Hypothermia kills an estimated 700 people experiencing, or at-risk of homelessness each year, according to the National Coalition for the Homeless. Every day, street outreach workers in cities across the nation go out into communities to encourage people on the street to take shelter, but many homeless people refuse.
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This is TALK OF THE NATION. I'm Ari Shapiro in Washington. Winter's approaching, and it's getting cold. That makes the problem of homelessness more urgent. The National Coalition for the Homeless estimates that 700 people on the streets die from hypothermia every year in the U.S. So each day volunteers and outreach workers head out to encourage homeless people to go to shelters.
In many cases they refuse, and in this hour we'll explore why. We'll begin with a guest who was once homeless himself and refused shelter, but we also want to hear from you. If you've been homeless, have you ever avoided shelter? Tell us your story. Our number is 1-800-989-8255. Our email address is firstname.lastname@example.org. And you can also join the conversation at our website. Go to npr.org and click on TALK OF THE NATION.
Later in the program, marijuana has been legal in Washington State for all of 12 hours now. So are the shelves bare in 7-Elevens across Seattle yet? But first, coming in from the cold. David Pirtle joins us here in NPR Studio 3A. Welcome to the program.
DAVID PIRTLE: Thank you.
SHAPIRO: Tell us your story. How did you end up homeless?
PIRTLE: Well, I became homeless in 2004 as a result of schizophrenia, untreated schizophrenia. It caused me to lose my job, and I wound up on the street.
SHAPIRO: And was schizophrenia part of your reason for avoiding shelters?
PIRTLE: Part of the reason was, you know, the paranoia and the fear of large groups of people that comes along with schizophrenia, but part of the reason was, and I think this is more generally the case with people, is that you hear a lot of terrible things about shelters, that shelters are dangerous places, that they're full of drugs and drug dealers, that people will steal your shoes, and there's bedbugs and body lice.
And yeah, unfortunately a lot of those things are true.
SHAPIRO: Those things actually happen.
SHAPIRO: Is there a wide range between the shelters that are, you know, safe and warm and clean and the shelters where people would rather just be on the street?
PIRTLE: Oh yes, there's - I don't want to say that all shelters are like that. There's a lot of very good shelters in this country. But there are a lot of big warehouses that are just places where we stick people at night and we really don't have any regard for how they live there.
SHAPIRO: What was it like for you on the worst nights, when you were not in a shelter?
PIRTLE: Well, not being in a shelter during the coldest nights is just, you know, fear of not waking up in the morning. It's fear of freezing to death. But you learn how to adapt. You learn how to, you know, stuff newspapers in your clothing to keep warm. You learn about hypothermia vans that come by and pass out blankets.
And I found it a lot easier to deal with eventually than the heat in the summer.
SHAPIRO: And when people in those vans would come by and say come on in from the cold, you said it was your schizophrenia, but knowing that you had this fear of not waking up in the morning, talk about the decision not to go with them to a warm place.
PIRTLE: All I can say is that my fear of the unknown, of what might be waiting for me at that shelter, was worse than my fear of the known risk, you know, of staying out on the street. That was where I was comfortable. And I think people, we're creatures of habit. We get comfortable in the most uncomfortable positions, and that just becomes home.
SHAPIRO: And did you have firsthand experiences in the shelter that made you think, no, this is not a place I want to be?
PIRTLE: I spent most of my time homeless out on the street. It wasn't until the very end of my homelessness that I ended up in a shelter. And I found out that a lot of what I was afraid of was true. I never found out what a body louse was until I got into the shelter. You know, I had my shoes stolen, just like people said you get your shoes stolen, although I will say that there were three people in the shelter who offered to give me a pair of shoes after that happened.
So there is a sense of community there. I don't want to give the impression that everyone in the shelter is bad. But you have a lot of people with a lot of problems, and so when you cram them all together, you just have one big problem. That's why I'm a big fan of smaller, scattered-sized shelters, where people can get more focus on what they need to get help.
SHAPIRO: There's obviously a huge range among shelters, but I understand that in some cases the schedules of check in, check out, meals, et cetera, can also make it difficult to look for a job, to tend to a family. Tell me about that.
