” ‘The last thing you own when you’re losing everything you own is probably your vehicle, so that becomes your home.’ Jenn Adams knows this from six years living in her Seattle van starting in 2007. ‘I’ve lived in three different vans and a doorway,’ she said in a recent interview I had with her. She talked about her experience and current work as an advocate and peer outreach worker to vehicle residents in Seattle.
I had my own experience resorting to living in my car and in an abandoned shed for six months in my hometown of Richmond, Virginia, when I was a young adult. The topic of vehicle residency as a unique form of homelessness has long been of interest to me. I wanted to explore more of the nuances of vehicle residency from the perspective of a woman with a much longer experience than me and one based here in Seattle.”
The above passages are from my new book, Way Home: Journeys Through Homelessness, in a chapter titled “Roll On.” This chapter draws from my interview with Jenn Adams. Make sure to listen until the end for her powerful words, which literally left me speechless.
Anitra Freeman is a force of nature with an infectious laugh and a sense of humor. Freeman is a wise elder, a Raging Granny, a founding member of the Women in Black in Seattle, a housing/homelessness activist, a wife, and a computer wiz. Freeman also lives with a form of bipolar disorder and experienced homelessness in Seattle. She is now stably housed and continuously giving back to our community and working to make our city a safer, healthier place for everyone, including people without homes.
Her story is an inspiration. I have included my oral history interview here. I wrote a chapter of my Way Home book on Anitra Freeman. Freeman says, “I have often said that people have personal problems, of course, but personal problems don’t cause homelessness. Personal problems don’t dig the hole in the sidewalk; they just influence who is going to fall into it. It’s systemic factors that create the hole.”
In April, I interviewed Seattle-based housing advocate and consultant Ginger Segel. I know a lot about health policy, especially as it relates to care for people experiencing homelessness. I do not know as much about housing policy as I would like to, so I was eager to hear her stories and perspectives.
Segel first spoke of how, as a student at Columbia University in NYC, she witnessed the role of the university in displacing low-income people in the expanding area around the university. When she moved to Seattle in the 1980s, she got involved in tenant’s union organizing and in Operation Homestead. Operation Homestead’s mission was to counter the harmful effects of the closing of Single Room Occupancy Hotels (SROs) happening throughout the country. The activists occupied emptied-out buildings so that homeless and other low-income people could live there.
Segel then worked for the Low Income Housing Institute (LIHI) on establishing the consumer-led housing building, the Aloha Inn, now renamed The Inn and run by Catholic Community Services. Currently, LIHI is a major player in the Seattle-area (and beyond) efforts to provide more affordable housing to people experiencing or at risk of experiencing homelessness. Segal and other advocates helped form the state Housing Trust Fund, which, since its formation in 1986, has provided over $2 billion in capital financing to affordable housing projects throughout Washington State.
Now working as a consultant on affordable housing projects throughout the state, Segel has seen first-hand some of the drawbacks of Housing First and permanent supportive housing, including through the newly established Apple Health and Homes Initiative. I was involved tangentially in the formation of this initiative and testified in its favor (when it was House Bill #1866) before the House Health Care and Wellness Committee of the Washington State Legislature. The Apple Health and Homes Initiative pairs healthcare and housing resources for permanent supportive housing for vulnerable (and high-needs) individuals. Segel points out that we need to examine the benefits and pitfalls of Housing First closely. Communities she works with sometimes say that they are forced to take people they cannot handle and that creates safety issues for other residents and staff members.
Segel stated, “Another problem in the advocacy community is we have said we’re going to solve this (homelessness) too many time but we never could solve it because the economic forces were always much stronger than our strategies.”
This Skid Road podcast episode includes excerpts from my three books on health and homelessness. The first excerpt is from the opening of my first book, Catching Homelessness: A Nurse’s Story of Falling Through the Safety Net (2016). It has to do with my realization of my hypocrisy in terms of homelessness, of ‘coming out’ with my story of homelessness and severe depression as a young adult. The second excerpt is from a chapter titled “Walk in My Shoes” from my second book, Soul Stories: Voices From the Margins (2018). I write about empathy and homelessness and the importance of providing basic foot care to people experiencing homelessness provided by nursing and medical students. The third and final excerpt is from the opening chapter, “Brother’s Keeper,” from my book Skid Road: On the Frontier of Health and Homelessness in an American City (2021). It tells the story of Seattle’s first official homeless person, the sailor Edward Moore.
