For a year, I worked with the homeless in New York City. Over the course of that year, I encountered more than 200 unhoused people.
Only three ended up in permanent housing.
Our team consisted of a social worker (me), two case managers, and a nurse.
Our nurse carried Narcan.
We coordinated with shelters, hospitals and city agencies.
We did psychosocial assessments, led crisis intervention and made housing referrals.
We were the exact kind of outreach team that Mayor Zohran Mamdani’s administration is putting forward as the solution to New York’s homelessness crisis.
This is why I am deeply concerned about the mayor’s proposal.
Mamdani’s plan focuses on ending encampment sweeps and shifting to a housing-first approach through his proposed Department of Community Safety, using outreach teams with social workers to connect people to supportive or rental housing and implementing crisis centers in subway stations.
The mayor’s rhetoric fails to grapple with the reality on the ground. I did this work. I believed in it. And I watched it fail the very people it was meant to help.
Seeing New York pursue that kind of initiative again violates my social and ethical responsibilities both as an observant Jew and a social worker.
Trying to help
The people I served were men and women ranging from age 18 to their 70s.
They included immigrants fleeing cartel violence, veterans, people recently released from jail, individuals with severe mental illness, people with physical disabilities, women escaping abuse and LGBTQ youth rejected by their families.
My colleagues and I would walk around certain homeless hubs and go into subway stations, hospitals, homeless shelters and parks, trying to get the men and women who had no place of their own into housing.
Here are some of the stories, using pseudonyms to protect the clients:
* Mario was an 18-year-old who had been diagnosed with schizophrenia a few years before and had just graduated from high school. He was from a staunchly religious Catholic family that kicked him out of the house when he disclosed he was gay. Mario had no employable skills. He had been getting Social Security disability benefits that his parents didn’t give him access to, and he’d found his way to a men’s shelter, not knowing how to navigate the responsibilities of adulthood between his schizophrenia and being on the spectrum. He disclosed that his mom did everything for him and that his stepdad was verbally abusive; he wanted to go back home because he was bullied and harassed in the shelter and feared for his life, but his mother said he could not live with his family because he was gay.
* Julio was an 18-year-old who escaped his town in South America. He had watched his best friend die while treading water as they tried to come to the United States to escape the cartels that wanted him to use the degree he hoped to obtain in pharmacology to distribute drugs, all of which I learned by conducting a psychosocial examination using a translator. He was determined to work, learn English, obtain asylum and escape the trauma he witnessed at home. He kept to himself in the shelter, fearing injury or death by other residents because of his nationality and desire to never participate in drugs.
* Olga, a Ukrainian woman nearing 40, whom we encountered living on a park bench in Brooklyn, was an addict who said her ex had abused her while high. They decided to get treatment separately, leaving their daughter to be raised by her paternal grandmother because it was safer for her. Unfortunately, Olga was still heavy into her addiction. Although she accepted our offer to get her off the streets and into a women’s shelter, she decided that our team should advocate for her to regain custody of her daughter immediately, before achieving sobriety, which she required to get into a family shelter where her daughter would be safe. Olga said to us that she needed her daughter to make her life better, not to ensure that her daughter was safe. After a week in the shelter, she disappeared, and we searched the area where we had encountered her, but couldn’t find her.
* James, a black Army veteran in his 60s, while caring for his cancer-stricken wife, entrusted his life savings, property and car to an old Army buddy. His supposed friend then used his power of attorney to steal all of James’ possessions, leaving him without a penny to his name as he dealt with the death of his wife. He ended up in a shelter where we encountered him and helped him get into a veterans home, because the Department of Veterans Affairs failed him.
* Tony, a Caucasian man in his early 30s, lived in a family shelter with his 8-year-old autistic daughter after his wife died and he lost his job trying to care for all of her needs alone. Tony found a job and, with the help of our team, found housing near his place of employment that allowed his daughter to attend the school that was meeting her needs after nearly two years of being unhoused.
