Thread by @ShellenbergerMD

Rising violence & chaos are rapidly killing the hoary demand by progressive activists that we deny the reality of addiction/mental illness in causing homelessness

Nobody lives in open drug scene "homeless encampments" because they can't afford the rent

latimes.com/opinion/story/…

"When you see somebody passed out in their own vomit or covered in feces, and there are needles, that’s not a manifestation of poverty or a housing shortage. That’s mental illness & drug addiction, and it’s scary. People are suffering and the situation is dangerous for everyone."

As the illusion that homelessness is a problem of high rents evaporates, progressives are now retreating to the position that homelessness is "bidirectional."

Well of course it is. Everybody knows that. But it's addiction/mental illness that causes people to live on the street.

"A common assumption is that there is a unidirectional causal pathway between drug use and homelessness," writes @KellyMDoran in JAMA.

No, not it's not, which is why Doran presents precisely zero evidence for her claim.

jamanetwork.com/journals/jaman…

Nobody denies homelessness makes addiction worse — that's a straw man.

And it appears to serve the purpose of misdirecting attention from the fact that progressive academics/activists/journalists have denied that addiction *causes* homelessness for 40 years.

Doran & her coauthors reveal their ideological motivations in the very next sentence:

"This misconception places the blame on the individuals and away from the root structural contributors to homelessness as well as perpetuates stigma and points to the wrong solutions."

Having acknowledged that addiction causes homelessness, and then having constructed a straw man out of the idea that anyone denies homelessness making it worse, Doran et al go *assert* without evidence that "the root cause of homelessness... is lack of affordable housing"! 🤨

All of this is progressive fancy-dancing to get around the fact that they have misled policymakers, journalists, and the public for 40 years in their active and willful denial of addiction & untreated mental illness as the primary cause of homelessness.

Why now? Because drug deaths reached 100,000 last year. Because obviously psychotic homeless people are more visible. And because people like @SoledadUrsua are calling bullshit on the Big Homelessness Lie

latimes.com/opinion/story/…

The addiction/mental illness homeless problem is all major American cities & worse on West Coast. What starts in the West moves East.

Miami has done comparatively well in reducing unsheltered homeless but I just saw dozens of homeless addicts, many psychotic, in Miami Beach

We don't have a clear view. Homeless counts have always been inaccurate and many have not happened or happened unscientifically and in an unstandardized way over the last two years of the pandemic. But nobody denies the problem grew much worse everywhere.

And the real problem to addressing the problem isn't lack of precision about how many people are on the streets and how many in shelters, RVs, and encampments. The real problem is overcoming the longstanding denial of the nature of the problem so we can move on to fixing it.

America is more divided than ever but I have found significant bipartisan agreement among reasonable Ds & Rs on homelessness in part because everywhere in the civilized world the problem is addressed in the same basic way: Shelter First, Treatment First, Housing Earned.

The drug death and homelessness crisis result from the same things: untreated mental illness, open drug scenes/markets, and namby-pamby treatment of addicts

Just as addiction requires intervention, so too do our cities, our states, and our whole country

californiapeacecoalition.org

In addressing the existential threat to cities posed by out-of-control drug-induced homelessness chaos is creating, we have the opportunity to come together around a policy that is neither liberal nor conservative but rather wholly practical and humane.

The mechanics of Shelter First, Treatment First, and Housing Earned are simple. Universal congregate shelters. Psych/addiction evals & care. Centralized/efficient case management. Camping bans. Housing as a reward for sobriety. Mandatory treatment as alternative to jail.

What all of that requires is simply facing reality. Progressives are right that we need universal psychiatric care, treatment on demand, and universal shelter. Conservatives are right that we must enforce laws, have rewards/punishment to change behavior, and contain costs.

When traditional progressive and conservative demands on drugs and mental illness are combined they are right. When they exist in opposition to one another, they are wrong. I'm not advocating a compromise. I'm advocating a combination.

We have three choices: 1. Let addicts/mentally ill living on the street in increasingly dangerous ways. 2. Lock them all up without regard for their civil rights or our shared humanity. 3. Treat them using the same tools every civilized society in the world uses.

The only reason we're not doing #3 is because both Ds & Rs are stuck in outdated paradigms. Progressives dominate the issue, and are thus the main obstacle. But that creates an opportunity for moderate Ds & Rs to demand Shelter First, Treatment First, Housing Earned.

I should have said "just" because they can't afford the rent.

They can't afford the rent bc their addiction/mental illness leads them to not work and they are using the money they have to buy drugs

Many stop paying rent and live with family and friends until they are kicked out