Anybody else remember when Utah was the envy of the country as they implemented Housing First? A relatively conservative state brought Housing First to life on scale. You may remember Lloyd Pendleton at national conferences touting their achievements and approach, or The Daily Show’s feature on Housing First in Salt Lake City. And while there has been healthy debate on whether Salt Lake and Utah as a whole was achieving what they said to have achieved, the progress they made and the strategy to get there was still enviable.
Those. Days. Are. Gone.
Under the direction of the State of Utah, Operation Rio Grande has been implemented. It is draconian. It is a huge, expensive step backwards for a community that used to give the rest of the nation so much hope. In a nutshell, it aims to restore public order to an area through arrests, then provide treatment, and then provide opportunities for employment. They are in Phase 1, which started mid August, with a stated objective of identifying, arresting and locking up dangerous criminals. Despite claims by the Speaker and the Lt Governor that they are rounding up the worst of the worst and interrupting drug cartels, the data does not bear this out. There have been more than 1,600 arrests, mainly amongst people who have no fixed address. There has been a handful or so of people with multiple warrants arrested, but by and large, no kingpins, senior members of drug operations, or anything that would come close to “worst of the worst”. It is not dangerous criminals that are being arrested, it is low level drug offences, jaywalking, and such. A previous article by the Salt Lake Tribune highlights this. Operation Rio Grande is a $67 million investment, of which $34 million is directly linked to police and jail.
At the Utah Homelessness Summit on October 11, 2017, I was critical of the State’s Operation Rio Grande. Since that time the Tribune published an article highlighting my critiques of the Operation, and while there has been an overwhelming outpouring of agreement and support through social media from across the country, it seems to have unleashed the trolls that are of the opinion that I am misinformed. The Speaker himself has been a vocal critic lamenting that being out of state somehow should negate my expertise on the issue. Others have suggested I do not know what is really going on.
We (OrgCode) have a vested interest in Salt Lake’s response to homelessness. We are currently under contract to advise on the development of three resource centers (shelters). Given Operation Rio Grande has been touted by some as the model for how the resource centers should work, we need to be informed and apply critical thinking to Operation Rio Grande.
I think it is important to provide an informed opinion on complex social issues. What many in Utah were unaware of is that I was in Salt Lake City just the month before the summit. On my own time, I spoke with many people impacted by the Operation. Those people experiencing homelessness overwhelmingly expressed fear and distrust of what was happening; felt they were living in a police state; felt they were much less safe than when the initiative began. I spoke with some state public servants who felt Operation Rio Grande is all about law and order and not about service, and see no way that the objectives of Phase 2 or 3 could possibly be met with the resources identified. Furthermore, state staff also spoke in hushed tones knowing that given this initiative was being spearheaded by the Speaker with the support of the Lt Governor that any dissenting opinion may result in their job loss. I spoke extensively with service providers, at different levels within their organizations, who felt sidelined while this process has been unfolding, making their work more difficult, and seeing many vulnerable people that they had been working with disappear. Like their state colleagues, service providers had little faith in Phases 2 or 3 being resourced in a manner that would allow them to be effective. Both the state public servants and service providers indicated repeatedly that all they had been known for in Utah in applying Housing First had been tossed out the window.
I examined all of the information that the State has put out on Operation Rio Grande. I read and reviewed a number of media reports that have come out regarding Operation Rio Grande. Up to that point, I was able to provide critical analysis of all that I had heard relative to stated objectives. While leaning towards a negative impression that this exercise was ultimately criminalizing homelessness, it is when the panel started to speak on October 11 that the intent was made clear. The first 10 minutes of Speaker Hughes speaking reinforced the objectives (which you can download and watch here). While there is language related to addressing people that are preying on those who are homeless, consider how many times “lawlessness” is implicitly or explicitly tied to homelessness. The orientation of the remarks is rooted in a lack of education on trauma and harm reduction. While nuanced, this is about command and control.
Since making my remarks, many within Utah have suggested that I am uneducated, or as the Speaker suggested, I can’t possibly know what is happening or how best to address it because I am from out of State. I am a passionate advocate for ending homelessness. I am a skeptical empiricst in the use of data to achieve this aim. I stay abreast of the peer-reviewed published literature on the subject matter, and I attempt to help community after community implement the most up-to-date approaches in ending homelessness driven by data. Working in communities throughout Australia, Canada and the United States, primarily, I spend about 220-280 days a year working from this perspective. I have the great fortune of seeing a diverse range of communities and approaches.
Imagine your community needed to build a new bridge. I am hoping that you would want the best possible engineers to design the bridge to meet the stated objectives of the bridge relative to traffic volume and the weight of the traffic relative to the length of space to be served by the bridge. You would then want the best construction team possible to build the bridge to those engineering specifications. If the best engineers or construction team were from another jurisdiction, wouldn’t you still want them? Or would you suggest that they don’t understand what bridges really are or mean in their community; or that because you were not from there you could not possibly understand their reality of spanning that space with a bridge.