PIRTLE: Yes, I know someone who used to go to the Gospel Rescue Mission downtown here in Washington, D.C., and he would pay a few bucks every night just to store his bag because there wasn't a shelter where he could stay during the day. So he would sleep during the day in the park, and then at night he would store his bag in a shelter and go off to work.
The shelter where I stayed briefly, you had to be in line. They technically opened at 7:00, but you had to be in line at 4:30 in the afternoon to be able to get your bed back, and this is obviously not conducive to anyone who is not working bank hours.
SHAPIRO: Winter is coming, and we're obviously concerned about people on the street in the cold. But we were saying before the show began that heat is also a problem. You know somebody in Washington, D.C. who passed away in the heat.
PIRTLE: Yes, unfortunately. His name was Korvin Newkum(ph) and he died in the shelter where I was staying because of the heat.
SHAPIRO: Because there was no air conditioning.
PIRTLE: Because there was no ventilation, and there were 300 men crammed in one small building.
SHAPIRO: What finally changed for you?
PIRTLE: What changed for me first and foremost was I got arrested, and I know that doesn't sound like a good thing, but it was a good thing for me because it was the first time anybody realized that I needed help. A lot of the time people out there with mental illnesses are unrecognized. And when I got arrested for trying to steal some food, the prosecutor and the defense attorney and the judge, they all said this guy is not a criminal, he just needs help.
So they told me I had to go to a shelter. That's how I ended up in shelter for the first time. And they also told me that I had to get treatment for my schizophrenia, had to go on medication and see a psychiatrist. And I slowly got better.
SHAPIRO: That's David Pirtle, joining us here in NPR's Studio 3A, formerly homeless himself, now an advocate for the rights of people experiencing homelessness and mental illness. Thanks for joining us.
PIRTLE: Thank you.
SHAPIRO: And let's go to a caller now. This is John(ph) in Grand Junction, Colorado. Hi, John, tell us your story.
JOHN: Hi, my name is John, as I said, and I was a shelter director for years. I ran a small shelter in Grand Junction, Colorado. And you know, I used to have staff meetings and we'd make long lists of every barrier there was to those things, and there are so many. They are crowded. On a winter night you can hardly sleep because the hacking is so heavy. The smell...
SHAPIRO: You mean people coughing?
JOHN: I think they really, you know, they're really tough to stay in. They really are, and they're really crowded. The good ones, when they run well, get very, very crowded, and ours is very crowded. We have an overflow into local faith communities.
SHAPIRO: So even though there are all of these drawbacks to shelter life, there is still more demand for them than the supply.
JOHN: You know, our - we're probably one of the few communities in America where we can say if you show up tonight, we'll house you. But yeah, I think that's - you know, in the larger metropolitan areas, it's overwhelming, the demand is so overwhelming.
SHAPIRO: So given that there is this long list of things that you would like to be able to fix about a shelter, what's at the top of the list?
JOHN: The top of the list for me would be to take the shelters, close them down and build or purchase small, single rooms. These things are a lot more expensive than people think. It's not as cheap as you would think, the bed night(ph) cost to put people in large rooms. And I think there are a lot of people that would come right off the street if they knew they had a locked room, if there weren't so much, you know, so much bureaucracy, if (unintelligible) weren't feeling so controlled, people could kind of breathe a little bit. I think you'd see people come in off (technical difficulties) much more expensive, because sheltering is very pricey.
SHAPIRO: Well, John, thanks for the call. It's good to get your perspective in this conversation.
JOHN: Thank you much. Bye.
SHAPIRO: In Boston, temperatures during the winter can get bitterly cold. The latest annual homeless census figure counts 6,647 homeless men, women and children in Boston; 181 of those people were living on the streets without shelter. Well, Jim Greene is director of the Boston Emergency Shelter Commission. He has years of experience in working as a street outreach worker, encouraging homeless people in the city to go to shelters. Jim, welcome to the program.
JAMES GREENE: Thank you, Ari.
SHAPIRO: What does a typical conversation with somebody on the street on a cold winter night sound like?
