On a bright, sunny morning in late October, Melody stood protectively next to a small cart neatly packed with her belongings, contemplating the day’s most pressing question — where she would sleep that night. Melody, who has been living unhoused since she was 13, is one of an estimated 1,774 individuals who currently live unsheltered in parks, streets, vehicles and other places not meant for habitation in Santa Cruz County, according to the 2022 Point-in-Time Count.
Her home for months had until recently been the Benchlands, an encampment in San Lorenzo Park that began as a City-sanctioned camp for people experiencing homelessness in 2020. The original idea was to give people experiencing homelessness a place to camp while social distancing during the height of the pandemic. But the Benchlands encampment, which sheltered up to 300 people at one point, quickly deteriorated without the infrastructure basics — such as water and electricity — that most people who are housed take for granted. Over time, health and safety concerns — both human and environmental — mounted.
Last spring, the City of Santa Cruz decided to close the encampment in phases, as emergency shelter beds became available. Notices of the camp’s phased closure — which began in early September and concluded in early November — were pinned to tents throughout the encampment, effectively telling the camp’s residents that they had to leave. Few, like Melody, had a plan.
Earlier that morning, Melody and a friend with whom she had been camping were ordered to clear their tent away from the walkway it obstructed. Melody, like many others who remained at the Benchlands throughout the month of October, thought she might have a few more weeks before she had to find a new place to live. But the efficient progress being made by workers to shut down the Benchlands zone by zone suggested otherwise.
“Sometimes if I don’t have a place to sleep or I don’t feel safe I just skate all night,” she said, gesturing to the skateboard on top of her cart. Melody, who is 34, suffers from anxiety. She said she often sleeps with her skateboard between her legs both to protect herself and to keep it from being stolen. Drug use at the encampment is almost universal. “It’s just how people cope,” she said.
Melody is frustrated with the way the City handled the phased closure, which she said resulted in her losing most of her possessions after having to move more than six times during the phased closure. But when asked why she didn’t relocate to the National Guard Armory Overlook camp at DeLaveaga Park, where City officials were directing Benchlands residents to go, or to an emergency shelter such as Housing Matters’ Paul Lee Loft, where 46 former Benchlands residents relocated between August and October, Melody doesn’t have a clear answer.
“This is all we have, we can’t go anywhere else,” she said.
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A community of last resort
Others who frequented the Benchlands included outreach workers, mobile health clinicians and volunteers from various church groups and nonprofits. All were trying to assist those still living at the Benchlands prior to its closure. That assistance took many forms, ranging from help with housing and shelter options; to treating injuries and chronic health conditions onsite; to registering people for community services to combat addiction and substance abuse; to simply providing a hot dog or a sandwich and some bottled water. The hope was to provide some help for this community of people who were dealing both with the trauma of living unsheltered and the trauma of being forced to leave a place that, however temporary, had been their home.
Brian Lands and Alejandro Grijalva, outreach workers from Housing Matters, were making at least two trips to the Benchlands every week before the camp’s closure. They also travel regularly throughout the County, visiting smaller encampments wherever they crop up. As a result, they have come to know many people who live unsheltered by name.
“When you’re living unsheltered you’re in constant survival mode. Your time horizon doesn’t extend beyond a few days.”
— Brian Lands, outreach worker at Housing Matters
Lands, who has been doing outreach for Housing Matters for eight years, maintains an “interest list” for those who might be ready to move to emergency shelter. He said he doesn’t push people to come into shelter, which requires a willingness to create a housing plan with Housing Matters case workers, because experience has shown him that that approach doesn’t work. Also, emergency shelter at Housing Matters is almost always full.
The interest list allows Lands to approach specific people who are on the list whenever a spot opens up at the Paul Lee Loft. The next step is for that person to come to the Housing Matters campus and meet with shelter staff. But, said Lands, people don’t always show up on time the first time.
Without a regular routine, or a phone with which to send and receive messages, it’s easy to lose track of upcoming events — like an appointment at Housing Matters.
Another factor that keeps people from coming into shelter is the worry that doing so would mean giving up certain freedoms. “They might think there’s a curfew, or that they can’t be in their Pallet [shelters] during the day,” said Grijalva, who has been doing outreach for Housing Matters for the past four years.
But neither of those things is true, at least at low-barrier shelters like Housing Matters. An unwillingness to part with belongings and a general distrust of people and organizations might be other reasons for avoiding emergency shelter. “Just the uniform that our security guards wear might be triggering for some people,” said Grijalva.
During their outreach sessions Grijalva and Lands casually check in with people one at a time, listening to their concerns and answering questions.