To take this a step further, I am not suggesting that there are not local experts when it comes to ending homelessness, but if you had someone or a team of people that could offer expertise that you did not have locally, wouldn’t you – like the engineers and construction team – want to bring in that expertise? If the experts suggested that you do something different and could justify their reasoning with evidence, wouldn’t you want to consider that? But alas, complex social issues whether it be responses to street involved activity or homelessness often have strategies and operational responses that are designed by non-experts where their opinions of the issues inform the response rather than the evidence. Imagine if we designed bridges based upon opinions rather than evidence. Operation Rio Grande – and especially its architects (Speaker Hughes, Lt. Gov. Spencer Cox) – lack the expertise necessary to figure this out effectively. They are like people trying to design and build a bridge without the expertise.
I am not saying that issues in the Rio Grande area did not need addressing. By all accounts it did. What I am critiquing is the response. First of all, the data shows they are not interrupting criminal activity. They are adding additional barriers to housing and employment by adding more arrests to people who are homeless and already have many barriers to housing.
Perhaps the intention is one of deterrence. We can trace Deterrence Theory back to Classical Theory in the 18th Century. In a nutshell – as rational beings, humans want to maximize pleasure and minimize pain. If the probability of arrest is high, the probability of conviction is high, and the severity of the punishment is large, then people will, according to this theory, avoid doing things that cause pain. The War on Drugs, from the national approach to localized responses that may not associate with the mantle, demonstrates time and again that the Deterrence Approach does not work. Drug use continues to go up decade after decade since Nixon first declared the War on Drugs, even with extremely high rates of incarceration associated with drug use. And the war is mainly on drug users, not drug makers, dealers, manufacturers or distributors.
“The failure of crime rates to decline commensurately with increases in the rate of punishment reveals a paradox of punishment,” writes Meares and Fagan in Punishment, Deterrence and Social Control. Crackdowns also do not work over the long term. As people in the Rio Grande area have indicated, they still get the drugs they need, just in different areas. Academically we can trace our knowledge about the fallacy of the impacts of crackdowns to the work of Sherman et al in 1995, which examined the results of raids on crack houses in Kansas City and Missouri. The positive effects of the raids were negligible and decayed in two weeks. (Sherman, et al., 1995, Deterrent effects of police raids on crack houses: A randomized, controlled experiment. Justice Quarterly, 12(4)).
Scholarship on the criminalization of homelessness intensifies in the 1980s. To be clear, being homeless is not illegal. The criminalization of homelessness refers to practices of enforcement that disproportionately impact people that are homeless. The general themes in the contributions to the peer-reviewed published literature looks at various elements that are all present in what is occurring in Salt Lake City with Operation Rio Grande. For example, there is an increased police presence and increased engagement with people that are homeless. To date hundreds of thousands of dollars have been spent on overtime of police alone. Another example, the language of “public safety”, “social disorder”, and “restoring order” is used by officials while at the same time there is more engagement with police, rooting out of misdemeanours, and confining use of public space (Operation Rio Grande has a “safe zone” for people that are homeless). Further, if you watched Speaker Hughes remarks you would have heard reference to these themes. “Stop and frisk” policies were made popular in New York City decades ago. It is another hallmark of criminalization of homelessness. Even the Former Chief of Police of Salt Lake City has indicated that he sees what is happening in Operation Rio Grande as an example of “stop and frisk”. Criminalization activities also are more likely to occur in areas that go through economic transformation or gentrification. The Rio Grande area in Salt Lake has been experiencing gentrification.
We would be remiss if we didn’t point out the influence of Dr. Marbut in what is happening in Salt Lake City. It is our understanding that the business community in the Rio Grande area have sought his counsel. We also are of the understanding that Marbut has had influence on the political leaders involved in the initiative, and that the State public servants involved have rejected the suggestions of Marbut. Nonetheless, we are critical of Marbut and have laid out step by step rebuttals of his claims, as have advocates like Retired US Navy Lieutenant Tom Rebman.
Another element of Operation Rio Grande is helping people access housing and treatment. On the surface, these are laudable, commendable objectives. But let us consider two things: first, the investment in these is low; and, second, these happen – by and large - after enforcement activities – not before or during.
State public servants and service providers alike that I spoke with are in favor of having more housing and treatment options. They are also suspicious that this will come to fruition. And where housing is concerned, let us be clear that the results of Phase 1 will only making achieving housing that much more difficult.
The Substance Abuse and Mental Health Services Administration would tell you that about 7% of the adult population in the United States has an addiction or dependency on alcohol. Further, about 3.5% have an addiction or dependency on other drugs. In both cases, about 90% receive no treatment or counselling whatsoever. To recap, almost everyone with an addiction is housed and gets no treatment of counselling.
Across the country, between 40-50% of all people in treatment programs for substance use are there because it is court ordered. While courts can force people to go to treatment and put consequences in place when people do not comply, the internal motivation to change is way more important than what is court ordered. Furthermore, most court ordered treatment focuses on Alcoholics Anonymous and/or Narcotics Anonymous, which have less than 10% long-term effectiveness rates in supporting sobriety.
