When the shelters are full, those without full-time housing take refuge in other spaces, which offer varying degrees of safety. Cars provide some measure of privacy but are far from ideal. Storage units, motels, and tent cities are other options.
“I haven’t slept in days,” says a vendor for Real Change, a weekly Seattle paper sold by those in extreme poverty. He requested that I not use his name, and he says he isn’t homeless—he lives in transitional housing—but nonetheless fears for his safety at night.
“It’s better than when I was living on the streets, I guess, but not by a lot. You don’t get a lock on your door. I don’t worry about them stealing my stuff while I’m out here working because I don’t have a lot of stuff, but I worry about, you know ... other stuff. At night. Sometimes, when I make enough out here, I check into a hotel just to sleep in a room by myself.”
New York City is currently debating whether or not housing costs should be considered a matter of healthcare. Common Ground director Brenda Rosen noted in an NPR report that the cost for providing transitional housing services was less than the cost of paying for the three places where homeless individuals usually end up: shelters, jails, and the emergency room.
And yet, says Eowyn Rieke, a physician with Outside In in Portland, Oregon, the problem of insufficient sleep is “an unrecognized” one. Even within the medical community that deals directly with the homeless, “we don’t talk enough about these concerns with our patients.”
Steve Berg, Vice President for Programs and Policy at the National Alliance to End Homelessness admits that sleep, specifically, wasn’t a factor of health that he had necessarily considered. However, the healthcare community has been helping secure funding to get chronically homeless populations into housing.
“The thing we know from research is that housing people in that situation improves their health and reduces cost,” he said. “There are striking reductions in the use of hospitals and emergency rooms. Mainly who it saves money for is the healthcare system. And I think people in the healthcare system have started to understand this.”
The Obama administration is currently pushing to increase funding to the Department of Housing and Urban Development by about $300 million, which would fund rent subsidies for as many as 37,000 chronically homeless people—a number that, Berg says, “would be enough to finally end chronic homeless by the end of 2016.”
“The process of Congress deciding how much money to spend on things is very bogged down right now,” he says, “but eventually they’re going to have to make a decision.”
In the meantime, though, there remain huge gaps in the care of those who sleep outside.
When the weather turns cold, cities open warming shelters. When populations are hungry, food banks and soup kitchens provide nourishment. There are resources for assistance paying utility bills, applying for jobs, even getting to and from work.
But aside from low-income housing, which is often in high demand and still often unaffordable, there is no sleep resource. And without a sleep resource, there seems to be little chance for solving the myriad problems associated with sleeplessness.
“Suffering from a lack of sleep, just how is a homeless person supposed to do all the things necessary for overcoming their homelessness?” asks Barbieux.