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COLUMBIA SOCIAL WORK REVIEW, VOL. XXII  |   53   52  |  COLUMBIA SOCIAL WORK REVIEW, VOL. XXII 

INSPIRATION FOR ARTICLE

As a hospital social worker for nearly ten years, I’ve worked with 
patients experiencing homelessness and was aware that solutions are 
sorely lacking. But it was only when I started working at the Emergency 
Department that I saw head-on the catastrophic outcomes of lives lived 
at the margins, without a safe place to stay. A few months into my new 
role, a patient arrived in critical condition. He presented with a high fever 
and was unconscious, appearing thin, soiled, wearing only boxers. The 
paramedic reported he was picked up from a tent encampment, and 
“who knew” how long he had been like this. It was jarring to see another 
human being in this shape. As with other patients in critical condition, I 
contacted the emergency contact, only to learn he had a loving family 
who lived out of state and had been unable to help him with severe 
substance use disorder. They were now distraught to hear about his 
condition. One of my co-workers said it best: “to someone out there, 
he is somebody.”  This case became a catalyst for me to want to learn 
more, and – even if in small ways - improve my practice with patients 
experiencing homelessness.

I am a Licensed Clinical Social Worker in Connecticut and a graduate 
of Columbia University’s School of Social Work. My work experience 
includes Yale Child Study Center and Yale University’s SHARE Program. 
Presently I work at Yale New Haven Hospital’s Emergency Service, both 
with adult and pediatric patients. 

CRISTINA
CANTÚ, LCSW



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WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS?

“Homelessness is, in a way, just the visible tip of the iceberg of problems 
in the country. The affordable housing crisis, poverty, racial inequities, 
substance and drug abuse addictions, mental health. All of them are 
sort of manifest when you see people living in the streets. Tackling 

homelessness is in fact a kind of triage, it’s just dealing with a part of 
these larger problems”   

(Kimmelman, 2022, 0:55).

CRISTINA CANTÚ, LCSW

H omelessness is a growing problem nationwide. According 
to the U.S. Department of Housing and Urban Development 
(HUD), the number of people experiencing homelessness 
rose 12% from 2022 to 2023 (HUD Exchange, 2024b). 

Low vacancy rates, increased rent costs, and income inequality all 
comprise difficult structural factors locking people out of the housing 
market. Those who most harshly bear the brunt of this crisis are people 
with social vulnerabilities. This paper analyzes the social problem of 
homelessness from the perspective of an urban hospital Emergency 
Department (ED), Yale New Haven Hospital (YNHH) in New Haven, 
Connecticut. Social workers in these settings have a dual role: working 
directly with individuals and families to connect them with available 
services and resources and advocating for structural interventions that 
can ultimately ease this problem. Social workers are also at the forefront 
of combating any stigma unhoused persons face by both approaching 
patients experiencing homelessness with dignity and respect while 
educating others that this problem is not one of the individual, but 
is rather a consequence of multiple other social problems we have 
collectively failed to address.   

ED social workers are consulted to help address the entire spectrum 
of psychosocial problems being faced by patients. Social workers 
are key team members in addressing cases of abuse and neglect and 
take primary responsibility for compliance with mandated reporting 
requirements. Because YNHH is a Level-1 Trauma Center, social 
workers also prioritize patients who arrive with full or modified traumas. 
Those arriving as cardiac arrests or needing urgent life-saving measures 
are also referred to social work. In all these cases, social workers act 
as liaisons to family members and provide support while also assisting 
with next steps. The role of a social worker in the ED also involves 
addressing any issue that impacts effective care or treatment of a health 
problem. 



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PREVALENCE, TERMINOLOGY, AND DEMOGRAPHICS 

According to the U.S. Department of Housing and Urban Development, 
homelessness has steadily risen since 2017 (HUD Exchange, 2024b). 
Based on the 2023 nationwide point-in-time (PIT) count, 650,000 
people were experiencing homelessness in the United States, and 
homelessness in families with children rose by 15.5% (HUD Exchange, 
2024b). Past studies have found, however, that flawed methodology 
and varying execution may lead to undercounting the persons who are 
homeless through the PIT count, with the annual number of people who 
are homeless being 2.5 to 10.2 times greater (National Law Center on 
Homelessness & Poverty [NLCHP], 2017).

