Razing encampments satisfies the public, hurts the homeless | Opinion

Rebecca Karb, MD, is an emergency and Street Medicine physician. 

Under the guise of public health and safety, Providence Mayor Brett Smiley recently announced plans to evict people from several large tent encampments in Providence.

It is important for us to be open and transparent about this fact: forced displacement of people from encampments does nothing to end homelessness. We have seen time and again that when we break up encampments in one location, new encampments emerge in other locations. The people living in those encampments do not just disappear, and predictably end up back outside in the absence of a comprehensive plan for permanent supportive housing. Far from helpful, encampment sweeps cost money, waste valuable time and resources, and are ultimately counterproductive.

On any given night in Rhode Island there are around 1,800 people experiencing homelessness, and this number is on the rise. In the wake of the pandemic, the housing supply has dwindled (the rental vacancy rate in Providence is at a low of about 3%, far below the preferred 6% to 8% needed to defend against constant upward pressure on rental prices) and affordable housing is scarce. Providence boasts the highest rental cost increases in the country over the past year.

More: Last year, ‘pallet shelters’ looked like a quick way to provide cheap roofs. Where are they?

Meanwhile, there are only 1,125 shelter beds, with over 600 people on a waiting list. All of these factors have contributed to the rise in unsheltered homelessness (people forced to sleep in uninhabitable spaces such as tent encampments, sidewalks, parks, and abandoned buildings). The encampments seen on the sides of streets or tucked behind parks are evidence of our systemic failure to address the spiraling housing crisis.

It can be difficult to bear witness to human beings living in such inhumane conditions so close to us, and perhaps natural to want to remove from sight a reality that elicits such complicated and contradictory emotions as sadness, guilt, empathy, fear and anger. To be fair, encampments are inherently unhealthy places to live. The lack of access to running water, bathrooms, electricity, and protection from the elements all pose significant health risks.

However, encampments also offer advantages to people experiencing unsheltered homelessness. Communal living on the street provides safety, security for people’s belongings, companionship, and the sharing of pooled resources to meet basic needs. Encampments allow couples, families and pets to stay together when there are no shelter options. Encampments also allow social service and medical teams reliable and consistent access to provide services and support.

Encampment sweeps harm people experiencing homelessness and undermine the work that outreach teams have been doing to build trust and connect individuals with resources and medical care. Sweeps disrupt daily routines and force individuals to spend time, energy and money on figuring out new sleeping arrangements, re-working transportation routes, and replacing lost or damaged supplies, documents and medications. Following sweeps, individuals can become disconnected from outreach teams, lost to follow up, and derailed from often hard-fought-for treatments plans.

More: RI has a Homeless Bill of Rights. Why advocates say it needs an expansion.

For example, our Street Medicine team will need to spend valuable time and energy simply locating patients in new places, and we will inevitably lose contact with some patients with whom we have worked hard to establish trusting relationships. This compromises the quality of care we are able to provide, and ultimately leads to worse health outcomes for this already underserved population.

The high costs of these disruptions to community and safety are certainly not worth the perceived (but false) public perception that encampment sweeps are solving the problem of homelessness. It is time for our government leaders to offer real solutions in the form of an adequate supply of safe, affordable, supportive housing and low-barrier access to health care.

Until that can be offered, do not destroy the communities of care, resilience and support that people form to survive the harsh reality of homelessness and do not make it more difficult for the social service providers and medical outreach teams who are trying to serve them.