On June 24, 2022, I sat down with Noah Fay, director of the Downtown Emergency Service Center (DESC) Housing Programs, at the DESC building in Pioneer Square. We discussed his work, first as a volunteer at DESC, then as an outreach worker, and now in DESC administration overseeing all of their varied housing programs. That morning, I had walked past tent encampments on the sidewalk just north of DESC. Noah talked about his nuanced views of encampment clearances (sweeps), encampments that grew exponentially in Seattle during the COVID-19 pandemic. Noah said, “I am not a fan of sweeps, but I am not a fan of simply saying, ‘We need to leave people where they are and leave them be.’ Neither of those are good alternatives and neither of those are informed by what we know works for people. Sweeps on their own are highly disruptive for people. (…) There’s already such a feeling of insecurity when you don’t have a place to live. Losing it time and time again is inherently pretty traumatic. (…) But I also think we’re shortsighted (…) if we are just adamantly saying, ‘No sweeps,’ and not saying what should come instead.”
Various cities around the country, including the Seattle area Burien, enforce stricter “anti-camping” bans, allowing more encampment sweeps and legal fines for unsheltered people. Many people and advocacy groups, including the National Health Care for the Homeless Council, point to the mounting evidence that sweeps harm people experiencing homelessness. Other groups like the National Homelessness Law Center have the campaign, “housing not handcuffs,” highlighting the fact that encampment sweeps are a form of criminalizing homelessness and poverty.
This past Monday, April 22, I conducted a workshop on homelessness in a large medium-security correctional facility in a rural area of Washington. The forty-five men who attended wanted to discuss the just-opened Supreme Court case, City of Grants Pass, Oregon v. Johnson, which will decide whether laws regulating camping on public property constitute ‘cruel and unusual punishment’ prohibited by the Eighth Amendment. Many of the men had experienced homelessness and had family members still living on the streets. Obviously, they were in prison for other crimes, but homelessness had complicated their lives. They asked me for resources on re-entry programs for when they are released from prison to reduce their chances of becoming homeless and churning through the homelessness, jail, and prison pipeline. Through the librarians at the facility, I was able to provide some of these resources. The Central Library of Seattle Public Library has a list of re-entry services, as does the Emerald City Resource Guide from Real Change. Seattle University’s Homeless Rights Advocacy Project, which advocates for legal and policy changes to prevent homeless people from entering the criminal justice system, also has a list of sources. My experience with the men at the prison made me even more grateful for the dedicated work of people like Noah Fay in providing compassionate, evidence-based housing and support services in our region.
Dr. Michael Copass, Seattle native, neurologist, Vietnam Army veteran/physician, and long-time head of the Harborview Medical Center’s Emergency Department, is a living legend in the Seattle area and in emergency medicine in our country. On July 26, 2015, I traveled to Sequim, Washington, to the home of Dr. Copass. Harborview physician Dr. David Carlbom and his wife, Dr. Judith Rayl (a retired physician and abstract photographer), accompanied me. I recorded this interview with Dr. Copass and his wife, Lucy, at their kitchen table. He spoke about his philosophy of care (“everyone is a gold coin”; about how the Seattle of the 1970s (as, perhaps, now) had “no organized plan for dealing with sadness”; about the creation of Harborview’s pioneering sexual assault center in 1972 by social worker Lucy Berliner, saying she did this by “churning through masculine indifference”; about the creation of King County’s stellar Medic One system of pre-hospital emergency care; about many other aspects of his long professional medical career.
On March 8, 2024, I sat down with Tamara Bauman to discuss her work, experiences, and perspectives on homelessness, domestic violence, and frontline staff burnout.
This project received funding support from a 4Culture Heritage Award, a Jack Straw Cultural Center Artist Award, and a Humanities Washington Stories Fund award. I want to thank these important arts and culture agencies and all the people who have talked with me about their work.
Encampment in U District Park, 2021, photo credit: Josephine Ensign
The lived experience, the direct and unintentional (as in not stunt journalism) experience of homelessness, is increasingly used and prioritized in policy and program realms. While much of this is good, I think it needs to be examined more closely.
As someone with the lived experience of homelessness when I was a young adult in my then hometown of Richmond, Virginia, it is a concept that I wrestle with. What counts as lived experience, who decides what counts, and is lived experience something that automatically turns people into, as referred to by Pathway UK, experts by experience?
I find it encouraging that there is a growing understanding of the importance of people with the lived experience of homelessness needing to be included in real, not token, ways for more effective program planning and policy-making. An example of this locally is Marc Dones, a Black non-binary person with the lived experience of homelessness and mental illness (bipolar disorder), who was named the first director of the King County Homelessness Regional Authority. This week Marc announced that he is leaving his position. People with the lived experience of homelessness have long been employed as outreach workers, but not many have become leaders like Marc and Derrick Belgarde, an Indigenous man, and CEO of the Chief Seattle Club. Representation and visibility matter. They matter in terms of informing better programs and policies. They matter in terms of countering negative stereotyping and social exclusionary practices of people experiencing, or having experienced, homelessness.
