CHAPTER
5
Children
Living Without Homes
Families
now comprise 40 percent of the U.S. homeless population.
Despite increased prosperity over the past decade, more
than one million American children are homeless today. The
Better Homes Fund in its 1999 research and policy report,
Homeless Children: America's New Outcasts, describes
the physical and emotional conditions of these youngest
citizens and how their lives are frequently linked to child
abuse, neglect and violence.[104]
In Massachusetts
the number of homeless families increased by over 100
percent, to 10,000 families, from 1990 to 1997.[105]
Since a homeless family is defined as a mother and two children,
we can estimate that approximately 20,000 children are
homeless in our state. This is a dramatic increase from
the estimated 1,600 homeless children only a decade ago.[106]
Currently, Massachusetts ranks fourth highest in the
country in terms of per capita income, yet it ranks 24th
highest in the number of children living at risk of homelessness.[107]
Homelessness
and Child Neglect
Mothers
who find themselves homeless struggle against conditions
that undermine the basic physical and emotional well-being
of their children. According to the Worcester Family Research
Project and The Better Homes Fund, homeless children
are hungry more than twice as often as other children.
Two-thirds report that they worry they won't have enough
to eat.[108]
For
these children, poor nutrition often begins prior to their
homelessness. Almost one-third of low-income families do
not have enough money to prepare three meals a day. Cash
assistance and food stamps do not cover food costs when
rents are high. Lack of adequate food is especially common
during winter when cash must be used to pay for heat. Even
when these families are housed in homeless shelters, their
children can still be undernourished. Although shelters
provide nutritionally balanced food, meals are usually served
at strictly scheduled times that can be easily missed when
mothers are searching for housing and work. Food preparation
for homeless families living in hotels and motels can be
challenging. Lack of refrigeration and the means to cook
usually result in fast food meals or no regular hot meals.[109]
Homeless
children are in fair or poor health twice as often as other
children. Homeless newborns have higher rates of low birth
weight and need special care after birth four times as often
as other children. Exposure to the communal conditions
of shelter life, including overcrowding and shared food
preparation, increases the risk of disease and infection.
Compared to other children, homeless children suffer twice
as many ear infections and five times more diarrheal and
stomach problems. Anemia, eczema, and headaches are other
chronic illnesses experienced by homeless infants, toddlers,
and school-age children. Childhood asthma is found in very
high rates because of substandard housing conditions, crowded
shelters that facilitate the spread of viral infections,
and exposure to smoke and other environmental allergens.[110]
Despite
the efforts of dedicated staff, many shelters are noisy
and chaotic, too hot or cold, crowded, and lack comfortable
surroundings. Children usually sleep in the same room with
their parents and siblings, and bathroom facilities are
shared with other families. When a homeless child gets sick
in this setting, a mother has no chance of providing her
child with a private and quiet place to rest. Preparing
a special diet in a shelter can also be very difficult.
Getting medical care for a sick child, something most parents
do routinely can become overwhelming and even ill advised.
Homeless parents are understandably reluctant to take their
sick children out in the weather and have them negotiate
several buses to medical care. Many shelters are not located
near public transportation. Lack of availability of other
adults to watch a sibling is another barrier to adequate
health care.[111]
Clearly,
poverty, the rising cost of living, and lack of affordable
housing are factors that can push families into homelessness.
For many, however, histories of victimization and violence
have played a role in making them and their children vulnerable
to losing their homes. The intergenerational links among
violence, child abuse, and homelessness are startling.
Although
homelessness does not cause child abuse, it can lead to
conditions in which child maltreatment is more likely to
occur.[112] For example, the Worcester Family Research Project
found that among homeless children, 8 percent had been physically
abused - twice the rate of other children. The study also
showed 8 percent had been sexually abused, and 35 percent
had been the subject of a child protection investigation.[113]
Homeless
children are at high risk for foster care, with 12 percent
placed in foster care, compared to just over 1 percent of
other children.[114] The intergenerational links between
placement in foster care as a child and later adult homelessness
should also be noted. According to the Child Welfare League
of America, 70 percent of homeless mothers who were in foster
care as children have had at least one of their own children
placed in foster care.[115] The Better Homes Fund research
confirms that a startling 44 percent of homeless mothers
lived outside their homes at some point during their childhood.
Of these, 20 percent were placed in foster care.[116] In
fact, foster care is one of only two childhood risk factors
that predicts family homelessness during adulthood -
the second being maternal substance abuse.[117]
Of
the overall family homeless population, 66 percent were
violently abused before age 18 by a childhood caretaker
or other adult in the household, and 43 percent were sexually
molested as children.[118] In adulthood, 63 percent
report violent abuse by an intimate male partner while 25
percent report physical or sexual assault during adulthood
by someone other than an intimate partner.[119] When the
violence from their childhood is combined with their experiences
as adults, an incredible 92 percent of homeless mothers
have been severely physically or sexually assaulted while
88 percent have been violently abused by a family member
or intimate partner.[120]
Nearly
25 percent of homeless children have witnessed these acts
of violence within their families. Fifteen percent have
seen their father hit their mother while 11 percent report
having seen their mother abused by a male partner. As described
earlier in this report, the impact on children of witnessing
violence can have a profoundly negative effect on their
behavior and emotional well-being.
Repeated
acts of violence, experienced during childhood and then
into adulthood, have left many homeless mothers with serious
psychological problems whose manifestations can have a major
impact on the health and emotional well-being of their children.
