A growing portion of homeless people in Oregon’s largest county is disabled, and service agencies report anecdotally that the people they serve are older and sicker than a decade ago.
The bad news, in other words, there are more homeless people overall; the good news, more are staying in shelters, rather than in tents, doorways or vehicles.
One of the most stunning trends in the report is the growing prevalence of disabilities, both in the overall homeless population and for those on the streets. Of 4,177 homeless in the county, 61 percent—2,527 people—reported a chronic physical condition, mental illness and/or addiction. That’s four percentage points higher than the 57 percent of the 3,801 total homeless in 2015 who reported disability: 2,177.
When people living on the streets are considered, the rate of self-reported disability nears a jaw-dropping three in four: 72 percent of 1,668 unsheltered people reported being disabled, up from 59 percent of unsheltered people who identified as disabled in 2015.
Among those numbers are Shawna Bisson, Andy Olive and Susan McIntire.
Bisson, Olive and McIntire have very different stories, successes and struggles. But they have at least two things in common: They all live on the street near St. Francis of Assisi Catholic Church in Southeast Portland, which offers a dining hall and other services to between 50 and 80 people who live nearby. And they’re all almost certainly disabled, though not all are officially recognized as such. Bisson, who said she “grew up in and out of foster care,” admits to active heroin use, is a Social Security disability applicant and lists diagnoses including bipolar disorder, post-traumatic stress disorder and borderline personality disorder.
McIntire receives a monthly $735 Social Security payment and uses cannabis to manage chronic pain from car and motorcycle accidents so severe she said she’s been pronounced dead more than once. She has a history of head trauma, “extreme” allergies so bad she carries an EpiPen and a toe that “keeps having a compound fracture when I walk.”
Olive also uses heroin, which he said “stems from my childhood.” Diagnosed with Tourette syndrome at age 10, he was “more or less raised to be a drug addict,” he said; after being bullied because of his tics, he started taking Haldol, also known as haloperidol. When he stopped using that, he said, hard drugs filled the gap. He also said he has idiopathic nerve damage in his right hand.
Compared to the last time the study was done in 2015, 350 more people in Multnomah County report being disabled—an increase of 16 percent in two years. The overall homeless population increased 10 percent, so the count of the disabled homeless population is growing faster than the homeless population as a whole in Oregon’s most populous county.
Those who work with disabled populations reacted strongly to the news.
“It’s heartbreaking,” said Janie Marsh, executive director of the Mental Health Association of Oregon. “My gut tells me, sure—look at how life [on the street] is. There’s so much stress. Poverty and houselessness can cause mental health crisis.”
Executive Director Bob Joondeph of Disability Right Oregon echoed Marsh’s concern. He said looming cuts to state and federal health care programs such as Medicaid could make things even worse.
“We’re on the verge of disaster for many people,” Joondeph said Monday. “Yep, we are. I don’t use those words lightly, believe me.”
Jason Renaud, a board member of the Mental Health Association of Portland (and volunteer for the Oregon Health Forum, part of the Lund Report), described the problem as “devastating.”
The point-in-time count is a self-report, Renaud said. “So the actual number is much higher.”
Oregon ranked 51st—dead last—in Mental Health America’s “prevalence of mental illness” report, released a week ago, an annual ranking of mental health systems which includes factors such as mental illness, drug dependence, depression and suicide for both adults and youth. This means Oregon has the highest prevalence of mental illness in the nation, according to the nonprofit. The state fared better, 21st, on the “access to care” chart, but was 40th overall, a ranking which reflects a combined 15 factors. “A low overall ranking indicates higher prevalence of mental illness and lower rates of access to care,” the website says.
“Anybody who’s saying we’re doing a good job [on mental illness] is bullshitting you,” Renaud said. “You just have to stop saying that.”
The information released by housing officials Monday doesn’t show a breakdown by disability type, but that information should become available when the full
report, prepared by Portland State University, is released in July. In 2015, 49 percent of reported disabilities were substance abuse, 36 percent were mental health and 9 percent were a chronic health condition.
Of course, as Bisson, Olive and McIntire’s stories illustrate, these conditions can be co-occurring.