A recurring issue in terms of people with the lived experience of homelessness working in some aspect of homelessness, especially in direct service work, is the danger of being retriggered, relapsing if clean and sober, not maintaining professional boundaries, and burning out. In trauma work, there is the phenomenon of trauma mastery, of a person being drawn to working with people in difficult situations similar to those they experienced and felt powerless to control. In trauma mastery, people, frequently unconsciously, return to sites of trauma wanting to ‘do it right’ this time, to have control and mastery of the situation. Too often, this sets people up for unreasonable expectations of themselves, co-workers, and their clients. As Jenn Adams, who works with vehicle residency outreach programs, told me, it takes years of support and even therapy to gain perspective on one’s own experience of homelessness. She points to mentors and work supervisors who check in with her, identify possible triggering situations, and help her maintain healthy boundaries in her direct service work.
In my discussion with Derrick Belgarde about the increased focus on people with the lived experience of homelessness, he said, “I’m a firm believer that lived experience should always lead in any field…The best ones are ones who can actually relate.” He followed this by talking about the fact that there is a spectrum of different types of homelessness that people experience. He says of these experiences, “They’re all traumatic and horrible and awful, but they’re all totally different, and I’m only an expert in one.” He added, “There needs to be more diversity in these decision-makings because they don’t think about that. I see a lot of the lived experience movement making grounds in homelessness work today, but a lot of them, I don’t think, come from the type of homelessness we’re trying to solve in the downtown core.”
The 2022 National Health Care for the Homeless Conference and Policy Symposium, billed as being held in Seattle and in-person for the first time since the pandemic, was held in the swanky Hyatt Regency Bellevue near a high-end shopping center at the beginning of May. The venue was ironic given the fact that Bellevue officials work hard, mainly through more aggressive policing and criminalization of homelessness, to keep the city sanitized, especially compared with Seattle.
I attended the conference and spoke with David Peery, a Miami, Florida, Black lawyer with the lived experience of homelessness during the Great Recession. David is the current co-chair of the National Health Care for the Homeless Council’s National Consumer Advisory Board (NCAB). I asked him if the NCAB folks have conversations about what ‘counts’ as someone with the lived experience of homelessness. He said that they follow a guideline of recent experience of homelessness within the last five years or longer ago if the person has stayed involved in direct homeless service provision, like being a peer outreach worker or in policy and advocacy work on homelessness. “A lot of times people who were homeless become judgmental about currently homeless people–unless they understand trauma-informed care,” he explained.
So while the lived experience of homelessness in homeless policy-making and programming is important, it should be more carefully examined and understood.
Tuna came one day, scratched at our door, begged for food, and never went away.
The Meaning of Home Photo credit: Josephine Ensign/2016
Tuna came one day, scratched at our door, begged for food, and never went away.
Home is where the cat is.
–male resident of Tent City III
Home is never permanent, but I know it is where I find safety.
–female resident of Tent City III
…home is a place one belongs to, a place of safety and a gathering point for reestablishing social connection.
–Madeline Ostrander, At Home on an Unruly Planet: Finding Refuge on a Changed Earth (p. 79)
Think of words that describe ‘home’ to you. Nouns, verbs, whatever words come to mind. Write them down. Circle the top five that are the most important. Now, pretend you live through a series of unfortunate events: loss of a job, fire, pandemic, and insurmountable medical debt. You lose one important item or word from your list for each of these four events. Say goodbye to each one as you cross it off. You are left with only one aspect of home that you carry with you into homelessness. For many people, that remaining aspect of home is family, beloved pets, safety, or privacy. For many people who actually experience homelessness, they are forced to give up everything that matters to them, everything that represents home, including a sense of belonging, of community, of a place to nurture and maintain health. Of dignity and self-determination. For other people experiencing homelessness, they have never had a true home, or at least a safe, secure home, to give up, thus making their exit from homelessness that much more difficult. Of course, the causes of homelessness are much more complex than just a series of unfortunate events. This list of events is based in reality since all of the events do contribute to homelessness. Not enough people know that spiraling medical debt is a leading cause of homelessness in the US, a factor unheard of among our industrialized county peers due to our profit-driven healthcare system.[i][ii][iii]
This meaning of home exercise, although incomplete and imprecise, can help people discern the difference between a house and a home. A home is much more than a house, a shelter. This exercise can help people realize some degree of what homeless people have had to give up and what they can regain with enough community support. Looking at success stories and people’s stories of what contributed to their experience of and exit from homelessness can help deepen our understanding of this complex issue. Stories from people with lived experience help inform us as individuals and as a society as to how we can build on individual and community strengths, on lived experience insights, to greatly reduce homelessness, if not outright solve it.
[i] Jessica E. Bielenberg et al., “Presence of Any Medical Debt Associated With Two Additional Years of Homelessness in a Seattle Sample,” Inquiry: A Journal of Medical Care Organization, Provision and Financing 57 (December 2020): 46958020923535, https://doi.org/10.1177/0046958020923535.
Note: This is based on results from my ongoing series of community-based “The Meaning of Home” workshops I have done with a variety of groups, including residents of Tent City III, high schoolers, faculty members, graduate students, and attendees at writing workshops. See more of this work here.