“I try to make eye contact as I go around with my cooler [passing out bottled waters] … and introduce myself,” said Grijalva, of how he approaches people he doesn’t know. He checks to see if the people he meets are entered into the County’s homeless services database, known as the Homeless Management Information System (HMIS), and updates their information or gets a picture for their profile if one is needed. “If people are interested in having a problem-solving conversation with me, we find a place to sit down and talk.”
Both Lands and Grijalva frequently conduct vulnerability assessments, known as VI-SPDATs. The Vulnerability Index - Service Prioritization Decision Assistance Tool is a standard assessment used nationwide to help determine who is in the most dire need for housing. Someone who is diabetic, for example, or pregnant, or in an actively abusive relationship, is likely to receive a higher vulnerability score than someone who may have been experiencing homelessness for just as long, but is in better health or living in relatively safer circumstances. This sometimes creates a sense of unfairness among those who are living unsheltered. But Lands and Grijalva do their best to connect with each person individually. The mere act of listening to what is going on in a person’s life seems to bring some small relief.
Controlling expectations is a difficult part of the job. Just because someone is on the interest list, or scores highly on the vulnerability assessment, doesn’t necessarily mean they’ll get referred for a housing support program.
“It’s not just a matter of connecting people to services,” said Lands, because demand for existing services is overwhelming. “The reality is that housing is so extremely limited. The safety net that people might think exists, doesn’t exist.”
Long-term health impacts
It’s fair to say that the long-term health effects of living unsheltered are devastating. Lifespans for people experiencing chronic homelessness are significantly shorter than those for people who are housed. Only 14% of people experiencing homelessness in Santa Cruz County make it past the age of 64, according to data collected by Santa Cruz County officials over the last 20 years. In contrast, 77% of County residents who are housed live to see their 65th birthday.
So far this year, 67 people in Santa Cruz County have died while experiencing homelessness. (In late October, a 52-year-old man was found dead in his tent at the Benchlands.)
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Research indicates that the health risks are greater the longer people remain homeless. The longer the duration of someone’s homelessness, the more likely they are to experience mental illness and chronic health concerns associated with coping behaviors like substance abuse. The health risks are also greater for older adults, regardless of how long they’ve lived unhoused. A 2022 study from UCSF found that adults over 50 who experienced homelessness for the first time were 60% more likely to die than those who became homeless earlier in life.
“There’s a cumulative toll associated with the complex trauma of living unhoused. That’s why we see the average age of death for people experiencing homelessness as being in their 50s.”
— Joseph Crottogini, Health Center Manager for the County’s Homeless Persons Health Project
Co-located on the Housing Matters campus, the County-run Homeless Persons Health Project (HPHP) provides medical care for roughly 1,200 unique patients who account for more than 6,000 clinic visits per year. These numbers don’t include people treated through HPHP’s mobile outreach clinic, which offers first-aid, medication management, and substance use treatment for people living on the streets and in encampments such as the Benchlands.
“Living outside definitely increases anxiety,” said Crottogini. “People might start using substances just so they can stay awake at night.”
Oftentimes addiction starts with mismanagement of chronic pain, and prescribed pain meds. High rents, no rent control, the lack of affordable housing, the high cost of healthcare, a shortage of skilled nursing care, and difficulties in accessing mental health care resources are all systemic factors that can lead to a person experiencing homelessness. “If you don’t have a good support system, it’s easy to wind up on the street,” Crottogini said. “You do this work long enough, you realize that everyone is vulnerable.”
On the positive side, Crottogini points out that the State and Federal government is trying to prioritize this issue, allocating more money to increase infrastructure for addressing and preventing homelessness. A new state program called the Housing and Homelessness Incentive Program (HHIP), for example, is providing funding to help community-based care providers expand and improve health services — such as mobile medicine outreach — specifically for people experiencing homelessness.
“The pandemic really forced us to expand our street medicine program as a strategy for continuing to provide quality healthcare to the unhoused without them having to come to the clinic during that first year.”
— Joseph Crottogini, Health Center Manager for the County’s Homeless Persons Health Project
Since then, government agencies have started to recognize the value of these types of interventions specific to people experiencing homelessness.
“Expanding our street medicine program … is just the latest example of how [the incentive program funds] might be implemented locally in the next 24 months,” he said.
But interventions like expanded street medicine and outreach services don’t necessarily make living unsheltered any easier. Life on the streets, and in encampments like the Benchlands, is incredibly harsh, noted Housing Matters’ Lands.
“It’s a myth that people choose to be homeless,” Lands said.
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