California’s $50 Million Encampment Focused Funding Strategy Needs a Focused Trauma-Informed Design and Care Strategy

A First-of-Its Kind Report States that Cities Spend Millions to Clear
Encampments that Largely Shuffle Residents from One Site to Another 

The Report also Calls for Research to Determine the Costs Associated
With Residents Trauma When Shuffled from One Encampment to Another 

A Jurisdiction’s Encampment Strategy Should Evolve Over Time

Encampment Focused Funding Strategy

As we await more details about the recently budgeted $50 Million Encampment Focused Funding Strategy, we do know that the one-time funding is projected

• “. . . to assist people in moving out of unsafe, unhealthy encampments and into safer, more stable housing;”
• “. . . for HCFC (Homeless Coordinating and Financing Council)-administered encampment resolution grants to resolve critical encampments and transition individuals into permanent housing.”

The Dominant Encampment Strategy

The dominant encampment strategy currently involves 1) resource-intensive outreach to connect persons living in encampments with services and temporary and/or permanent housing; 2) requiring that persons leave encampments; and 3) clearing, cleaning, and closing encampments by removing structures and belongings.

Resource-intensive outreach to connect persons living in encampments with services and temporary and/or permanent housing

Resource-intensive outreach generally involves street outreach workers connecting persons living in encampments with supportive services, including food assistance, medical, behavioral, and mental health services. Outreach workers may also offer transportation or bus tokens to help persons connect with services.

Resource-intensive outreach also involves medical services that include wound cleaning and care, basic medical checks, physical disability care, medical appointments; behavioral services that offer connections to substance use treatment programs; and mental health services that include mental health assessments and referrals to specific mental health services.

Also, there is housing navigation, which addresses housing-specific issues that need to be resolved in order to obtain temporary and/or permanent housing. Housing navigators generally conduct a standardized housing assessment, determine an appropriate housing solution temporary and/or permanent housing, and help find and secure suitable housing.

Requiring that persons leave encampments

Requiring that persons leave encampments involves ensuring that every encampment resident has somewhere to go at the point of its closure. Such places include temporary shelter, permanent housing, other encampments, and new encampments.

The preferred choice regarding “somewhere to go” is permanent housing and least preferred choices are going to other encampments and forming a new encampment. Temporary shelter, while not the preferred choice, is preferable to living in encampments due to limited permanent housing availability.

Clearing, cleaning, and closing encampments by removing structures and belongings

The level of clearing, cleaning, and closing encampments is often determined by the size and the complexity of the encampment. Clearing means removing all structures and personal belongings from the encampment site. Cleaning means removing all trash and debris from in and around an encampment. Closure means requiring all encampment residents to leave the site and no longer live there.

An Evolving Encampment Strategy

A Jurisdiction’s Encampment Strategy Should Evolve Over Time.

An evolving encampment strategy involves understanding why living in an encampment is the preferred choice for some encampment dwellers than living in temporary shelter. So, an evolving encampment strategy:

• Recognizes why some persons want to live in an encampment;
• Recognizes why Some Persons do not want to live in a shelter;
• Acknowledges the increasing need for Trauma-Informed Design and Care shelters; and
• Acknowledges the need for a Trauma-Informed approach when transitioning persons into hotels/motels.

Recognizes Why Some Persons Want to Live in an Encampment

Living in an encampment appeals to some people more than staying in shelters because they feel a greater sense of safety living in an encampment than in a shelter. They may feel a sense of “safety in numbers,” meaning they feel safer living with people they have gotten to know than in a shelter where they know less or fewer people.

Living in an encampment also appeals to some people more than staying in shelters because they feel a greater sense of community living in an encampment than in a shelter. They may feel a sense of “family” because those living in their encampment take care of each other, particularly during a very challenging time in their lives.

Safety and community are also interrelated because fellow encampment residents watch each other’s personal belongings. A sense of community or social support is also felt out of respect of each other’s desire for autonomy and privacy. Their community allows each other to come and go as they please.

Recognizes Why Some Persons do not Want to Live in a Shelter

As noted above, for too many persons residing in encampments, living in a shelter does not provide the same sense of safety nor the same sense of community they feel when living in an encampment. In a shelter, the “safety in numbers” and the sense of “family” may not be as strong, which they have come to rely on to guard against traumatizing and re-traumatizing experiences.

Acknowledges the Increasing Need for Trauma-informed Design and Care Shelters

An evolving encampment strategy acknowledges the increasing need for trauma-informed design and care shelters. The planning recognizes that

• for a significant number of persons experiencing homelessness, living in encampments in survival mode is the preferred choice over living in a shelter that is not trauma-informed; and
• the physical and social environment of homeless shelters can contribute to traumatizing and re-traumatizing experiences to shelter residents.

Transitioning some persons living in encampments into shelters that are not trauma-informed will likely be unsuccessful.

Trauma-informed design and care shelters can eliminate several of the reasons why at least some of the persons living in encampments refuse to stay in a shelter. Reasons include:

• Not wanting to live in an open warehouse type setting with little or no privacy day after day;
• Living in a facility that offers little room for movement;
• Lack of confidence that another shelter stay will be different from previous stay(s);
• Will not be able to follow all the early check-in and early wake-up rules because of a disability, illness, work, and appointments;
• Concern for personal safety once inside the shelter;
• Feel too vulnerable to potential verbal and physical abuse from others;
• Fear of potential violence by others to self and others;
• Do not want to be separated from a partner, friend, or pet;
• Very limited space with locks to store personal belongings;
• Concern that personal possessions will be stolen;
• Fear of having personal possessions thrown away;
• Lack of privacy while using restroom and shower;
• Unsanitary conditions;
• Fear of other people’s infectious diseases;
• Feelings of shame, blame, guilt, and stigma; and
• Inadequate staffing especially overnight. 

