The Dignity of Being Inside

By Jessica Mennella

We are two years into the COVID-19 pandemic and Americans remain disconnected, stressed, confused and unsure (if only about whether a sudden dry cough means allergies, or something else). Alcohol and substance abuse has increased. The share of adults reporting symptoms of anxiety and depression is up 31% from 10.8% in 2019. The past two years have not been easy for anyone; for people living on the margin, they’ve been much worse.

Step back for a moment and imagine experiencing this pandemic unhoused, living outside, just as scared that you are going to die, as confused about social distancing, and as lonely as housed people are but with no place to go. This is what it is to be one of the half-million unhoused people in this country: facing a pandemic without a secure place to deal with life stresses in privacy, dignity, and safety.

Homelessness: A Homemade American Crisis

In January 2020, at the start of the pandemic, more than 580K Americans were unhoused. Seventy percent were individuals; the remaining 30% were families with children. Thirty-nine percent had no permanent shelter and 19% were experiencing chronic homelessness, defined as living in a place either not meant for human habitation or in an emergency shelter for over a year.

The problem of housing in the United States began during the Reagan Administration, elected on a mandate to cut federal spending. Over two terms, the Administration reduced funding to local governments and federal assistance programs across the board, including cutting low-income housing subsidies by 60%. The national housing budget decreased from approximately $29 billion in 1976 to approximately $17 billion in 1990, resulting in $8 billion in cuts to housing assistance affecting the poorest Americans.

In California and San Francisco specifically, state and local governments have unsuccessfully played catch-up from the reduction in federal resources of forty years ago. A 2016 study conducted by McKinsey determined that only 50% of California’s households, and virtually none of the state’s low-income and very-low-income households, can afford the cost of local housing. It further identified a 3.5-million-unit gap in housing in the state, with no real plan for reversing this trend. As a result, California’s homeless population in 2020 topped 161,000, accounting for 28% of America’s unhoused people. Of this number, over 8,000 were based in San Francisco.

For the last four years, California’s politicians and business leaders have attempted to address the issue of homelessness in the state. In 2021, Gavin Newsom announced a $12 billion program to end homelessness and proposed an additional $2 billion in funding in the 2022 budget. In 2020, San Francisco Mayor London Breed created the city’s Homeless Recovery Plan, which targets 6,000 placements in housing and shelters in San Francisco. And in 2018, with the vocal support of Salesforce’s Marc Benioff, San Francisco came together to pass “Prop C,” which would tax the city’s richest corporations to fund homeless services on an annual basis. (The implementation of the bill was held up in the courts for almost two years; now passed, the funds are just beginning to flow.)

The tendency when debating solutions to homelessness is to debate its root causes, offering suggestions such as ‘people need to stop doing drugs, stop drinking’ and more. This approach ignores one crucial reality: when facing challenges, as we all do, the dignity of “being inside” is not quite comparable to anything else. It means you can eat inside, sleep with a roof over your head, go to the bathroom indoors, be intimate privately, drink or do drugs in the safety of a home, and ultimately, have the privacy that is needed to find healing from the difficulties we all face as humans.

During the pandemic, San Francisco attempted to help a part of its unhoused community by opening “Shelter in Place” residencies in city hotels, but the overall loss of social services and limited accommodations left the population’s needs largely unmet. With programs shuttered and no place to go for support, the unhoused community found connection in tent encampments – and on the streets. As a result, San Francisco’s decades-long crisis of the unhoused came out of the shadows and into the public purview.

As a result of the recent focus, an unprecedented amount of funding is becoming available in the state. At this point, however, it’s more than just a place to live that people need. To properly support the unhoused population and reverse the trend of homelessness we must assist people in moving through a complex system successfully, offer resources to address the systemic issues that lead to becoming unhoused, and rebuild community, connection, and housing confidence when a person is unhoused.

DISH: An Organization with a Different Approach – and Surprising Results

One organization in San Francisco approaching housing in a broad, holistic way is DISH: Delivering Innovation in Supportive Housing. Started in 2006, DISH’s goal is to provide high-quality, permanent housing to San Franciscans suffering from serious health issues. Beyond providing a roof over the heads of tenants, DISH offers the community, connection and support that allows tenants to begin their own process of healing from the traumas that caused them to be unhoused.

According to DISH’s Executive Director Lauren Hall, “transitioning into housing is challenging because people transitioning to being homed have been living in survival mode. They have had to find shelter every night, get moved by the police, take care of basic human functions out in the open – they spend each day figuring out how to survive. Once they get into housing all the things that they've been holding back can rear up. At DISH, we concern ourselves with this: how do we help people simply figure out reconnection? Once someone gets to us, they're no longer unhoused. They're just a person who needs a community and needs to be reconnected so that they can thrive in whatever way that looks like.”

The DISH Model for Success: Simple Yet Powerful

With an 18-day average homeless-to-housed time, a 99.8% housing retention rate, and an 89% tenant satisfaction rate, DISH is beloved by its 570 permanent residents, all of whom formerly fell under the definition of chronically homeless. The organization credits its success directly to its employees and the community they have built. From Desk Clerks to Property Managers to the Executive Director, everyone in the organization is hyper focused on connection, both within the DISH organization and with and among the residents at each of its eight supportive housing properties.

For DISH Community Development Manager Mattie Loyce, “There's work that DISH does as an organization to understand itself that then reflects upon how it supports, treats, and works with its resident population. They’re inherently and purposefully intertwined.” DISH staff and DISH tenants feel a mutual respect and belong to a common community.

“It's heartbreaking when someone passes away and we look at who they put down for their emergency contact, and it'll be the name of the General Manager,” Hall says. “So many people are so isolated, and this is their one place that they experience community and belonging.”

Residents join community advisory boards, and by taking on leadership positions within their buildings, develop a sense of belonging, a sense of identity and dignity, and a sense of housing self-esteem. Says Loyce, “community is integral to supportive housing because it's how we break down the heightened sense of isolation that comes with being unhoused. Once you are housed, the very real, human need for shelter has been served, and you can work from a different point, you can succeed differently.”

Boeddeker Trekkers is a DISH-led resident walking club held every Friday morning in the park right next to one of the DISH buildings. According to Loyce, this community effort “has become a beautiful, kind of holistic and safe space for a significant number of residents.” In August, DISH celebrated its Trekker regulars, including ten individuals that had come over 40 times in 52 weeks. For Loyce, “What's happening here is that there's a particular need met, a regular space, but one that isn't technically recovery based, or survival based.”

A key to the DISH model is the concept of harm reduction, which provides residents with the support to live securely, and places them at the center of the decision-making process. If residents use drugs or alcohol, DISH allows them the space to decide on their own to get sober, instead of requiring sobriety as a price of entry. According to Hall, “it's like any of us trying to get sober. No one else makes us do that. We decide like, ‘Hey, I'm going to stop using, stop drinking, stop smoking’.”

This combination of connection, community, and support gives residents the space they need to safely deal with the problems that ultimately caused them to become unhoused. Residents regain their dignity, see beyond their current experience, and envision a better future for themselves. DISH offers residents the opportunity for self-leadership, defining their own path in the way they need.

“Residents will sometimes get an opportunity to go elsewhere,” says Hall, “a bigger unit, an apartment versus a single room with a shared bathroom, and they’ll say, ‘I really don't want to go because I don't want to leave this community.’ We try to support them and to build a new community at DISH, and I know we're successful because people want to be here.”

As the tragedy of homelessness continues to play out in our streets, we can continue to debate ways to end this problem. Or we can celebrate and support organizations and people like DISH and its employees who are already on the front lines, successfully doing the difficult and important work of ending homelessness today.