GREENE: Well, hopefully, if we've done our job well, it sounds like a continuation of a conversation that you've been having in the weeks and months before the cold weather event. We have a year-round interagency street outreach network in Boston that's outstanding, very skilled and experienced outreach workers who are likely to know somebody like David by name, know where he stays, have already discussed some of his fears with him.
But even more importantly, maybe, they have relationships with the folks at the Pine Street Inn or the Woods Mullen Shelter or the Long Island Shelter, so that they can - if they're encouraging someone to come in, they're not just saying why don't you go down to that place you're so terrified of, but let me give a call to Ivan or Niurka(ph) down at the shelter, or let me talk to Leo and see if we can get you a bed.
And I think that the relational fabric that outreach teams build are both part of good public health and preparedness, but they also help overcome some of the social isolation that David was describing. So I think that, you know, hopefully what we need to do in the coldest months of the year, and I would agree with David, or in the hottest months of the year, builds on a daily and also nightly effort to encourage people not to let the streets be their last stop.
SHAPIRO: But you know, it sounded from both what David said and what John said earlier in the program as though the most persuasive case can't make somebody want to go to a shelter that may be a really terrible place.
GREENE: Well, for the most part, our shelters are pretty full year-round. So as difficult as it is to have, you know, 150 roommates in a dormitory, in a large building, people are going there hoping to get their needs met. And I think a part of what we do here in Boston - you know, Mayor Menino emphasizes preparedness. That's a public health best practice.
So we talk about adding overflow. We talk about working with people to identify that maybe if one shelter is a place they had a bad experience, that there's another shelter facility that they would consider. Sometimes taking people down to see a place can make a big difference. But I think, you know, we see our numbers go up in the warm weather months because, as David described pretty well, people lead pretty truncated lives in fairly crowded conditions during the winter months.
SHAPIRO: Well, stay on the line with us, Jim. We're talking with Jim Greene, he's director of the Boston Emergency Shelter Commission. And if you've ever been homeless and opted not to go to a shelter, we want to hear from you. Give us a call at 1-800-989-8255. Or send us an email, email@example.com. We'll be back in just a minute. I'm Ari Shapiro and this is TALK OF THE NATION from NPR News.
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SHAPIRO: This is TALK OF THE NATION from NPR News. I'm Ari Shapiro. It's tough to count how many people are homeless, but according to national estimates, over the last two decades, homelessness is on the rise. Foreclosures are partly to blame, and there's a whole host of other factors at work, as well, from mental illness and addiction to the availability of public assistance and jobs.
Shelters try to fill the gaps between homes and the streets, but people who are homeless don't always want to check in. If you've ever been homeless and reluctant to go to a shelter, tell us your story. Our number is 1-800-989-8255. Our email address is firstname.lastname@example.org. And you can join the conversation at our website. Go to npr.org, and click on TALK OF THE NATION.
We're joined now by Irene(ph) in Sacramento, California. Hi, Irene.
SHAPIRO: Tell us your story.
IRENE: Well, I've been homeless two and a half years in three states, from Minneapolis to Eugene, Oregon. Now I'm in Sacramento, California. I'm currently staying with a man with a disability, and we protect each other, but at shelters, often women will cut in the line - in front of me in line, for example, and then tell staff that I'm the wrongdoer. So it's an abusive environment where I'm not respected, my credibility isn't respected.
If there's security cameras or lots of witnesses, usually it doesn't happen, or they can't get away with it.
SHAPIRO: Sounds like a lot of people in high stress, in close quarters, just does not make for a pleasant situation.
IRENE: Right, I think it's good to have a right to exist. They have a right to have personal space, protected personal space, and for society not to be abusive, that personal space needs to not be violated.
SHAPIRO: All right, well thanks for the call, Irene.
IRENE: Thank you.
SHAPIRO: We're going to go to another caller now. This is Michael(ph). Hi Michael.
MICHAEL: Hello, thanks for having me on.
SHAPIRO: Sure, go ahead.
MICHAEL: I was homeless for five years. And my perspective on shelters was that I was never going to give up my right to speak and to have my own perspectives on faith, and I wasn't going to trade that to sit (technical difficulties) to what someone else had to say about how bad my life was.
SHAPIRO: So you felt judged in a shelter, is that what you're saying?