Disability woven through heartbreaking stories
More than 18,000 people in Multnomah County rely on long-term federal disability payments that top out at $735 per month, according to the official press release announcing homeless population figures.
McIntire, 64, is among those receiving these payments, and Bisson, 42, has applied for disability. But applying for the federal payments doesn’t happen without years or decades of traumas and hardship for most.
These stories can be so troubling, they’re at times nearly impossible to witness. But the way they explain their reality is suggestive of both how much homeless people been through, and how resilient they can be.
“I’m a drug addict, and I have mental health issues,” Bisson said, sitting next to her tent, taking a break from writing poetry in a notebook. She’s used heroin for 24 years, and methamphetamine, she said, but blames domestic violence by her husband for losing her five children to foster care, then to adoption.
“I always wanted to be [for my children] what my parents weren’t for me,” she said, her eyes filling with tears. “My step-dad was a child molester. I still run a lot.”
Down the block, Olive put together a functional rock n’ roll drum kit from salvaged parts over a two-year period. He showed a reporter his kit, jammed into a shopping cart next to his tent, in between asking five or six people nearby for a light for a cigarette stub.
He said nerve damage in his right hand doesn’t stop him from playing music, but “it does affect my grip when I play for a long time.” Olive is clearly creative: besides the music, he’s a painter who said he painted the hippos on the side of Hippo’s Hardware. But two decades of heroin, the loss of a beloved black Labrador and not seeing a doctor in “five or six years” has taken its toll.
“Sometimes it surprises me that I still have love in my heart,” Olive said. “And I still have a great amount of it still.”
None of those interviewed for this story, whether executive directors of organizations or unsheltered homeless individuals, were surprised by the high numbers of disabled people on the street.
Yet mental illness and addiction among the homeless is hardly the image that comes to mind for disability: Google the word “disabled,” and images of individuals in wheelchairs pop up on the screen. Disability rights advocates have fought for decades, with some success, to reduce stigmas around disabled people.
Joondeph, of Disability Rights Oregon, said there’s a “distancing” when it comes to homeless people with mental illness or addiction. “It’s scary,” Joondeph said. “Many people walk to the other side of the street, say, well, ‘That’s not me, those are other types of people.’”
Disability is about functionality, not diagnoses, he said.
“At the end of the day, it’s not a measure of diagnosis, it’s a measure of functionality, and every one of us has limits on our functionality. But when your abilities are diminished to the point where you can’t take care of basic life needs, now you’re falling into the category that Disability Rights Oregon addresses.”
Older and Sicker
Marsh, the executive director of the Mental Health Association of Oregon, said it’s her understanding that “there’s an increase in the elderly adult unhoused and homeless population as well.”
Marsh’s words echo those of Margi Dechenne, longtime manager at Catholic Charities of Oregon, who said in May that the average age at the organization’s drop-in center has increased from 41.2 years to “49-something.”
“That happened in 10 years,” Dechenne said. “So that gives me pause, when I think about the increasing age of our clients, because they’re older and sicker, and they’re less able to maintain employment.”
The point-in-time count shows Multnomah County’s homeless are aging. The number of homeless people over age 55 —like McIntire—grew from 704 to 816 in the last two years: a 16 percent increase.
Things won’t get better as long as we’re stereotyping the homeless, Marsh said.
“We need a community that is willing to work with us in whatever it takes,” she said.
“Mental illness is so associated in the broader community with long-term disability,” Marsh said. “I hate to continue with that idea—I was diagnosed with something similar that I should be on Social Security. I’m not.”
How we think about the complicated, multifaceted situations involving disability, homelessness, mental illness and addiction on the street should be a balance, Marsh said.
“It’s scary, it’s traumatic, and bad things happen oftentimes when you’re out there without a home, without a house,” she said. At the same time, “Recovery happens. It’s not only possible, it’s probable.”
Human beings, in other words, are much more than the sum of their housing challenges—or their disabilities.
“Don’t think they’re all the same, or that they’re here because they’re lazy,” cautioned Father Robert Krueger, 88, who is retired but still lives at the St. Francis of Assisi parish house and is known as “Father Bob” to local homeless people. “Most of them have a reason they’re on the streets.”
Hard as her current situation is, Bisson said, disability doesn’t define her. What does?
“My writing. Listening. My compassion.”