While the US accounts for about 5% of the world’s population, it has the reputation of having about 25% of all people incarcerated around the globe. An enormous amount of those incarcerated, especially in the federal system, are for drug related offences. Billions are spent annually in this regard. And yet, there continue to be large volumes of people who use alcohol and other drugs. Is criminalization of substance use a deterrent to using alcohol or other drugs? Clearly not. It just ends up with more people incarcerated. And, interestingly, if you look at Department of Justice statistics you will see that when it comes to violent crimes, more people were under the influence of alcohol (and no other drug) at the time of their arrest (which, let’s be clear, alcohol is legal).
Across the country I have worked with a litany of police, sheriffs, and judges in training, policy advice and counsel to help them understand how to deal with the overlapping complexities of homelessness and substance use, helping them focus on social service rather than social control. I am honored to have had so many in law enforcement realize that OrgCode can help them improve their approach to engaging with complex social issues. They have helped me understand the pressures and realities of policing and the court process as it relates to homelessness, but would acknowledge that enforcing their way through use of drugs and alcohol and behaviors associated with homelessness has not worked historically.
If the leaders in the State and Salt Lake were to examine the peer-reviewed, published literature, they would learn the following: stable, appropriate, affordable housing is the MOST important first step if you want people to fully participate in training and achieve sobriety; health and social outcomes improve with a housing focus; people have less interaction with law enforcement when they are stably and appropriately housed.
Through HUD regulations – a major funder in homeless serving programs – every community is required to have something called Coordinated Entry. In Coordinated Entry, a community sets its own priorities related to who is going to get housing in which order. Salt Lake could very easily decide that the same population being targeted in enforcement activities is the top priority for housing. What would happen if they did? Especially if there were more resources as considered in Operation Rio Grande?
Well, people would be housed before there was any conversation about treatment. In this regard, the literature is also quite convincing (see most of Tsemberis’ work; or the evaluation of the program I designed and ran which saw a 49% decrease in alcohol use with 17% quitting altogether, and a 74% decrease in use of other drugs with 33% quitting altogether). The entire movement to have communities implement Housing First (which Utah used to believe in and be a champion of) knows that if you house people first you have a greater likelihood of addressing any other issue in a person’s life. And the approach to doing this is one grounded in harm reduction – a central and critical element to Housing First.
It is time for Utah to fully embrace all aspects of harm reduction. If you are unfamiliar with harm reduction, it was born from public health professionals. In a nutshell, harm reduction could be explained as follows: it isn’t what’s pretty, it is what works. We are trying to reduce harm to the community at large while also reducing harm to the specific person. Harm Reduction approaches have been proven time and again to produce better health, social and economic outcomes. But achieving it almost always means a person has to park their own morality to get there. People do not need to be sober to be housed unless they want to be. If a person is housed and uses alcohol or other drugs, the approach tries to reduce the harm associated with the use rather than trying to focus on abstinence or cessation of use. Harm reduction, as outlined in the literature and proven time and again, is not about legalizing drugs, nor is it about enabling people to use alcohol or other drugs.
If Operation Rio Grande had designated just more than half of the money to housing as the first step, 900 of the most vulnerable people could have received an $700 subsidy to assist with rent every month for 5 years, and still have money to assist them to stay housed through case management. Most of those vulnerable persons housed will never need treatment – they will remain housed and continue to use alcohol or other drugs. They will be like most other Americans that use alcohol or other drugs.
That said, the availability of treatment beds in the state is inadequate as it currently stands. Adding more treatment bed options is a very good idea. In the approach outlined above there would remain close to $30 million to add more treatment beds, and to achieve other objectives like participation in the labor force. As local behavioral health experts know, a focus on Medically Assisted Treatment is a very good idea rather than focusing on just willpower alone.
Substance use is not a character flaw. As Dr. Gabor Mate – a medical doctor who has worked with homeless and under-housed persons throughout his career – has demonstrated, there is a strong association between use of substances and trauma. As Dr. Carl Hart – a neuroscientist at Columbia University – has demonstrated, most of what we think we know about drugs and alcohol is wrong, and built upon myth rather than science. It is time all of us (not just the people of Salt Lake City or elected officials in Utah) improve their knowledge of the science related to substance use, not feelings and opinions related to substance use.
On the matter of labor force participation, if Operation Rio Grande is serious about increasing the number of people that were homeless having jobs, then the approach has to be Supported Employment. There is reason to believe that half or more of those housed could participate in the labor force if a Supported Employment approach is used.
They say decisions are made by those that show up. I commend Speaker Hughes for showing up in the Rio Grande district, creating a storefront, soliciting input from people that met in his office and trying to spearhead a response to the issues he was seeing. I also showed up, did my research and some critical thinking, and saw what was happening. I agree that we can do something really effective to help end homelessness and address issues that the Speaker has seen and experienced. Where I disagree is the approach. With $67 million on the table, we can and should do better to avoid criminalization of homelessness, meet people’s actual needs, and make a huge dent in the issues through housing…first.