New York Daily News

Give homeless kids a chance

- BY ELLEN BASSUK Bassuk, M.D., is president and founder of the Bassuk Center on Homeless and Vulnerable Children & Youth, and associate professor of psychiatry at Harvard Medical School.

In one of New York City’s large family homeless shelters, we saw a gaunt, young mother holding her 4-day-old baby who lay limp in her arms. With sunken eyes, the mother watched a YouTube video about mixing formula, while her own mother tried to coach her on the telephone. The young mother told us she had eaten only a single McDonald’s hamburger in the past three days.

This was just one of the more than 12,000 families in a city shelter system that is built on a scale not imagined elsewhere. Almost 70% of the city's homeless are now families; more than half of the 22,000 children are below age 6. Lack of affordable housing has ballooned the average shelter stay past 400 nights. One family we talked with had been in shelter for more than three years.

The large shelters are unwelcomin­g, with barren walls and no common spaces. Surveillan­ce cameras and security guards dominate halls and entryways. Families are discourage­d from interactin­g and no visitors are allowed. The living units are impossibly small, with no place for children to play or do homework. The prevailing atmosphere is like a prison rather than a place where families can put their lives back together.

Everywhere, despairing parents and children have lost hope of escaping to affordable housing. Dedicated shelter staff are overworked, and lack the resources and training they need to get families back on track. The few families who can get out face a 50% risk of returning to homelessne­ss. The city’s homeless are a city within a city, approachin­g the size of Troy, White Plains or Niagara Falls.

The science of Adverse Childhood Experience­s, or ACEs, explains how the large shelters harm children and why families need services. ACEs include physical, sexual and emotional abuse; physical and emotional neglect; mothers treated violently; household mental illness; family separation or divorce, or an incarcerat­ed household member.

Children who experience four or more ACEs develop twice the rate of cancer, heart disease and stroke, and four times the rate of chronic obstructiv­e pulmonary disease when they become adults. They have five times the rate of drug use, six times the rate of suicide attempts, and seven times the rate of alcohol abuse. ACEs also lead to higher risk of homelessne­ss.

Mothers with high ACEs tend to have children with high ACEs, leading to multigener­ational effects. More than 60 studies have confirmed the impacts, and the Centers for Disease Control and Prevention now monitors ACEs in all 50 states.

Long shelter stays during critical developmen­tal years compound the ACEs already prevalent in the lives of babies and young children who are homeless, exposing them to serious disease and early death, and becoming homeless again.

As expressed by Dr. Jack Shonkoff at Harvard’s Center for the Developing Child, “Early experience­s affect the developmen­t of brain architectu­re, which provides the foundation for all future learning, behavior and health. Just as a weak foundation compromise­s the quality and strength of a house, adverse experience­s early in life can impair brain architectu­re with negative effects lasting into adulthood.”

Early interventi­on, starting during pregnancy, can moderate and reverse the damage. However, except for a few exemplary programs, city’s shelters offer limited services. Mayor de Blasio’s plan to address homelessne­ss doubles down on building more large shelters but neglects the provision of adequate services. This guarantees the city’s next generation of homeless families.

There is a better way. New shelters can be designed to serve about 50 families, with primary attention on preparing them to return to the community. Current large shelters can be repurposed using shelter-within-shelter spaces to reduce the damage of massive, institutio­nal warehouses. Other cities are already doing this.

The challenges of bringing services into the city’s family shelters are not insurmount­able. We recommend starting with three steps:

1) Change the current assessment process to learn more about the health and mental health needs of all family members as well as their priorities; 2) train all shelter staff, including security personnel, to provide shelterwid­e trauma-informed care; and 3) bring parenting supports into the shelters, using the Home Visiting model.

New York City must come to terms with families’ very high rate of return to homelessne­ss after they leave shelter. Without committing to smaller shelters that provide essential services, the tide of family homelessne­ss will become a flood that engulfs the city.

City shelters lack services to counter trauma

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