The PIT count is a measure mandated by HUD and seeks to count all 
sheltered and unsheltered people within a specific area one day per 
year. The most recent PIT data available for the state of Connecticut 
is from the January 24, 2023 count. The number of individuals found 
to be experiencing homelessness across Connecticut at that time was 
3,015, which represented a 2.9% increase from 2022 (Advancing CT 
Together [ACT], 2023). According to the count, the number of persons 
experiencing chronic homelessness remained stable at 117 (ACT, 
2023). The PIT count also found that homelessness among youth (ages 
24 and younger) had increased by 7.06% (ACT, 2023). As of 2023, 
Connecticut’s rate of homelessness was 8.1 people per 10,000, which 
was lower than the national rate of 18 out of 10,000 (National Alliance to 
End Homelessness [NAEH], 2023a).   

HUD categorizes types of homelessness into four groups: literally 
homeless, at imminent risk of homelessness, homeless under other 
federal statutes, and fleeing/attempting to flee domestic violence. 
Literally homeless means having a primary nighttime residence not 
meant for human habitation, staying in a shelter, or a person being 
discharged from a facility where they remained less than 90 days and 
have no other residence (HUD Exchange, 2024c). Imminent risk of 
homelessness is defined as a person who will be homeless within 14 

days, with no place to go or resources to secure permanent housing 
(HUD Exchange, 2024c.). Homeless under other federal statutes refers to 
unaccompanied youth less than 25 years of age or families with children 
and youth who do not otherwise qualify as literally homeless under HUD, 
but may qualify under other federal programs (HUD Exchange, 2024c). 
For example, the Department of Education defines homelessness as 
lacking a “fixed, regular, and adequate nighttime residence” (Parolin, 
2021, p. 46), which may capture a wider number of people. Finally, 
fleeing/attempting to flee domestic violence refers to an individual or a 
family fleeing intimate partner violence, including dating violence, sexual 
assault, stalking, and other dangerous or life-threatening conditions 
that relate to violence and having no place to go or resources to secure 
permanent housing (HUD Exchange, 2024c).

HUD also has a longer definition for persons categorized as chronically 
homeless: people who have been without a residence for extended 
periods of time. The definition, as delineated in section 401(9) of the 
McKinney-Vento Assistance Act (42 U.S.C. 11360(9)) is as follows:   

Lives in a place not meant for human habitation, a safe haven, 
or in an emergency shelter, and has been homeless and living 
as described for at least 12 months or on at least 4 separate 
occasions in the last 3 years, as long as the combined occasions 
equal at least 12 months and each break in homelessness 
separating the occasions included at least 7 consecutive nights 
of not living as described (HUD Exchange, 2024b, para. 4).

People who are deemed chronically homeless qualify for specific HUD 
programs. However, because of the intricacy of the definition, it is often 
difficult for people to provide proper evidence to qualify as chronically 
homeless with barriers such as difficulty obtaining identification or 
documentation and long wait periods (Wusinich et al., 2019).

Further exploration of the demographics of homelessness makes it 
clear that “the hazard of experiencing homelessness is not uniformly 
distributed across different populations” (Willison et al., 2023, p. 1). 

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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According to the NAEH, the marginalized groups with highest incidence 
of homelessness also have “extensive histories of experiencing 
oppression, including displacements from land and property and 
exclusions from housing opportunities” (2023a, para. 9). HUD data 
from 2022 shows that rates of homelessness are highest among 
Native Hawaiian or Other Pacific Islanders (121.2 out of 10,000), Black 
or African American (48.2 out of 10,000) and American Indian (44.9 
out of 10,000) (NAEH, 2023a). Comparatively, the rate for the white 
population is 11.6 out of 10,000 (NAEH, 2023a). In 2020, nearly 40% of 
those experiencing homelessness were Black, and 23% were Latino, 
while they comprise only 13% and 18% of the population, respectively 
(Center on Budget and Policy Priorities [CBPP], 2022). These numbers 
are not a new trend. Homelessness data from 2007 to 2017 shows that 
Blacks, American Indians, and Native Hawaiians were at least twice as 
likely than whites to experience homelessness (Willison et al., 2023). 

It is also worthwhile to explore the distinction between persons who are 
sheltered and unsheltered. Being unsheltered means having a primary 
nighttime residence that is a public or private place not meant for 
human habitation; for example, a city sidewalk, vehicle, an abandoned 
building, a park, under a bridge, a train station, or a tent encampment 
(NAEH, 2023a). A sheltered person is anyone who is temporarily residing 
at a publicly or privately operated shelter; for example, congregate 
shelters, transitional housing, a hotel or motel paid for by charitable 
organizations, or an institution such as a hospital or treatment facility. 
Notably, anyone who is couch-surfing, doubled up with others, or 
paying for their own hotel room is not considered homeless but may be 
considered at-risk for homelessness (HUD Exchange, 2024a).