MICHAEL: Oh and not just judged but told that there was only one way for me to be a better person, and that was through whatever their perspective on faith was.
SHAPIRO: So a lot of religious messages?
MICHAEL: Absolutely, and, you know, considering the fact that police all want to send you to the shelter, and the judges want it, your first guest, was actually told by a judge to go to a shelter, this is in fact an establishment of religion by the state, when we hand these services over to faith communities. What we're doing is we're (technical difficulties) people who are very often ill-adapted to defending themselves.
SHAPIRO: OK, Michael, thanks for the call.
SHAPIRO: And our guest is Jim Greene, director of the Boston Emergency Shelter Commission. Jim, how common is it for shelters to come with rules, whether it's you have to be alcohol-free, or you have to subscribe to a particular religious philosophy, or you have to have a family or be seeking a job? What are the barriers to entry in some cases?
GREENE: For the individual adult population that have mostly been calling in, you know, for the most part the rules have to do with being respectful of other guests, with certain times of day when meals are offered or when you need to take your bed so that you can tell whether all your beds are full. But there aren't rules about - you know, our city-run shelters are nonprofit-run shelters.
The philosophy is to try to respect the dignity and the individuality of people. Admittedly, you have to go through, you know, the front door and register for a bed, and you're sharing space with other people that you might not choose if you had your own place to live. But there aren't necessarily those kind of moral judgments that someone is talking about.
I think the goal is to offer people a range of options and also the services that help them move beyond shelter, whether that's counseling and case management, employment. Substance abuse counseling is a big priority. And I just think, Ari, that one of the things that's important is people have come by their objections and their struggles that they've been voicing here usually by a very legitimate and often very hard path in their lives.
And I think the goal is to extend outreach and offer people options and hope you find the right mix. So we have some shelters, for example, that are for women only. We have - some of the shelters for women are some of our smaller shelters, 10 beds, 20 beds, trying to offer things that respect some of the challenges that people face if they've experienced trauma or adversity in their lives.
SHAPIRO: All right.
GREENE: So I think you try to have a full menu of options for people, as full as possible.
SHAPIRO: Well, one approach to this problem of getting the homeless into shelters is what's known as a low-barrier shelter. Kathy Sibert is director of the Arlington Street People's Assistance Network, or A-SPAN, which runs an emergency winter shelter that is low-barrier. She joins us from her office in Arlington, just outside of Washington, D.C. Welcome to the program.
KATHY SIBERT: Thank you, Ari.
SHAPIRO: What does low-barrier mean? What's a low-barrier shelter?
SIBERT: What low-barrier means is that people can come in, even if they're inebriated or using substances or have a mental illness or anything like that. And so they're admitted in, as long as they're not of harm to themselves or to others.
SHAPIRO: And how common is this right now?
SIBERT: What do you mean, how is...?
SHAPIRO: I mean, are many shelters in the United States low-barrier, or is this still sort of maybe there's one in each major city?
SIBERT: I think that generally most shelters have some kind of barrier. It might be that you cannot drink, or you cannot use substances or something like that. But - so it's usually - in each jurisdiction they usually have one that's low-barrier.
SHAPIRO: I can imagine many homeless people do not want to be in a shelter with people who are inebriated or using substances. Do you run into that problem?
SIBERT: No, we really don't because what happens is, and it's exactly what Jim was talking about earlier because I really, really agree with him about the importance of outreach and the importance of establishing a relationship. And so what happens is, we have already developed a relationship with the people that we serve on the streets.
And so when they come - remember our shelter currently is only open from November 1st until March 31st. So when they come to the shelter, we've already developed a relationship with them, and the way our rooms are set up, we don't have a huge room where everybody sleeps. So there may be four to six people in a room.
SHAPIRO: Jim and Kathy, I'd like you both to stay on the line. We're going to take another call, from Pam(ph) in Berkeley, California. Hi Pam, go ahead.
PAM: Hi, yeah, I was homeless in Berkeley, and I found it very, very difficult to go in at the times that they wanted us to go in and to leave at the times that they wanted us to leave. It was difficult because it was exhausting. You had to leave whether it was rain or shine. And a lot of people had nowhere to go. And so you would find women that were just, you know, sitting outside the shelter at all hours of the day, waiting for the shelter to open up again.
