Editorial: Santa Clara County’s one-size solution fails homeless residents

Rats. Trash. Desperation. Mental illness. Humanitarian crisis. These words define the conditions at the sprawling Columbus Park homeless encampment in San Jose.

No matter how many millions of dollars San Jose and Santa Clara County throw at homelessness, if the premise to the solution is flawed, then the problem cannot be fixed. And therein lies the rub, because applying a one-size-fits-all template to homelessness doesn’t work.

The county and city have made an effort. San Jose has erected interim housing—tiny homes, Pallet homes and converted shipping containers. The county has approved $75.5 million to build six affordable housing projects, and funded 3,648 affordable units, of which 830 are operational. San Jose wants to spend $113 million to convert four motels into interim and permanent housing through a Project Homekey grant. Both will spend millions more through Measure A, a $950 million affordable housing bond approved by voters in 2016.

Yet, housing alone will not fix the problem. A roof has never been the solution, only part of the solution. The other part of the equation is supportive services, and its implementation and delivery have been an utter failure.

This is why homeless encampments like Columbus Park exist. Decades of inadequate community services—lack of supportive housing and mental health services, reliance on police and jails—have pushed the region’s most vulnerable into inhumane conditions.

In the 2021 state auditor’s report “Homelessness in California,” which analyzed each county’s effectiveness in addressing homelessness, Santa Clara County is called out for its gaps in continuum of care services. The county “does not comprehensively identity services that are needed and not available.”

We need to revamp the county’s health and human services infrastructure to create a true continuum of care system. We cannot continue to operate critical services through departmental silos. They must be integrated seamlessly.

With Gov. Gavin Newsom allocating $14 billion over two years to address the state’s homelessness and mental health crisis, we have a once-in-a-lifetime opportunity to correct decades of negligence and get it right.

So where do we begin? For starters, we need to centralize services under one roof—housing, health care, behavioral health and legal. These pieces are all interconnected.

Then within this centralization, we need navigators who can steer homeless people to the appropriate organizations. Peer support workers, who have lived-experience, can be a vital part of this workforce.

In tandem, the county needs to triage homeless individuals by deploying social workers, health care professionals and peer support workers to conduct surveys and identify demographic percentages and needs. There are multiple federal government studies that cite more than 30% of homeless people suffer from a mental illness disorder. That impacts how dollars should be divvied up for critical services and housing types.

For example, permanent supportive housing for those with mental health or substance use challenges includes case management, mental health counselors and peer support workers on site. Without this built-in component, most of these individuals will land back on the streets. This continuity of care element isn’t always factored in.

Interim housing for the homeless bridges the gap until affordable permanent housing comes online. However, the number of unit types should be contingent on a need ratio—with or without supportive services. Supportive services may include meals, job and permanent housing assistance, medication management, health care, social workers, therapists, peer support and legal aid.

The most difficult groups to get off the streets are the chronically homeless and those struggling with severe mental illness and substance use. The severe shortage of detox facilities and acute care psychiatric hospital beds countywide exacerbates the problem. The ratio of acute-care beds should be 50 to every 100,000 residents. We stand at 18 to 100,000 in a county of 2 million residents.

This means alternative solutions are necessary. We need to build out more residential treatment facilities because hospitals in California take at least a decade to come online. We can’t keep dumping people in jails, which have become ad hoc hospitals for the mentally ill. That criminalizes an illness and is as cruel as herding people into unsanitary homeless camps.

If Santa Clara County truly wants to achieve its goal of getting 20,000 people off the streets by 2025—only three years from now—it has to do something very un-government-like. It has to pivot quickly and centralize its systems to help the thousands who have no idea where to turn for help.

Tom Insel, the former director of the National Institute for Mental Health, said helping a person comes down to three Ps: People, Purpose and Place. The meaning is simple even if achieving it is complicated. He said people need support, a safe place and they need to find purpose. This philosophy can apply to anyone.

How about if we add one more letter, specifically for Santa Clara County: “W” for will. That’s what it takes to change how it’s always been done.

Moryt Milo is San José Spotlight’s editorial advisor. She has more than 20 years of experience in Silicon Valley journalism, including roles as the editor for the Silicon Valley Business Journal and as a reporter and editor with the Silicon Valley Community Newspapers. Follow Moryt at @morytmilo on Twitter and catch up on her monthly editorials here.