Ellen L. Bassuk, MD
Founder and President of The National Center on Family Homelessness
Newton, MA

Ellen L. Bassuk, MD is a leading clinician, researcher and advocate on behalf of homeless families and individuals. At the forefront of homelessness for three decades, she has pioneered some of the seminal work on the role of violence, trauma and mental illness in the lives of homeless families and children. Dr. Bassuk has served in leadership positions in the Worcester Family Research Project, National Resource Center on Homelessness and Mental Illness, National Child Traumatic Stress Initiativ

Each year around this time, children across America head back to school. They are ready to show off new sneakers and back packs and tell summer stories to their friends. Teachers are eager to dive into lesson plans. Coaches are ready to start practice. Even parents look forward to the return of normalcy to family schedules. Everyone seems to have a reason to be excited about the new school year.

But for 1.5 million homeless children around the country, it’s an altogether different situation. These kids are not likely to have new shoes or any other back-to-school items, nor do they have happy summer stories to share. Their summer involved the physical and emotional trauma, illness and hunger associated with homelessness. Not to mention moving from shelter to shelter, doubling up with family members and friends, staying in dingy motels or living on the streets. One-third of them spent the summer trying to find their next meal.

With one in every 50 children experiencing homelessness in America each year, this national tragedy is only getting worse. According to “America’s Youngest Outcasts: State Report Card on Child Homelessness” (www.HomelessChildrenAmerica.org), more than 690,000 homeless children are in kindergarten through grade 8. Reading and math proficiencies for these students are 16 percent lower than their peers. Homeless children are twice as likely to repeat a grade, have learning disabilities or drop out of school. Many will not graduate from high school. Shockingly, there are more than 650,000 homeless kids under the age of 6 in America. That’s more than the population of Denver, Colorado.

Make no mistake; we are experiencing the greatest number of children enduring homelessness, or on the brink of homelessness, since the Dust Bowl Era of the Great Depression. Families are forced into doubling up with relatives and friends at an alarming rate because of their economic situations, shelters are at occupancy and government services are not keeping pace with the recession.

The face of modern homelessness has changed substantially. Today, approximately 34 percent of America’s homeless population consists of families, a dramatic change from just one percent in the 1980’s. The dynamics of homelessness have also changed. The amount of available affordable housing units nationwide has shrunk by 14 percent in recent years. Many communities around the country have a three year waiting list for affordable housing. As many as 6 million Americans spend more than half their income on housing. The result is not only more homeless children, but longer periods of time that families stay homeless.

The good news is that ending child homelessness is realistic. Years of research and programs, both successful and unsuccessful, provide evidence that this moral imperative is within our reach, even in these tough times. The solutions include:

Housing
Homelessness is fundamentally a housing crisis. Rapid re-housing through increased housing vouchers is critical to preventing and ending family homelessness. The federal government must also expand the overall stock of affordable housing by fully capitalizing on the National Housing Trust Fund and other federal housing programs.

Services
For many families and children, housing is not enough. To be successful in the long-term, any comprehensive solution must include services and instrumental supports that address employment, income, education, family preservation, healthcare, hunger and violence. Many homeless children and families are eligible for these services and supports, but their access is hindered by various significant barriers, such as a lack of transportation, difficulty navigating complex bureaucracies, a lack of proper documentation, excessive waitlists and even discrimination.

Solutions start with increased funding for key mainstream programs, such as job training, health insurance and the Supplemental Nutrition Assistance Program, and extending priority to homeless children and families. Case management services need to be expanded so that shelters and other homeless programs have adequate staff to assist families in accessing and navigating mainstream programs. Barriers to mainstream programs should also be removed by providing presumptive eligibility, expediting review processes and eliminating documentation requirements. Coordination among mainstream programs at the federal and state levels should be enhanced to ensure delivery of comprehensive, integrated care. More training must be offered to mainstream service providers about the unique needs of homeless families and children.

Trauma-Informed Programs
The stress of homelessness is often compounded by past traumatic experiences, such as catastrophic illness, abrupt separations, physical or sexual abuse and intimate partner violence. Traumatic stress impacts every aspect of a person’s life, from their capacity to form sustaining relationships and overall physical and mental health, to their ability to maintain housing and employment and achieve educational success.

The National Center on Family Homelessness has developed a cutting-edge family intervention program to help end the vicious cycle of trauma, and equip children and families with the internal and external supports they need to be successful. The program, Building Strengths and Advocating for Family Empowerment, provides best practices for paraprofessionals in homeless and domestic violence shelters and transitional housing programs. These practices include a comprehensive model for treating traumatic stress in children through therapy, relational support intervention—which empowers and supports women to access the community-based services—and a multi-family group intervention to help families re-build attachments and re-establish routines and rituals.

Education
While some homeless children succeed in school, it requires focused help from educators and an array of supportive services. The McKinney-Vento Homeless Assistance Act requires schools to remove barriers to education so that homeless children may attend and succeed in school. The law mandates that each school district name a liaison responsible for identifying homeless students, enrolling them in school, connecting them to services and working with parents to understand their child’s educational rights.

Unfortunately, the federal government is falling short in funding for the McKinney-Vento Act, spending roughly $58 million nationally each year. To realize the program’s promise, it should be fully funded at $210 million annually.

As our kids return to classrooms nationwide this fall, we should ponder this question - since when has it been acceptable to do something half-way? Growing up, my teachers would never allow me to submit incomplete school work. Similarly, we as a society should not tolerate inadequate funding of programs, services and solutions that have been proven to work towards ending child and family homelessness.

Workforce Development
Ultimately, comprehensive services cannot be effectively administered without addressing the needs of the homeless service delivery workforce. Too often, providers are overworked, underpaid, isolated from peers in their field and have limited opportunities for training or career development. As a result, homeless services are sometimes outdated and not reflective of state-of-the-art knowledge and practice. 

Fortunately, web-based technologies present a way around workforce development challenges. Our profession should leverage these tools to aid providers with best practices and innovative programs, training and technical assistance and professional standards and competencies.

Research
The transition from shelter to community is difficult, in part because community-based services are not readily available or accessible. It is the reason why many families fall back into homelessness. Homeless providers must bridge the gap between shelter and community-based living to ensure that children and families are adequately supported and receiving the services they need to thrive. Ongoing research and evaluation should be prioritized to improve our collective understanding of the characteristics and needs of homeless children and families, and effective program and policy interventions to prevent, address and end homelessness.

It is both a tragedy and a disgrace that there are 1.5 million homeless children on American streets. Because of this, we will lose approximately $240 billion in societal contributions over their lifetimes. Government officials should be mindful of the moral and practical reasons for investing in these children and, especially in these times, they must find ways to prioritize homeless programs, services and infrastructure.