And then, you know, when it was open up again, you had to be in there by a certain time. I was dealing with both mental illness and substance abuse, and I think people forget that with substance abuse, you don't have much control. You need help, you really need help, and you can't necessarily come in without having alcohol on your breath.
You can certainly not drink while you're in the shelter. I've been sober for a few years now, but at that time I just, I wasn't able to do what they wanted me to do and to come in at that time.
SHAPIRO: OK, Pam, thanks for the call.
SHAPIRO: And Kathy, how common is it for shelters to address these more fundamental problems that she's talking about: the substance abuse, the mental illness?
SIBERT: That, Ari, is really - and I know Jim will agree with me on this, too - is that really shelters are really for people in crisis. And so what happens is they're really an open door to the services that you're offering there. So in our shelter, what we offer is we have mental health counselors there. We have substance abuse counselors.
We also provide nursing services so that we have a nurse practitioner there four nights a week, which is really nice because so many of the people living on the street have really serious medical issues. And they don't have, you know, a way to get medical care.
So for you and me, Ari, you know, when we get like let's say bronchitis, we go to the doctor, they give us a prescription for antibiotics, and the next day we're feeling a lot better. If you're living on the streets, you don't have that ability. And so by the time they end up in the ER, they have full-blown pneumonia.
SHAPIRO: And I'm sure that if somebody shows up at the shelter with bronchitis, then suddenly you have a bronchitis outbreak in the shelter, which might be another reason people don't want to come.
SIBERT: But remember that when someone comes in and they're ill, what we do is we have them assessed. And so what we then do is we call an ambulance and have them taken to the emergency room. And really it's been - we have a really good relationship with our local hospital, and it's been really terrific because we've really saved people's lives.
SHAPIRO: Great. Let's take another call. This is Elbe(ph) from San Antonio, Texas. Hi. You're on the air.
ELBE: Hi. Nobody has addressed the thing about animals. And I just want to say, when I was homeless, I had a dog. I used my dog as protection because I was just a single young woman on the streets. And, you know, they wouldn't let him in shelters. They - you couldn't have an animal, and I needed my dog. I mean, my dog was kind of my family. And so we slept outside because I didn't want to have to give up my dog.
SHAPIRO: And were you worried about your health in the heat of Texas, in the cold? It gets very cold at night in the desert.
ELBE: There were times, mostly with heat, but it wasn't so bad. I mean, I've been in situations where I also had to sleep in the cold when I was on the East Coast. And that's much worse, you know, but - and you can go to places. During the day, I would find places to go, and if they would let me, I'd tie my dog up outside and go into the library or - for something. In order to get cool, I'd go in the grocery store, and my dog would wait outside.
But you can't - you know, there's a lot of young women that are out on the street that are completely homeless, and, you know, and a lot of them have dogs for protection so they don't get raped or...
ELBE: ...murdered or something. And it's just really - you know, it's something people need to be aware of, and the shelters need to be aware of it.
SHAPIRO: I'm sure a lot of folks who see a homeless person with a dog think, oh, well, a pet is a luxury. But you're saying, no, it's really vital for survival on the streets.
ELBE: You bet you. I mean - and I hate to say it, but, you know, he helped me with panhandling, too, because he was a cute dog, and people go, oh. And I'd say, well, I'm trying to get some money for dog food, and they would give me money. And it would. It would be for dog food, but it also would be - you know, he was helping me. He was my friend. He was my family...
SHAPIRO: OK. Elbe...
ELBE: ...and I just couldn't do that to him, to get rid of him.
SHAPIRO: Thanks for the call.
ELBE: Thank you.
SHAPIRO: Well, Jim, do shelters have a way of dealing with what, you know, I had not thought, but clearly appears to be a serious need when single women on the street and have a dog for protection with them?
GREENE: You know, Ari, I think in general - and it's important to tie that back - the street outreach team that I ran for a decade did a lot of problem-solving when people were out on the street and had pets and had animals. It's a - we saw that on a wide scale in Hurricane Katrina, that the sheltering of animals is a challenge.
