A homeless encampment near Market Street in downtown San Diego / Photo by Adriana Heldiz

We report on homelessness issues a lot at Voice of San Diego. That includes updates on the annual homeless census, the status of shelters during the pandemic, funding meant to help get people off the streets and much more. But what rarely gets talked about in news are the myths about why someone becomes, or continues to be, homeless. 

On the latest episode of the San Diego 101 Podcast, we do just that. With help from experts and people with lived experience, we break down the following common misconceptions: 

  1. People experiencing homelessness have substance abuse or mental health issues 
  2. The help is there but they don’t want it because they prefer to live on the streets 
  3. It could never happen to you or me

One of our podcast guests was Margot Kushel, a physician and researcher at UC San Francisco who works with people experiencing homelessness. She shared what she’s learned in her work about the correlation between mental illness and homelessness. Here’s more of her conversation with our podcast host Adriana Heldiz, edited for length. 

Adriana Heldiz: Many folks think that homeless people suffer from serial mental health illnesses and addiction and end up homeless because of that. Is that true from your perspective? 

Margot Kushel: Well, we certainly see many people who are homeless who don’t have those problems — people who are going to work every day, but simply can’t afford the rent. But we’re clearly seeing people who have these problems disproportionately be impacted by homelessness. What really determines whether an area — a city, a state, a country — has more homelessness or less homelessness is not actually about how much mental health or substance use problems there are. It actually has much more to do with how much housing there is that’s affordable. So even within our own country, we see that the areas with the highest substance use and mental health problems don’t always have the highest homelessness. And in fact, they usually don’t. The areas that have the highest homelessness are the areas with the biggest disconnect between what housing costs and what people make. 

So I would say those two things can be true. Absolutely people with substance use and mental health are at high problems are at risk of homelessness. Absolutely. They’re also more visible. The general public is tending to make what we might call a “heuristic error,” or an error that you make when you see one thing and make assumptions about it. 

They’re definitely at higher risk. It’s those illnesses, those problems that interfere with people’s ability to make money. They interfere with family relationships. They interfere with a lot that can lead people to be homeless. But what we’re saying is when you have housing costs that are much lower, it’s much easier to have folks, even those folks with mental health and substance abuse problems, be successfully housed. 

And then once people are homeless, we’ve shown empirically that if you offer housing on what we call a housing first basis, which is that you say, we’re going to start with the housing, but you offer the appropriate services. For example, if someone has bad mental health or substance use services, they may need help organizing their life. They may need help getting their rent paid on time, they may need help getting connected to their doctors. Doing that we’ve learned two really interesting things: People stay housed really successfully, even if they’re really, really sick, and the other is that they do take you up on those offers of health. They don’t turn it down as long as it’s offered on a voluntary basis. 

Heldiz: San Diego is in that crisis where there isn’t enough housing. And, like you said, cities and counties that struggle with housing affordability see more people suffer from homelessness. 

Kushel: Absolutely. California is the second worst state in the nation on a key measure of housing affordability, where in California we only have about 25 units of housing that are available and affordable for every one hundred extremely low income households. The only state in our country that’s worse is Nevada. That means for every one hundred families who are making low incomes, and we measure this as less than 30 percent of the median income of the area, there are really only 25 units of housing that they could really afford in any reasonable way to rent. When you see that, it’s not surprising that we have a homelessness crisis.

Hear more from Kushel and other key takeaways from guests featured on the latest podcast, here. 

Read These Comments 

For this week’s comment section, we asked readers on Instagram to share what other misconceptions they’ve heard about the homeless community. Here’s what they had to say. 

“They ‘choose’ not to be in shelters, but shelters are often overcrowded or just awful!” – Marin Callaway 

“Getting out of homelessness is as easy as ‘just getting a job.’” – Natali Rahimzadeh 

“That they’re all on the streets. Lots of homeless often crash at a friend’s, if it’s available.” – thenairisaid 

“People get ‘bussed in’ to San Diego from all over the country.” – Lydia Ekeroth 

What We’re Working On 

  • Local governments missed their shot at $61 million in state money initially reserved for homeless housing projects in San Diego. Lisa Halverstadt and Jacob McWhinney explained how they’ll now have to compete for funding with other jurisdictions across the state. 
  • Sidewalk vending rules are headed to the City Council for approval next month. The proposed rules include vending restrictions on certain streets in downtown, Little Italy and some beach areas. We wrote about a contentious public discussion over the issue this week. 
  • Did you get tested for COVID-19 at a trolley stop? If so, how long did it take to get your results? Earlier this week we revealed that some waited as long as 13 days, while others never received their results. 

At the top of this newsletter, I said “we” cover homelessness issues a lot at Voice of San Diego. And by that, I mean reporter Lisa Halverstadt. She works hard to stay on top of important issues. Kudos, Lisa! If you have thoughts on this topic, or something you want us to share in our next newsletter, drop me a line at megan.wood@voiceofsandiego.org.

Megan is Voice of San Diego’s director of marketing. She is responsible for producing and overseeing strategies that extend the reach of the organization....

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