For example, 36 percent of these women, three times the
rate of other women, have experienced Posttraumatic Stress
Disorder. Forty-five (45) percent have had a Major Depressive
Disorder, twice the rate of other women. Thirty-one (31)
percent have attempted suicide at least once, and 12 percent
have been hospitalized for mental illness.[121]
Homelessness
and Mental Health Problems
It is
not surprising that the very condition of being homeless
is emotionally abusive to the vast majority of these children.
Chronic stress, worries, fears, and disruptions are the
mainstays of their lives. Within a single year, 97 percent
of homeless children move, many up to three times, and more
than 30 percent are evicted from housing according to the
Worcester Family Research project.
Family
homelessness researcher Dr. Ellen Bassuk and her colleagues
report that the accumulated impact of severe environmental
stresses under which homeless babies live results in a significant
slowing of their physical, cognitive and emotional development.[122]
They report that more than 20 percent of homeless children
between 3 and 6 years of age are extremely distressed and
have emotional problems that are serious enough to require
professional care. Twelve (12) percent have clinical
problems such as anxiety, depression, and withdrawal. Sixteen
(16) percent have behavior problems manifested by severe
aggression, and hostility. Speech and stammering problems
are six times more likely to occur among homeless children.[123]
Homeless
children between 6 and 17 years of age struggle with very
high rates of mental health problems. Nearly one-third
have at least one major mental disorder that interferes
with their daily activities; nearly half have problems such
as anxiety, depression or withdrawal; and over one-third
manifest delinquent or aggressive behavior. Unfortunately,
less than one-third of homeless children who might experience
relief through treatment are receiving it. Most disturbing,
the likelihood of their receiving treatment drops as the
severity of their mental illness increases.[124]
Homelessness
and Educational Neglect
Sadly,
at least one-fifth of homeless children do not attend school.
Children's educational needs are often pushed aside by the
daily demands of finding food and shelter. Improvised living
arrangements are often too short in duration to make enrolling
in a new school worthwhile. Even when enrollment is sought,
lack of prior academic and medical records or lack of transportation
from shelters to school can create obstacles.[125]
For
those who manage to attend, their physical and emotional
status can make academic success difficult. Fourteen (14)
percent of homeless children are diagnosed with learning
disabilities, including dyslexia or speech and language
problems. The Better Homes Fund reports that 36 percent
of homeless children have repeated a grade, while 14 percent
were suspended from school. These effects that result from
their academic and emotional problems occur at double the
rate of other children.[126]
It is
not difficult to see that academic failure resulting from
homelessness and its effects can lead to school drop-out
which, in turn, has implications for future poverty and
homelessness.
Homelessness
and Substance Abuse
Alcohol
and drug problems are evident in 43 percent of the fathers
of homeless children. Although most men do not live with
their homeless children, 70 percent of fathers are in touch
with them. Similarly, 40 percent of homeless mothers report
alcohol or drug dependency at some time in their lives.[127]
As we have seen in the previous chapter, the impact of parental
substance abuse is most often devastating for children.
Although
the relationship among homelessness and alcohol and drug
abuse, poverty, domestic violence, child abuse and mental
illness is complex, and intergenerational factors make it
difficult to sort out which problem or combination of problems
served to trigger others, one thing is clear - children
living in these families do not go unscathed. Often they
are physically and emotionally defeated by the chronic stress
and instability in their young lives.
The
Better Homes Fund in its report, Homeless Children: America's
New Outcasts, provides an in-depth and comprehensive
set of recommendations to address the plight of these children.
Its seven-point platform includes:
- Protecting the health of homeless children;
- Eliminating hunger and food insecurity;
- Improving mental health services;
- Preventing unnecessary separation of families;
- Expanding violence prevention, treatment, and follow-up
services;
- Ensuring access to school and opportunities for success
in school; and
- Supporting education, training, and work for homeless
families.
Long-term
solutions are also proposed, including developing an adequate
supply of decent affordable housing, and maximizing the
economic resources of poor families.
MCC
supports this comprehensive agenda and proposes the following
recommendations aimed specifically at addressing the pressing
needs of abused, neglected and traumatized homeless children.
RECOMMENDATIONS:
- Support the hiring of trauma specialists within
family shelters and train staff to identify children who
have suffered from abuse, neglect or who have witnessed
violence.
Trained trauma specialists can identify women and children
with histories of violence, provide a range of support
and psycho-educational groups and, when necessary, family
therapy and counseling for children.
Staff that have contact with homeless mothers and children
should be enabled to identify, empower, and, when necessary,
refer for services women and children with histories of
violent victimization. Training direct service staff about
the impact of abuse, neglect and domestic violence on
children will ensure greater responsiveness to their special
needs.
- Fund the hiring of experienced case managers within
family shelters.
Shelter staff meet numerous daily demands of shelter life,
including orienting new residents, planning and providing
meals, implementing recreational activities for children,
etc. In order to facilitate integrated, comprehensive
services for homeless mothers and their children across
state and private agencies, shelters must be funded to
supplement their staff with experienced case managers
to assist each family in their transition to more stable
and permanent housing.
- Link homeless mothers and their children in shelters
to newborn home visitation, parent aide services, and
local family resource centers.
Homeless new mothers of all ages could benefit substantially
from newborn home visitation services during their stays
in shelters and as they transition into more permanent
housing. Parent aides could also provide consistent support
to mothers with older children and help them address a
range of personal and parenting issues. Linking these
fragile families to a range of supports available through
local family resource centers could help stabilize them
and counter the effects of isolation and depression that
many of them face.
- Ensure that transportation needs of homeless mothers
and their children are met.
Special efforts must be made to remove transportation
barriers that impact on the access of children and their
mothers to health and mental health care or on their ability
to attend school or locate housing and jobs.
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