By Ana Turner, MD
Across the Nation on Jan 24, volunteers take a census of people experiencing homelessness starting at 4am.
Our very own UF Courtesy Faculty, Dr. Colleen Bell, volunteered with the HOPE Outreach Team from The Sulzbacher Center to help. This census provides statistics to the Department of Housing and Urban Development (HUD) for funding for local homeless programming. It is estimated that over the course of a year the number of people who experience homelessness is three to four times the number identified in the PIT, because people move in and out of homelessness during the year. Last year’s point in time count found 1,869 persons who were homeless in Jacksonville, 286 of which were considered “chronically homeless.” Most of us assume that persons who are experiencing homelessness are addicted to drugs or experiencing mental illness. However, according to the State of Florida Council on Homelessness 2017 Annual Report, the prevalence of chronic substance abuse was 13.30%, severe mental illness was 14.8%, and according to the DSM5, prevalence of Alcohol Use Disorder alone in men is 12.4%, and one in four people in the world will be affected by mental disorders at some point in their lives. In fact, the majority of those experiencing homelessness are temporarily homeless, doubled-up or couch-surfing, paying to stay in motels, and are very much like you and me.
So how does one become homeless? According to the Out of Reach 2016 Report, a household earning minimum wage would need to work 99 hours weekly to afford a two-bedroom rental unit in the average Florida community. Even for those who are working multiple jobs, being able to afford a rental unit in Florida is challenging. For the average two-bedroom rental unit to be affordable working 40 hours per week, the household would need to earn almost $20 per hour. However, many low-income workers earn minimum wage, which is just over $8 per hour.
Because people who are homeless are less likely to access primary health care and address health concerns early, health issues are exacerbated. Uninsured emergency room visits and inpatient stays skyrocket. Like physical health costs, treatment for mental health issues and substance abuse among those who are homeless is often limited to crisis response and emergency services. Ultimately, people who are uninsured and homeless cycle in and out of crisis and health systems, resulting in high community costs but limited improvements in health. A recent study of 107 chronically homeless individuals living in Central Florida estimated the community costs of $31,065 per person per year, for an annual cost for these 107 individuals totaling over $3.3 million. In contrast, providing those same individuals with appropriate housing and services in the form of permanent supportive housing would cost approximately $10,000 per person per year (Shinn, 2014). So the question may not be how does one become homeless, but rather, without affordable housing, how does one not?
Ana Turner, MD
University of Florida College of Medicine
Community Psychiatrist UF Gainesville
Department of Psychiatry at the IM Sulzbacher Center
Consult Liaison Psychiatrist UF Health Jacksonville Dept of Psychiatry