* Antionette was a transgender black female in her late 20s whose family decided that, despite her numerous physical and mental health issues, she could no longer be part of their lives because she wanted to live hers as a woman. Antionette was placed in a men’s shelter because she was born male and was assaulted by the other residents for having both male and female physical attributes. We helped her obtain housing vouchers, but it took months before we found a place that was handicapped-accessible and welcoming to her.
* John, a double amputee in his 50s, had lost his legs from diabetes and suffered from addiction. He got around in a motorized wheelchair, but some of the men he shared a room with stole parts of it, leaving him bed-bound.
* Mark, who was in his mid-20s, was released to a supportive-living apartment after spending a decade in jail. He ended up back behind bars after a month because he could not maintain his mental health needs, even with support.
* Lloyd, a Jamaican man in his 50s, had been living on the streets for more than 10 years. He refused to enter a shelter, even when the temperatures were below freezing, because of the violence he witnessed in them. “Get me a ticket home,” he’d repeat every time my team and I approached him. “When my girlfriend and I broke up 15 years ago here in Brooklyn, she took my stuff, including my passport and money. I don’t want to go into a shelter or an apartment. I want a plane ticket to Jamaica.” He refused our help in getting housing and would not listen when we explained what he needed, such as an ID, to get on a plane.
* Joseph, a Caucasian man in his late 20s, overdosed right in front of me on a Friday morning. Our nurse, thankfully, was with the team that day and administered Narcan, warning him of the dangers of using illicit substances. The following Monday, she had to administer it to him again.
* One cold winter day, my colleague and I were on our break in her car in an area known to be a homeless hub. The temperatures were dangerously low when we encountered Olivia, a “lady of the night” standing on the corner wearing a bustier, underwear and sandals covered by an unbuttoned down coat. She complained that there was no “business” and that she couldn’t eat, but still refused our help when we offered food and shelter.
* At the 9/11 Memorial & Museum, we tried to help an 18-year-old black woman who admitted to being mentally ill. She asked us to help her get an abortion and told us she was raped on the streets and couldn’t have a baby because she wasn’t stable and needed help. We got her admitted to the hospital, from which she disappeared after 24 hours. We couldn’t find her, despite searching for her for a month.
Equity of care
I could go on. Over the course of the year, I entered many subway stations, hospitals, shelters and parks and even traveled to the infamous Wards Island with the express goal of getting people off the streets and into housing.
I encountered people surrounded by dirty needles, men and women who hadn’t bathed in months, and immigrants who sought sanctuary, all of whom hoped for a better life.
I am not arguing against compassion.
I am arguing against illusion.
To truly and effectively help those who are living on the streets, we need to improve mental health care, improve education around caring for the mentally ill, develop programs to give adolescents and young adults basic skills to enable them to have jobs to support themselves — and, by doing so, help people thrive.
We need education for families caring for mentally ill relatives, so young people like Mario aren’t abandoned at 18 with no skills and no support.
We need programs that teach adolescents and young adults basic life and job skills before they fall into homelessness.
We need systems that recognize that equality of distribution is not equity of care.
Mental health care cannot thrive in a socialist environment.
Socialist systems tend to prioritize uniformity and standardization to ensure equality. Mental illness, however, requires (1) highly individualized treatment plans, (2) flexibility in frequency, modality and intensity of care and (3) rapid adjustment when symptoms change.
In a socialist society, mental health services are rationed due to limited resources. There are long waitlists for psychiatrists and therapy. Crisis care is prioritized over preventive care. There is limited access to specialized clinicians.
As someone who has treated those with severe depression, psychosis or suicidality, delays are not inconvenient; they are fatal. Therapy is not interchangeable labor. A bad fit can worsen symptoms.
As a social worker, I am trained to look not only at my clients, but also at the systems surrounding them. Human beings are shaped by biology, psychology, environment, culture and trauma. Ignoring any one of these factors leads to failure.
As an observant Jew, I am guided by the commandment “Justice, justice you shall pursue.” Justice is not performative compassion. It is not ideological purity. It is not policies that sound humane while quietly abandoning those who cannot conform to them.
Reprinted with permission from Tablet magazine.
This story originally appeared on NYPost