And they work with the Animal Rescue League and the animal rescue and other things just to try to help people not lose that last one possession that matters so much to them, but at the same time not overlook their own safety and well-being. And so I think there are no shortage of challenges.
The thing that I think is important to recognize is that most of our adult shelters would fit the low-barrier criteria that you've talked about. But when you come in the door, there are options inside there. There are health clinics. So when you talk about people, you know, catching the flu, et cetera, our Boston Health Care for the Homeless Program does flu clinics in all of our shelters. That's the preparedness side. It's good public health.
We have housing counselors in the shelters so that you're talking to people about a goal. You know, the real goal for people is not just that shelter bed for a night, but that long-term plan to get back on their feet and get into housing again. So I think that you want to have a menu of options and deal with the addictions, the mental health, but understand all the barriers that people are talking about.
And it's incredibly - I think it's part of the reason I've been doing this for 27 years, is that the problem-solving and the partnerships that you have to develop are incredibly challenging, but also, at the same time, creative. And one of our low-threshold housing programs actually has formerly homeless people who come from the street, the majority with significant mental illness. They adopt and mentor dogs that have been homeless through the Animal Rescue League until they get adopted.
SHAPIRO: You're listening...
GREENE: I mean, I think you have to really pull it all together.
SHAPIRO: That's Jim Greene of BOSTON Emergency Shelter Commission, and you're listening to TALK OF THE NATION from NPR News.
We have an email here from Hannah(ph) in Portland, Oregon, who says: I was a barista in Portland for many years and interacted with homeless people daily. She writes: Most were vets, and they had access to housing or shelter if they wanted it. What I learned from talking to them was that they did not want to live indoors. The war made them feel unsafe when closed in, so they chose to live outside. She says: I never hear this reality being discussed when there's conversation about ending homelessness. What about tent cities or other alternative shelters that might work better for these people?
Are there creative ideas out there about different ways to approach shelter for homeless people who have specific needs?
GREENE: Sure. I mean, we certainly have a range of kind of one-on-one options with people. But I will say this: There can be a tendency to romanticize tents or encampments. In my 27 years, I've seen an awful lot of very unhealthy and harmful activity go down. Places catch on fire because people are using some sort of heating in the winter that catches the corner of a blanket they've put up to try to stay warmer.
Assaults happen, or people leave their tent for the daytime, and somebody else comes by and kind of moves in - a sort of cuckoo's nest phenomenon - and the person doesn't know they're there when they return at night. So we try to discourage people from camping out and living in tents because there aren't sanitary facilities, et cetera.
But I think that we have found that some people - and this is certainly true among veterans - that sometimes people who don't want to go into a shelter, whether it's that they can't - they feel cabin fever and closed in, or they don't want to be dependent upon a place like a shelter. They want their independence. Some of those people - we have had Housing First programs that work with them toward a permanent housing placement. You know, HUD and the Veteran's administration have the VA Supported Housing, or VASH program, to try to get some of those veterans back into housing but still working with them on addressing their fears, their post-traumatic stress, their aspirations, their addictions.
But - so I think you really do have to approach people individually, but I think also innovative housing partnerships, our public health commission shelter has a program funded by SAMSA for people with mental illness and substance abuse. And they don't have to be perfect or altogether again but that, you know, linking treatment to housing program connecting the dots for people and staying with them when they move into houses.
SHAPIRO: All right.
GREENE: Gets a lot of people off the street.
SHAPIRO: Thank you. That's Jim Greene, director of BOSTON Emergency Shelter Commission. He joined us from member station WBUR. Jim Greene, thanks for your time.
GREENE: You're welcome, Ari.
SHAPIRO: And we also spoke with Kathy Sibert, executive director of A-SPAN, the Arlington Street People's Assistance Network. She joined us from her office in Arlington, Virginia. Kathy, thanks for being with us.
SIBERT: Thank you, Ari.
SHAPIRO: Up next, recreational marijuana is now legal in Washington state. So we'll learn what's changed today for smokers, sellers and law enforcement after a short break. Stay with us. I'm Ari Shapiro. It's TALK OF THE NATION from NPR News. Transcript provided by NPR, Copyright NPR.