Persons who are unsheltered often have generally poorer health and 
face a higher risk of premature death when compared to those who 
are sheltered (Richards & Kuhn, 2022). The data also shows that those 
from marginalized communities have higher rates of being unsheltered, 
as noted below. According to HUD 2022 data, Native Hawaiian or 
Asian Pacific Islanders, Asian Americans, and Native Americans have 

the highest incidence of being unsheltered – with 53%-55% of their 
homeless population living unsheltered (NAEH, 2023a).

People of marginalized genders also have a higher incidence of being 
unsheltered, based on HUD 2022 data, with 56% of transgender people 
who are homeless being unsheltered and 78% of homeless gender-
questioning individuals being unsheltered (NAEH, 2023a). Connecticut 
law requires shelters to accept people based on their gender identity, 
regardless of sex assigned at birth. However, this law does not 
necessarily stymie the bias or microaggressions that people who are 
gender-nonconforming may experience in shelter settings. An analysis 
of the 2015 U.S. Transgender Survey by the Williams Institute at the 
UCLA School of Law found that close to 85% of transgender adults 
who are homeless reported not seeking shelter at a homeless facility 
because of concern for mistreatment (O’Neill et al., 2020).

CONTRIBUTING CAUSES TO HOMELESSNESS 

What leads any one person or family to become homeless can be 
examined as the interplay of three types of factors: structural factors, 
precipitating or adverse life events, and individual vulnerabilities. 
Structural factors can include rental market conditions, housing policy, 
income inequality, and the social safety net or lack thereof. Adverse life 
or precipitating events may include sudden loss of income, catastrophic 
health problems, exposure to a natural disaster, loss of family member, 
divorce, or foreclosure, to name a few. Individual vulnerabilities include 
non-heterosexual identity, low educational attainment, unemployment, 
veteran status, a history of incarceration, mental health and substance 
use disorders (Nilsson et al., 2019), and involvement with child welfare 
and juvenile justice systems (NAEH, 2023b). However, while individual 
factors increase the risk of becoming homeless, according to Colburn 
and Aldern (2022), the root causes of high rates of homelessness are 
primarily housing market characteristics–structural forces out of the 
control of any one person. Simply stated by Colburn, “in places that 
are expensive, homelessness is high, and in places that are cheap, 
homelessness is low” (KingCountyTV, 2022, 5:03).

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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In their book Homelessness is a Housing Problem, Gregg Colburn and 
Clayton Aldern (2022) made an exhaustive study of data comparing 
rates of homelessness across cities and counties along with factors 
usually associated with homelessness. They examined poverty rates, 
weather, mental illness rates, substance use, and areas with generous 
welfare benefits. The data clearly indicated that those factors did not 
correlate with rates of homelessness. Colburn and Aldern (2022) noted 
that, in fact, the areas with the highest wealth distribution paradoxically 
experience the highest rates of homelessness. Conversely, a state such 
as West Virginia, where the opioid epidemic has hit hardest, does not 
have the high rates of homelessness seen elsewhere (KingCountyTV, 
2022). At the same time, the vast majority of the 40 to 52 million 
people who experience substance use or psychiatric disorders are not 
homeless (Pitkin, 2022). Colburn and Aldern (2022) showed that it was 
ultimately rent levels and rental vacancy rates that were most associated 
with regional rates of homelessness. This explains why places like 
San Francisco and New York have such high numbers of homeless 
people–there are simply not enough affordable dwellings for people 
to inhabit. Once this housing crunch is a set condition, like a game of 
musical chairs, those with vulnerabilities will be more likely to end up 
without a spot. While it is important to consider individual comorbidities, 
particularly when advocating for treatment, shifting the view to 
structural factors is helpful because it reduces the tendency to blame 
the individual for the problem they are experiencing, and it helps divert 
attention to structural interventions that can actually make a difference 
(Colburn & Aldern, 2022). 

