Hiding behind his hands. This is what Jimmy would resort to whenever anyone's attention drew close to him. Bent over, covering his face so that no one would see him, Jimmy displayed an apparent shyness that seemed a bit awkward for a 59-year-old man. Measuring 5-foot-10, he shrunk as he crouched forward, wanting to disappear. Then as his friends would chide him, “Come on, Jimmy,” the man with graying hair and missing front teeth would smile, even laughing as he peered from behind aging finger gates.
Growing up on a farm, you needed your hands to tame the land and your family. At least this was Jimmy's experience. His father physically and verbally abused the children in the household and insisted that they tend to the farm, even if their studies suffered. As a sharecropper, his father decided it best to pull Jimmy from school when he was in the 6th grade, never to let him return. Jimmy resented his father for this and for his inability to read. When he was old enough, he left the farm and tried to make a life for himself in the city.
Jimmy began drinking beer and later whiskey in these years. It was all part of having a good time with his friends. Employment was difficult for Jimmy. Illiterate and with few work skills, he was limited to being a laborer on construction sites and similar settings. As a teenager he had begun hearing voices and experienced paranoia, some of which he managed with his alcohol use. But this also cost him a number of jobs. In time Jimmy began to try other drugs with some of his coworkers and friends until someone introduced him to crack cocaine. It did not take long for him to lose his place and his belongings. He had no friends and had no contact with his family.
This road of destruction finally met its end in an abandoned house where he was getting high. As some neighbors stumbled upon him, he lashed out in fearful anger, attacking them to get them out of the house. Addicted and homeless, Jimmy was arrested and mandated to treatment for his drug addiction.
Who are the homeless?
This true story is not unlike that of many people who have become homeless, seemingly stuck behind many psychic and social barriers. Despite the stereotypes of the skid row homeless, clinicians would be mistaken to see this group, representing 2.3 to 3.5 million of the U.S. population in a given year, as a homogenous entity. Addiction counselors know that each person's story is unique, and they also understand how ethnicity, gender, religion, physical ability, sexual orientation, veteran status, and socioeconomic class all may affect someone.
The homeless population represents a heterogeneous group of men, women, and children, all of whom share the common condition of having lost their place of residency. Living in shelters, cars, abandoned buildings, or under bridges, they fight for survival knowing that they could be displaced from these temporary spaces and lose all of their personal belongings. Without protection they may be attacked by fellow street people, the police, or a group of mischievous teens. Battered women, representing a large number of homeless women, live in fear of their former partners, who may attack or even kill them in spite of restraining orders and numerous legal interventions.
Children, one of the fastest growing segments of the homeless population, are frequently moving from school to school, not knowing where they might live and whether they might be taken from mothers who sometimes are regarded as unfit because of their low economic status and high-risk lifestyles. Being homeless constitutes a state of crisis riddled with uncertainty.
It is important to note that those who become homeless are more likely to experience trauma—and multiple levels of it. Like Jimmy, many have experienced childhood trauma and will need counseling to work through these painful memories as they affect current functioning. For homeless women, childhood trauma often extends into adulthood, especially when domestic partners become abusive and the patterns continue. Veterans, who make up an estimated 33% of the overall homeless population, often bring with them the experience of trauma in combat situations. More recently, a number of female veterans have been reporting sexual trauma while serving in the military.
1 Then after becoming homeless, many are victimized while living on the street.
Addiction and mental health treatment
Addiction and mental health problems are common among the homeless population. Burt and associates2 conducted a study of nearly 3,000 homeless persons and found that in the 30 days prior to survey, 38% of the homeless experienced problems associated with alcohol abuse, 26% with drug abuse, and 39% with mental health issues. When considering that many of these problems co-occur, the combined percentage of homeless persons affected by one or more of these problems reached 66%. There is a clear need for addiction and mental health services for these men and women.