Report Sheds Some Light on Homeless Deaths, Lack of Services

http://www.noozhawk.com/noozhawk/article/072710_homeless_death_report/

By Lara Cooper, Noozhawk Staff Writer

The review, which will go before the Board of Supervisors in August, finds that most of those who died had some type of mental illness

While providing some useful data, a new report detailing homeless deaths in Santa Barbara at times highlights more questions than it provides answers. Commissioned earlier this year by the Santa Barbara County Board of Supervisors after community outcry over an increase in homeless deaths, the report depicts — from the numbers available — a more complete picture of deaths that occurred in 2009.

Social worker Ken Williams approached the county Public Health Department about the issue in 2007. The Homeless Death Review Team was formed, including representatives from the county Alcohol, Drug and Mental Health Services and the Social Services departments, the Santa Barbara Police Department, Casa Esperanza and Santa Barbara Cottage Hospital.

The review team held its first meeting in October 2007, but it didn’t meet again until last January. In February of this year, county supervisors commissioned a review in response to the deaths that occurred over the winter.

The review, which will go before the supervisors on Aug. 10, looks at the deaths of 45 homeless people. Of the deaths documented, 90 percent were men, and men ages 50 to 59 made up the majority of the cases. Three-quarters of all of the deaths occurred in people ages 40 to 59, regardless of gender, race and ethnicity. Nearly all of the people were U.S. citizens, and six were military veterans.

But the difficulty of gathering data on people who often try to stay invisible is demonstrated throughout the report, especially regarding the lack of information about violence against those who are homeless. The Homeless Death Review Team was asked to look at violence, but information was difficult to collect for several reasons, including that homeless people often don’t report violence through formal channels, and there’s no organized system to gather that data. It’s also difficult to identify whether a person is homeless by reading police and hospital reports, so much of the information on homeless violence is anecdotal.

Williams collected data from January to May of this year for the report, based on his daily work with the homeless and from information forwarded from the police department and Cottage Hospital. During those four months, Williams recorded 39 reports of violence, of which 25 involved assault, five were rape and three were domestic violence.

“Only seven informed Ken that law enforcement was notified, while 17 involved a visit to the emergency room or hospitalization,” states the report, which added that although the information is limited in scope and unvalidated, Williams’ findings represent “a good snapshot of violent experiences reported by people living on the streets.”

As a case in point, some of the causes of death are murky. The report lists natural causes most often, with accidents following next.

“These numbers may be somewhat misleading, however, as 18 percent of the death certificates were unmarked for any manner of death,” according to the report. Twenty percent of the deaths were related to illicit drugs, 18 percent were directly attributed to alcohol, 11 percent were trauma-related, and one death occurred from exposure and hypothermia. There were no homicides listed, although one remains under investigation as a possible homicide.

Another particularly revealing finding shows that nearly 90 percent of the 45 homeless people who died had some type of mental health diagnosis, ranging from adjustment disorder to schizophrenia. However, a majority of those 45 people didn’t make contact with the county’s Alcohol, Drug and Mental Health Services at any point, even if they were referred by an outside agency to get substance abuse help. ADMHS remains stretched for resources, and that lack of care could have contributed to another number in the report, which shows that drugs and alcohol were most prevalent as either the primary cause or contributing factor to the deaths.

Santa Barbara County’s homeless rate, about 1.5 percent of the population, is higher than the national average, according to the report. A combination of high housing costs, temperate climate and large tourism industry all contribute to growing numbers of homeless.

“Obviously a better job is needed reaching out to the dual diagnosed — those with mental health issues and substance abuse problems,” Williams told Noozhawk on Tuesday, adding that he has recorded 21 deaths so far this year.

The report also outlines a series of studies revealing that mortality rates are higher among the homeless. One study even called areas of homeless “death zones” because they are so much more likely to exceed normal mortality rates. In light of that, Williams said a solution to homelessness takes on a moral dimension.

“I am hoping this study will spur the community to reach out with compassion to those who were forced to the streets due to physical or mental problems, returning war vets or the recession,” he said.

The Board of Supervisors will review and discuss the study at the Aug. 10 meeting.

— Noozhawk staff writer Lara Cooper can be reached at .(JavaScript must be enabled to view this email address).

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