In the wake of the “Seattle is Dying” news special which aired on KOMO last month, there was some coordinated pushback from Seattle elites. A PR firm was hired to help coordinate talking points in opposition to the conclusions of the special and in favor of some of the programs already operating in the city. Those talking points were then rolled out in a series of seemingly unconnected articles at news outlets like the Seattle Times and Crosscut.

One of the arguments made repeatedly in these pieces is that drug use (and also mental illness) are just one part of the problem. For instance, a piece written by Catherine Hinrichsen, director of Seattle University’s Project on Family Homelessness, was published last month at Crosscut. The piece offers six criticisms of the news special including this one:

The program conflates homelessness with drug use, mental illness and crime, and attempts to paint a few individuals as representative of our entire homeless population…

We already know we have a woeful lack of mental health services here. Drug addiction, which can be a cause or result of homelessness, is a nationwide epidemic, not a Seattle-only problem, and it affects people with homes, too.  Homelessness is decreasing nationally, but rising in cities where rents are too expensive.

But facts don’t matter in this program, because instead we hear lively stories from the two people with lived experience who talked to Johnson — the young man who uses meth and reacts delightedly to hearing that he’s on a list of most frequent offenders; the woman who says “100 percent” of people on the streets are addicted because everyone she knows is.

Today, Crosscut published another critique of the news special, this one by Dr. Richard Waters. It opens by referencing the same point:

Contrary to what some may assume, most people living homeless do not have a substance use disorder (SUD): it’s about 35%, according to a recent local survey. Nor are most people with a SUD (the medical term for addiction) living homeless; 86% of overdose deaths recently were in individuals with housing…

KOMO-TV’s special, Seattle is Dying, despite contextual errors, highlighted a frustration that resonated with some. It overtly implied a solution with an appealing simplicity: Incarcerate those living homeless and with SUDs for even minor legal infractions, provide medication treatment and counseling, involuntarily if needed, and people will emerge grateful and in recovery. We will save lives, the argument goes, and rapidly solve these issues.

Dr. Waters figure is accurate but it’s also misleading. If you follow his link to the 2018 Seattle/King County Count Us In survey results, you’ll find the 35% figure mentioned in the executive summary of the report.

Approximately 70% of Count Us In Survey respondents reported living with at least one health condition. The most frequently reported health conditions were psychiatric or emotional conditions (44%), post-traumatic stress disorder (37%), and drug or alcohol abuse (35%). Twenty-seven percent (27%) of respondents reported chronic health problems and 26% reported a physical disability.

However, one of the points the Count Us In report makes is that the homeless in Seattle (and King County) are indeed made up of various semi-distinct populations. There are some who are only homeless for a period of weeks or months and others who the report designates the “chronic homeless” who make up about 29% of the total. Here’s how the report defines chronic homelessness:

HUD defines an individual experiencing chronic homelessness as someone who has experienced homelessness for a year or longer—or who has experienced at least four episodes
totaling 12 months of homelessness in the last three years—and also has a disabling condition that prevents them from maintaining work or housing…

In 2018, Count Us In estimated 3,552 individuals experiencing chronic homelessness in Seattle/King County. These individuals comprised 29% of the total count population.
Compared to 2017, the number of individuals experiencing chronic homelessness increased by 28% (779 persons).

Of the total of just over 12,000 homeless counted in 2018, 52% were living on the street. Among the chronic homeless the figure was 71 percent. So these are the people who have been on the street longer and who are much more likely to be living in tents or vehicles rather than shelters. And among this subgroup the percentage who report a drug or alcohol problem is not 35% but nearly two-thirds:

Individuals experiencing chronic homelessness most frequently reported living with psychiatric or emotional conditions (63%), drug or alcohol abuse (63%), or post-traumatic
stress disorder (57%). Over half (52%) of survey respondents experiencing chronic homelessness indicated that behavioral health or medical issues were the primary cause of
their homelessness, compared to 32% of all other survey respondents.

There really is some truth to the idea that not everyone who is homeless and living on the streets is addicted to drugs or alcohol. There are some people who are on the streets for other reasons for a short period of time, a week or a couple of months and then recover.

However, I think when most people in Seattle (and elsewhere) think about the homeless, they have in mind the chronic homeless, i.e. the people living in tents who aren’t recovering. Among the “chronic homeless” a majority report drug and alcohol abuse. And keep in mind, these are self-reported figures. It seems possible that the drug and alcohol numbers are low overall as not everyone wants to admit to having such a problem.

A recent piece in the Seattle Times written by the executive director of the Washington Association of Sheriffs & Police Chiefs suggested dividing the homeless into three groups:

The first are those who need and will accept help, who have had a misfortune or have made bad choices and who find themselves, unwillingly, in a situation where they clearly need a hand up. We need to offer services — housing and treatment for behavioral problems and addiction when persons in this group are amenable to them.

The second are those with chronic addiction problems, who are frequently accompanied by mental health issues as well. Offering services is not enough for this group, because of the nature of addiction. We cannot rely on people to “help themselves” without a negative incentive, such as criminal charges or jail if they do not engage in treatment.

The third are “criminal transients” who choose to live outside, are entirely resistant to any intervention, have no interest in changing their lifestyle, and engage in criminal activity to support themselves. Many hide under the umbrella of “homeless” to gain sympathy and handouts, but they often victimize and prey on truly homeless persons. They are criminals and we must hold them accountable for their crimes. To view them as homeless is a disservice to those who want and will accept help.

This makes sense. What’s needed in Seattle and elsewhere is to separate the people who are short-term homeless for reasons relating to divorce, losing a job, etc. from those who are long-term homeless because of drug, alcohol, or mental problems. The same approach is not likely to help both populations. The former need temporary shelter and help to find another job. The latter need help facing their addictions or they’re probably not going to get off the streets.