When looking at structural or root causes of homelessness, it is worth 
examining how these factors contribute to minority communities being 
disproportionately affected by homelessness. The dynamics involved 
are complex, entrenched, and undeniable. Centuries of discrimination, 
from slavery to segregation, weigh on present generations. Racist 
policies such as neighborhood segregation and exclusion of Blacks 
from federally-backed mortgages led to wealth disparities between 
white Americans and people of color (Willison et al., 2023). These 
wealth disparities now “exacerbate risks of housing insecurity and 

homelessness for people of color due to a lack of protections, including 
at community and family levels, to mitigate or bounce back in cases of 
financial hardship” (Willison et al., 2023, p. 2). Interventions intended to 
help–the systems of support for homeless persons–do not help Black 
persons equitably (Pitkin, 2022). The disproportionate presence of the 
child welfare and criminal justice systems in communities of color have 
long-term effects and carry risk into later adulthood (Pitkin, 2022). Other 
factors that contribute to housing instability among communities of color 
include higher cost burden among renters of color and the inadequacy 
of housing stock to meet the needs of multigenerational families 
of color (Lake, 2020). Based on an analysis of yearly HUD surveys, 
Desmond (2023) also finds that “Black renters continue to face routine 
discrimination when searching for apartments” (p. 69). Considering the 
sum total of these facts, perhaps this is why Balasuriya et al. (2020) 
writes, “Regardless of mental health status, people who are homeless 
generally have a history marked by poverty and social disadvantage…
and they are likely to belong to an ethnic minority” (p. 3).

HOMELESSNESS, MENTAL HEALTH, AND SUBSTANCE USE  

As discussed earlier, there is a public perception that mental 
health problems or substance use disorders are a direct pathway 
to homelessness (Pitkin, 2022). In fact, the relationship between 
homelessness and mental health problems is more complex. Studies 
have found a bidirectional association between homelessness and 
mental illness (Nilsson et al., 2024). While mental illness may contribute 
to loss of housing or inability to remain housed (and is a vulnerability as 
discussed earlier), homelessness itself contributes to worsening mental 
health (Padgett, 2020). It follows that depression, suicidal thoughts, 
symptoms of post-traumatic stress disorder, and substance misuse are 
more prevalent among the homeless population (Substance Abuse and 
Mental Health Services Administration [SAMHSA], 2011). Rates of more 
severe mental illnesses, such as schizophrenia, are at 25%–30% among 
homeless persons (Padgett, 2020) and were noted to be at 26.2% of all 
sheltered persons in 2010 (SAMHSA, 2011).

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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Significantly, homeless and marginally housed individuals do appear to 
have a more than 50% rate of traumatic brain injury (TBI), which is much 
higher than the general population (Padgett, 2020). TBI can influence 
a person’s executive function, for example increasing impulsivity and 
impairing working memory (Ozga et al., 2018). Deficits in executive 
function may complicate efforts to maintain stable housing and thus 
become a vulnerability.

More than one-third of people experiencing homelessness have been 
found to have a substance use disorder (SUD), with two-thirds of those 
individuals having a lifetime history of SUD (Polcin, 2016). Again, as with 
other health problems, “the relationship between homelessness and 
substance abuse is complex, with studies suggesting that substance 
use can be both a cause and consequence of homelessness” (Polcin, 
2016, p. 2). One thing is clear: being homeless is not a condition that 
supports recovery. Polcin (2016) argues for housing options that offer 
harm reduction and built-in options for treatment. 

HEALTH AND HEALTHCARE BARRIERS

People experiencing homelessness contend with a higher burden of 
health problems (Morris & Gordon, 2006). Canham et al. (2018) discuss 
tri-morbidity, meaning the confluence of physical health problems, 
mental health problems, and substance use disorders that leads to 
higher mortality rates. There are varied numbers describing mortality 
rates among people experiencing homelessness. Franco et al. (2021) 
report that homeless patients have twice the mortality rate of non-
homeless cohorts. Meanwhile, Omerov et al. (2019) place the number 
much higher, describing excess mortality at eight times higher for men 
and twelve times higher for women, although this estimate also includes 
other high-risk groups, such as prisoners and sex workers.  

Medical problems most heavily experienced by homeless patients 
include chronic pulmonary obstructive disease, arthritis, musculoskeletal 
disorders, seizures, hypertension, diabetes, liver diseases, tuberculosis, 
hepatitis C, HIV, dental problems, skin problems, and foot problems 
(Canham et al., 2018). People experiencing homelessness also faced 

twice the mortality rate from COVID-19 as compared with the general 
population (Gavidia, 2022).  

Conditions associated with homelessness have obvious adverse effects 
on health and can include exposure to the elements, living in crowded 
conditions, exposure to violence, poor nutrition and sleep, and lack of 
access to bathing. Barriers to accessing healthcare, delays in seeking 
care, and difficulty adhering to treatment also contribute to poor health 
outcomes (Canham et al., 2018). Omerov et al. (2019) further describe 
barriers to care faced by homeless patients such as lack of health 
insurance, lack of identification, lack of mail or telephone service, poor 
transportation, and limited knowledge of where to receive resources.

