FOSTERING THRIVING BEYOND SURVIVING IN PITTSBURGH’S HOMELESS COMMUNITY
As we enter the holiday season, we are reminded to express gratitude for the blessings in our lives. Even when life is a struggle, we can usually find someone or something for which we are thankful. Among the blessings in most of our lives, we may feel especially grateful for the warmth and comfort of our home.
Home implies much more than a place to live. It also means feelings of security and the intimacy of family or others with whom we dwell. Those who reflect on the gift of home should also come to recognize that, at this very moment, many people in the world, including people in our Pittsburgh community, are deprived of a home.
According to the U.S. Department of Housing and Urban Development’s (HUD’s) Annual Homeless Assessment Report, the sheltered homeless of the United States exceeded 326,000 people on a single night in 2021. This figure does not include the many unsheltered homeless who live in tent communities under bridges, along the rivers and in other areas of the city that are mostly out of sight. The annual Point-in-Time Homeless Count for Allegheny County identified 880 homeless individuals in the county. HUD estimates that about one-third of homeless are unsheltered.
If we consider homelessness more
broadly to consider individuals who may have a place to reside but lack the comforts, security and social support associated with being at home, the numbers are far greater. Those who face poverty, struggle with alienation from social supports due to mental and physical health, including addiction, suffer from abuse or neglect, or have experienced trauma, are homeless in this broader sense. They are also at greater risk for literal homelessness.
Meeting people where they are
At Point Park University, our graduate programs in Community Psychology, Clinical Psychology and Critical Psychology share an interest in the study of social structures that impact mental health and well-being. The programs also emphasize practices that aim to ameliorate the suffering of those outside our society’s usual circles of compassion and concern. Homelessness
is of particular interest, because it represents an extreme condition where the usual social systems break down and leave people vulnerable to mental distress and early mortality.
Research by Dr. Robert McInerney, Professor of Psychology, in collaboration with graduate students, showed that systems of care for the homeless tend to focus on helping them merely to survive. However, studies of homeless people on the street in Pittsburgh have shown that survival alone is insufficient: People who live on the street are seeking not just to survive, but to thrive.
Efforts to help the homeless to survive are necessary and crucial. According to Dr. Jim Withers, a faculty member at Mercy Hospital in Pittsburgh, the average life expectancy for the homeless is 47 years. Due to negative experiences in hospitals and other health care settings, many street people actively avoid medical care. When they do, they tend to use the Emergency Room rather than maintaining relationships with physicians in Primary Care.
Dr. Withers found that medical treatment of the homeless in hospitals tended to result in ineffective care. In 1992, in an effort to address this problem, he dressed as a homeless person and began to visit the homeless of
Pittsburgh on the streets. If they would not come to him, he would go to them.
Dr. Withers coined the term “Street Medicine” to describe his efforts to better serve the homeless where they live and on their own terms. He went on to establish the non-profit organization Operation Safety Net, which has served the unsheltered homeless in Allegheny County for over twenty years, and treats thousands of homeless patients annually.
Their services include a van that provides mobile medical care, a winter shelter and assistance with housing and legal issues. Over the years, Dr. Withers has developed a database to help track the names and locations of homeless individuals in the region in order to improve continuity of care and to save lives. The success of these services has helped to launch an international movement, including the annual International Street Medicine Symposium and the Street Medicine Institute.
Studies have proven that these efforts are effective at reducing all-cause mortality, helping homeless individuals transition into stable housing, and increasing utilization of Primary Care. With access to treatment, homeless are being provided with new opportunities to heal from their physical and mental wounds, and are better empowered to return to a life of thriving, with the support and comforts of home.
Fostering social bonds
I have been fortunate to participate in these efforts, alongside my graduate students, bringing food, clothing and other supplies – the resources of survival — to the homeless of Pittsburgh. Our interactions, however, have enriched our understanding of what it means for the homeless genuinely to thrive. At these events, we get to know people by their names and faces, and they come to know us. We learn their stories, and we share ours, too. The repeated encounters, we found, were moments where we bore witness to and participated in building a sense of community. These moments began to feel more like thriving than mere surviving.
These interactions illustrate the centrality of social connection. We recognized that thriving meant relating with each other in ways that include but go beyond meeting the bodily needs of people living on the streets. During these events, we would lose ourselves in conversations and activities to the point of forgetting who is doing the caring, and who is being cared for. The social bonds that form are genuinely mutual, and gratify a basic human need for connection to others.
These observations are supported by research. For example, Dr. Melissa Johnstone and colleagues, as reported in Housing Studies, have found that social support for the homeless is a key factor in predicting long-term well-being. Similarly, in the International Journal of Environmental Research and Public Health, Dr. Mary-Catherine Anderson and colleagues studied the homeless of Nashville, Tenn., and found that the establishment of social networks was key to predicting well-being among the unsheltered homeless.
In an effort to foster opportunities for thriving among the homeless of Pittsburgh, Dr. McInerney and our students established the Mobile Thriving Respite. For the past four years, this community-based initiative has
held regular “pop-up” events at homeless shelters. These free social opportunities have included movie screenings, karaoke, board and card games, and opportunities for artistic expression. Food and refreshments also afford opportunities for conversation and building social bonds — not just eating to survive.
The Respite has also partnered with a variety of local organizations to help host these events. Partners have included Allies for health + well-being, Allegheny County Department of Human Services, Storyburgh and the Pittsburgh Mayor’s Office. These efforts have also been assisted by a grant from Awesome Pittsburgh. Currently, the Respite is coordinated by Arin Shatto, a student in the M.A. in Community Psychology program at Point Park University.
Thriving beyond surviving
A well-known psychological theory, put forth by Dr. Abraham Maslow, holds that people are motivated to meet basic human needs. The idea is that individuals first need to meet basic survival needs for shelter and safety before they are able to seek out needs for social connection, self-esteem and self-actualization. In our encounters with the homeless, we have found this theory to be somewhat lacking.
Many homeless are indeed fighting to survive and to meet the most basic needs for shelter, food and security. However, to be deprived of basic needs for survival does not mean people on the streets are not also motivated to thrive. Like the rest of us, they want to belong and to be seen as someone who matters to others. They long for meaningful encounters, for creating something beautiful, and to be seen as good and worthy of love and appreciation. These, and many other aims, Maslow originally identified with the highest level of human achievement, which he called self-actualization. But they are desired by everyone, and can actually help people
on the margins of society to achieve the more basic needs of survival.
I have had the opportunity to visit many homeless camps around the Pittsburgh area. In these small tent communities, which are mostly invisible to passers-by, I found additional evidence that the homeless of our city are motivated by the highest values. These shelters tend to meet basic needs for survival: That’s why they tend to be under bridges or other secure structures that provide protection from the elements. However, one rarely finds a tent all alone.
In these communities, even brief interactions are sufficient to reveal the strong bonds people make with their immediate neighbors. They support each other and look out for each other. Maybe more interesting of all, almost invariably the locations of these tent communities are chosen for their beautiful views.
In nearly every case, I have found the homeless to reside on a cliff or hill that, while sheltered, nevertheless opens upon an expansive, often breathtaking view of a river or the city. That observation, perhaps more than anything else, helped me to realize that street people are motivated by much more than mere survival. In their own ways, even in states of extraordinary deprivation, their souls seek to find moments for genuine human flourishing.
Spending time in these tent communities helped me to appreciate a deeper meaning of home that we often forget. Home, in the end, is much more than a place to live. It is realized most fully where one is empowered to seek and express the deepest longings of the heart—for beauty, love, truth and goodness.