steps in the archway of a downtown business.

Police and private groups asked her to move along, to no avail. The business owner grew so upset that he doused Ms. Dixon with a bucket of cold water and called to have her arrested.

"Um, do you know what you're doing?" the dispatcher asked over an open radio channel when the responding officer ran a background check on the woman with the well-known Baltimore name.

"Yes, I know," the officer replied with a smirk. "This certainly isn't the mayor of Baltimore."

Indeed not, but at our downtown clinic we came to know Ms. Dixon as "the mayor" of Health Care for the Homeless - so permanent a presence she became in the archway across the street.

Hundreds like her dot Baltimore's urban landscape. This year's census counted 3,002 on a single night. Exposed to the elements and generally in poorer health because of it, they're four times more likely to die prematurely.

Unfortunately, the supply of emergency shelter to ameliorate homelessness, even temporarily, is shrinking rapidly. And the closure of three large shelters in the city this year is exacerbated by the difficulty of establishing a winter shelter, which no one seems to want in his backyard.

Fortunately, Ms. Dixon won't suffer this winter. Two months ago, we did the only thing we hadn't yet tried: We placed her in a private apartment and provided the intensive services she needed to stay there.

Ms. Dixon is the beneficiary of a growing program called Housing First. Two years ago in September, with assistance from the city, we housed 28 people living in a downtown park. Two years later, all but three are still housed. Two-thirds now contribute financially to their housing. Half take medications for chronic illnesses.

Such success was predictable: In an older and larger program in New York, 85 percent of the 500 Housing First participants remained housed after five years. Similar results are seen in other cities where local leaders attempt creative solutions to persistent social problems.

And the realities of homelessness are troublingly persistent for both Sheila Dixons - the homeless woman and the mayor. When the former lived on the streets, she lived constantly under stress. The business owner blamed her for being in his doorway; passers-by sneered at her; police lamented the constant game of catch and release as she moved in and out of Central Booking and, always, back to the same stone step.

Now Mayor Dixon is under pressure, too: from community leaders over the placement of this season's winter shelter, from advocates troubled by the lack of a meaningful affordable-housing plan, and from a general public growing sick and tired of people living their private lives in public spaces.

A Housing First-focused solution makes sense for both Dixons. Few would argue that the "mayor" of Health Care for the Homeless was better off in the vestibule of a downtown business. Clearly, we save money by housing her. Savings to the criminal justice and health systems over the past two months alone likely exceed her rent for the entire year.

But until sufficient housing is available, assisting folks such as Ms. Dixon also requires that we keep them from dying on the streets. "Housing" and "shelter" are not opposing forces. We need both, now.

One Sheila Dixon has learned this lesson from the other. Rightly holding firm on her winter shelter plans, the mayor of Baltimore is poised to release a comprehensive plan to address homelessness and even end it over the next 10 years. It promises to include the expansion of effective strategies like Housing First, along with the shelter, housing, health care, and employment people need to get - and stay - off the streets.

Both Sheila Dixons warrant our collective assistance. It took a range of services to end one's homelessness, and it will take broad community support to help the other one make homelessness rare and brief.

If we no longer want "the homeless" in the doorways of our businesses or under our expressways, we can't keep the solutions to homelessness out of our own backyards.

Kevin Lindamood is vice president, external affairs, for Health Care for the Homeless. His e-mail is klindamood@hchmd.org.

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