Beyond these barriers, Omerov et al. (2019) found that stigma and 
bias can also prevent adequate provision of healthcare to patients 
experiencing homelessness. Based on a research review, unhelpful 
relations with medical providers and social care professionals were 
characterized by a lack of respect or empathy toward clients, judgment 
for appearance, patient feeling invisible, unrealistic follow-up advice, 
and restricting freedom or autonomy. They further highlight the problem 
of some healthcare professionals showing “insensitivity to ethnic 
disparities or the unique needs of people of color” (Omerov et al., 2019, 
p. 6).

On the flipside, Omerov et al. (2019) also describe the experiences 
of homeless patients with professionals the patients believed were 
supportive. Positive experiences include respectful social interactions, 
feeling comfortable showing vulnerability, being able to laugh together, 
flexibility regarding appointments, feeling listened to, providers 
remembering details of their lives, and when patients were given 
decision-making power. 

EMERGENCY DEPARTMENT USE 

Given the wide range of health problems, and the propensity of these 
problems to worsen while homeless, these patients understandably 
have higher utilization of the ED. Franco et al. (2021), who conducted 

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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a study focusing on the YNHH ED and the greater New Haven 
area, explain that people experiencing homelessness represent a 
disproportionate share of ED visits compared to housed cohorts. 
Unhoused patients have approximately three times more usage and are 
four times more likely to return within three days as compared to housed 
individuals (Franco et al., 2021). Homeless patients are also more likely 
to present with injuries acquired while in the community; for example, 
assaults, both physical and sexual (Morris & Gordon, 2006).  

Franco et al. (2021) describe the ED as a “de-facto shelter and sobering 
center [which] serves not only as medical but also social safety net” 
(p. 9). In effect, the ED provides respite from conditions faced in 
homelessness and serves as a 24-hour drop-in center. Notwithstanding, 
Franco et al. (2021) highlight that this higher frequency of ED care does 
not translate to improved health outcomes for homeless patients, and 
it places a strain on an already stressed system. Franco et al. (2021) 
conclude that “homeless patients require social needs to be met 
alongside medical ones,” and that this can be best achieved through 
collaborations with community partners (p. 8). Social workers are 
uniquely positioned to create those connections.

ROLE OF SOCIAL WORK IN THE EMERGENCY DEPARTMENT

ED social workers can play a role in improving outcomes for persons 
who are experiencing homelessness. In Canham et al.’s (2018) article 
Health Supports Needed for Homeless Persons Transitioning from 
Hospitals, the authors provide a clear guide as to the six realms of 
intervention that can make the most impact. They conducted a literature 
review and analysis and concluded that stopping the cycle of hospital 
discharge and readmission of homeless patients requires attention to 
a full range of needs–both medical and basic needs. Canham et al. 
(2018) acknowledge that systems are insufficient to meet the needs 
of homeless patients; for example, lack of access to specialty health 
services, lack of affordable step-down care, and lack of rehabilitation 
beds. The efforts made by professionals can, at the very least, improve 
the probability of success. The six themes related to health support 

cited by Canham et al. (2018) are a respectful and understanding 
approach to care, conducting housing assessments, communication/
coordination/navigation with outside providers, support for after-care, 
complex medical care, and medication management, basic needs, and 
transportation.  

Drawing from personal experience as a social worker in the ED, the 
recommendations by Canham et al. are an effective guide to direct 
practice. As mentioned earlier, people experiencing homelessness may 
arrive for care to the ED having experienced stigma and bias in the past 
(Omerov et al., 2019). A respectful and understanding approach can 
counter this and helps to facilitate the development of a collaborative 
working relationship in which an effective housing assessment can be 
conducted. As delineated above, homelessness can be experienced 
in multiple ways, and a patient’s particular circumstances should drive 
specific recommendations. Obtaining nuanced information is key 
in determining the appropriate next step. The same can be said for 
assisting patients in seeking services to address mental health services 
or substance use treatment. Conversations that help identify possible 
barriers or obstacles to obtaining this care are important to avoid 
making unrealistic recommendations. 

The YNHH ED is located in a state which has an established hotline, 
211, to assist callers with housing and other needs. The hotline is 
the entry point for services for people and families experiencing 
homelessness. The process entails an initial interview in which personal 
data is gathered and leads to an appointment for a housing assessment 
by a state-contracted agency. It is essential for social workers to 
understand the local system of support with clarity to be able to explain 
it to patients. 

