Every time I think I have homeless people figured out, I meet another homeless person who is the perfect counterexample for my latest theory. That is to say, the homeless are a complex and diverse people. So why are people homeless?
There are some factors, however, which are more common, at least among our homeless here in San Jose. I surveyed 127 of my homeless patients recently, trying to better understand some of the commonalities. Many of my findings were disturbing.
I asked my homeless patients if they had been diagnosed with a learning disability (LD) or had been in special education as a child. 39.4% of homeless patients responded positively. Compare this with the 1.7% prevalence of LD among the general public, according to the National Center for Learning Disabilities (NCLD). They also state that among school aged children, 2.5% are diagnosed with a learning disability and 5% attend special education classes. My finding of nearly 40% seems ridiculously high, until you compare it with the estimated 37% of kids in the juvenile justice system believed eligible for services under IDEA (Individuals with Disabilities Education Act), according to NCLD.
I know several neighbor kids who have learning disabilities or are in special education classes. Learning is harder for them than it is for other kids. Some struggle with identifying symbols, others have a hard time thinking abstractly. Sometimes I wonder about their futures. What kind of life is ahead of them?
According to the NCLD, over 55% of people with learning disabilities have some kind of involvement with the criminal justice system within 8 years of leaving high school. 67% of people with LD make $25,000 or less annually within 8 years of leaving high school. There is a strong association between LD and poverty.
In the old days, it seems like it was more acceptable to have cognitive limitations than it is now. One of my grandfathers was a logger, the other one worked in a nickel mine. One had a high school diploma, the other dropped out in the 8th grade. Both raised large families in rural Oregon with single incomes. My grandmothers both kept the house in order and raised the kids. Other people of that time worked in factories, on farms, in mills, in shipyards, and in canneries where people could make a living wage without higher education.
It seems that our society now, at least here in Silicon Valley, is hostile to people with learning disabilities and people with other kinds of cognitive disparities. In addition to learning disabilities, many of my homeless patients suffer with developmental delay, traumatic brain injuries, genetic brain diseases, or dementia. Many of these patients want to work, and I find myself optimistically wracking my brain, trying to help the patient think of a job he could do to get a little pride and income and room to rent, but I realize how very limited the patient is, and I know how much patience his employer and his customers would have to have with him, and I feel the deep despair in the room as I offer my hollow suggestions. After the office visit has ended and I have written the scripts, my patients wander off to a 3 hour wait at the pharmacy and then to huddle in a blanket in a church doorway or a bush near the creek. Oh, how I long for them to have a meaningful role in a community that values them! Oh, how I am heartbroken than they are punished every day for something they are powerless to change.
I get it. Who has time to train people extra long, to accommodate for their disabilities? It seems that we as a people will need to create space for those with cognitive dysfunction if we want to reduce their suffering and include them in our society.
Cortiella, Candace and Horowitz, Sheldon H. The State of Learning Disabilities: Facts, Trends and Emerging Issues. New York: National Center for Learning Disabilities, 2014.