Acknowledges the Need for a Trauma-informed Approach When Transitioning Persons into Hotels/Motels 

An effective encampment strategy also recognizes that transitioning some of the persons living in encampments into hotels/motels may be difficult

• If the hotel/motel is located in a city, district, community, or neighborhood that is totally, or largely, unfamiliar to persons who are relocated;
• Out of concern that once relocated, persons will no longer have contact with the community, social networks, and persons that have been part of their everyday life;
• Due to worry that their voice and choice will not be considered regarding the services and housing needed to end their homelessness;
• Fear of stereotypes and biases based on race, ethnicity, age, sexual orientation, and gender-identity.

An evolving encampment strategy needs to stay focused on the kind of living environment in which persons now living in encampments now can succeed in the long-term, which is permanent housing rather than temporary housing and encampments. Encampment residents can best benefit from the specific supportive services they need to be linked to long-term care while living in permanent housing. Housing provides the stability to address health, behavioral, and mental health needs.

However, an evolving encampment strategy considers the need for temporary housing because of the limited supply of affordable permanent housing including supportive housing and the length of time it takes to assist persons living in encampments to obtain the housing. Thus, the need for a strategic trauma-informed design and care approach is key to an evolving encampment strategy.

A strategic trauma-informed design and care approach ensures that outreach workers, housing navigators, and peer specialists maintain a consistent presence at the encampment site to develop a trusting relationship with as many encampment residents as possible. Thus, residents will have multiple opportunities to connect initially and to keep on connecting with outreach and engagement workers at their own pace.

A strategic trauma-informed design and care approach involves outreach workers, housing navigators, and peer specialists using a trauma-informed lens that helps recognize and respond to the previous trauma experienced by encampment residents. Trauma-informed design and care involve understanding, anticipating, and responding to the impact that trauma can cause in a person’s life and building increased awareness about addressing existing trauma and preventing re-traumatization.

An Evolving Logic Model

Housing First

Housing First is an approach that has paved the way for a strategic trauma-informed design and care approach. Core components of Housing First emphasize a low barrier tactic to permanent housing. Everyone is “housing ready.” Homelessness service providers must be “client ready.” A low barrier tactic is designed to “screen-in” rather than “screen-out” persons with the greatest barriers to housing, so that they experience improvements in the areas of health, income, mental health, and substance use as a result of achieving housing.

Housing First is in and of itself a trauma-informed approach because core components prioritize the right to self-determination. Respect, choice, and safety are critical to helping a person exit homelessness and successfully remain housed.

Low Barrier Shelter

As a result of the success of a Housing First approach, many shelters have implemented a low barrier approach by removing as many pre-conditions to entry as possible such as active substance use and mental health issues. Pets, partners, and possessions (“three Ps”) are not barriers either. A low barrier approach accommodates the “three Ps” as much as possible and respects resident choice regarding services and safety.

Trauma-informed Design and Care

A strategic trauma-informed design and care approach recognizes that persons living in encampments may prefer to live on the streets in survival mode than live in a low barrier shelter because of their fear that the physical and social environment of the shelter will contribute to traumatizing and re-traumatizing experiences.

Trauma-informed low barrier shelters can eliminate many reasons why persons living homeless on the streets refuse to live in a shelter. A low barrier approach removes as many pre-conditions to entry as possible and pets, partners, and possessions are no longer reasons to refuse shelter. A trauma-informed design and care approach can eliminate many of the reasons why persons living in encampments may still refuse to stay in a low barrier shelter.

The U.S. Department of Health and Human Services Substance Abuse and Mental Health Services Administration has developed a trauma-informed design and care model.

SAMHSA provides the following three principles that serve as guidelines for trauma-informed design for the physical environment of shelters: 

• Realizing how the physical environment effects [sic} an individual’s sense of identity, worth, dignity, and empowerment;
• Recognizing that the physical environment has an impact on attitude, mood, and behavior, and that there is a strong link between our physiological state, our emotional state, and the physical environment; and
• Responding by designing and maintaining supportive and healing environments for trauma-experienced residents or clients to resist re-traumatization.

and a set of four assumptions and six key principles concerning trauma-informed care.

SAMHSA’s model is also based on four assumptions. In short, a service provider

1. Realizes the widespread impact of trauma and understands potential paths for recovery;
2. Recognizes the signs and symptoms of trauma in clients, families, staff, and others involved with the system;
3. Responds by fully integrating knowledge about trauma into policies, procedures, and practices; and
4. Seeks to actively resist re-traumatization.

The six key principles are

1. Safety;
2. Trustworthiness and Transparency;
3. Peer Support;
4. Collaboration and Mutuality;
5. Empowerment, Voice, and Choice; and
6. Cultural, Historical, and Gender Issues.

Thus, an evolving encampment strategy should further the integration of a Housing First, low barrier, and trauma-informed design and care approach to shelter, which will help a jurisdiction’s encampment strategy evolve over time.

An evolving encampment strategy should also anticipate that some persons living in an encampment may find the integrated approach to shelter preferable to living in encampments.