Likewise, being familiar with community resources is imperative, as is 
establishing relationships with community providers and maintaining up-
to-date information on service and resource availability. Finally, a warm 
hand-off to community healthcare providers or other agencies, when 
possible, may improve chances that the patient will have continuity of 
care. 

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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FUTURE TRENDS

Two emerging demographic trends among the homeless population 
should be highlighted. First, as individuals with chronic patterns of 
homelessness age, they require more medical services and help with 
activities of daily living. While symptoms of severe mental health or 
substance abuse may become less acute through the lifespan, chronic 
health conditions progress and worsen. Communities, states, and the 
federal government would be wise to begin planning to address this 
need today by perhaps investing in permanent supportive housing units 
for the elderly with healthcare personnel on hand. 

Second, the number of young people experiencing homelessness is also 
growing at alarming rates. Homeless youth may include young people 
who are part of families, head of households, or individuals (CBPP, 
2022). Young people with involvement in the child welfare or juvenile 
justice systems, those who identify as LGBTQ, pregnant and parenting 
youth, young people with special needs, and young people of color may 
be at higher risk of homelessness (NAEH, 2023). Simultaneously, the 
current cohort of teens who are estranged from the educational system 
may struggle to become earners as young adults and will thus have 
greater vulnerability to becoming homeless. Without comprehensive 
prevention and early intervention efforts by communities, states, and the 
federal government, this trend will result in a whole new generation of 
people with established patterns of homelessness. 

SOLUTIONS 

Ending homelessness is neither out of reach nor an impossible goal. 
The CBPP recommends expanding housing choice vouchers, including 
providing universal housing vouchers to reduce hardship for all families 
(2022). They further recommend shoring up the social safety net. More 
specifically, we know that for people with chronic homelessness or 
those having difficulty maintaining a residence, a permanent supportive 
housing model works, as it provides on-site support including case 
management and ease of access to healthcare, mental health, and 
substance use disorder treatment. For those experiencing transitional 

homelessness, a rapid-rehousing model with a rental subsidy, even if 
time-limited, is effective. Partnering with developers to build affordable 
housing is also a critical component in easing a housing shortage. 
Communities and states would be wise to begin today to expand all 
these programs. It will require financial resources and investment like 
any other federal, state and local initiative. 

In continuing to think about solutions to homelessness, it is crucial 
to hear the voices of people experiencing it as they are the primary 
stakeholders. A hopeful development occurred in New Haven last fall 
when six tiny houses were installed in the area where tent encampments 
had been torn down (Grace-Flood, 2023). The prefabricated units were 
assembled and installed by former tent encampment residents and 
neighborhood volunteers. While small, it is a worthwhile effort that can 
perhaps be scaled up in the future, and it demonstrates that creative 
and grass-roots solutions can play a role in ending homelessness, one 
person at a time.  

CONCLUSION 

Social workers are uniquely positioned to contribute to positive solutions 
to help address homelessness. Working directly with individuals to help 
address health, mental health, and substance use needs is important. 
Helping folks problem-solve to exit homelessness and maintain housing 
is essential. Providing guidance in navigating the complex systems 
set up to help is valuable. Because a social worker is one strand in a 
community safety net, they can be most effective when partnering and 
collaborating with local resources. Educating others regarding factors 
that contribute to homelessness is important, particularly when it 
comes to acknowledging system failures, housing market conditions, 
and entrenched inequities in our social environment. Simultaneously, 
maintaining a view on the broader context and advocating for solutions 
on the macro-level has to take precedence. This problem will only be 
solved when communities, states, and the federal government make 
meaningful investments to increase affordable housing and fortify safety 
nets.

WHAT CAN SOCIAL WORKERS DO TO HELP THE GROWING NUMBER OF PEOPLE  
EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW



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Balasuriya, L., Buelt, E., & Tsai, J. (2020). The never-ending loop: Homelessness, 
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Canham, S. L., Davidson, S., Custodio, K., Mauboules, C., Good, C., Wister, A., & Bosma, 
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Center on Budget and Policy Priorities. (2022). Ending homelessness: Addressing local 
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Colburn, G., & Aldern, C. (2022). Homelessness is a housing problem: How 
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Desmond, M. (2023). Poverty by america. Penguin Random House. https://
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EXPERIENCING HOMELESSNESS? CRISTINA CANTÚ, LCSW


