The Fastest-growing Homeless Population (that Governments Avoid Mentioning)

And the simple solution that governments aren’t doing

On the west coast of Canada two weeks ago, I was walking through Vancouver, British Columbia’s Downtown Eastside neighborhood. It was a gut punch and head spin. The area is as intense a center of unhoused populations as any I’ve seen in Los Angeles, New York, or Toronto. Everywhere were the kinds of scenes of humans beaten down by poverty amid a city and nation of wealth that can make a bystander turn in one direction or the other: into despair and anger at the brutal society that’s created this, or into frustration and anger directed at homeless people as if they themselves are the cause and problem.

Fortunately, I was actually on my way somewhere that would soon show me different insights and shockingly simple solutions.

Btw involuntary commitment is proven not to help

The province of British Columbia (BC) has the most aggressive involuntary commitment laws in all of North America. (After researching my book Your Consent Is Not Required, I can say this authoritatively. Many other states and provinces have laws with some of the same strictures as BC has, but no others have all of them.)

In BC, the criteria for psychiatric detention are so broad as to potentially apply to virtually anyone at any time. If a doctor thinks you’re simply at risk for possible “mental or physical deterioration,” you can be incarcerated in a psychiatric hospital.

You have no right to an independent hearing or appeal for one month—and during that time you can be drugged, electroshocked, or otherwise “treated” against your will.

And even when you get to a hearing in hopes of preventing another three or six months of detention and forced treatment, it doesn’t matter if you’re demonstrably mentally competent to make decisions—the BC Mental Health Act excludes your mental competency from being considered. And you can be forcibly treated for years on end, even as you’re living independently in your own home in the community.

Any medical or psychiatric advance directive you might have written can legally be ignored. You also have no right to have a legal representative or substitute decision maker, like a trusted relative, talk to the psychiatrist and help guide your treatment.

These draconian laws are almost certainly unconstitutional—that’s why both right-ish and left-ish governments in BC have fought tooth and nail for many years to keep legal challenges from ever making it into courts. (One court challenge, mercifully, is finally scheduled to proceed in 2025. If you’ve been involuntarily committed in BC in the past decade and might like to share your experiences, contact me and I’ll put you in touch with the legal team.)

Predictably, then, BC has very high rates of psychiatric incarceration and long-term outpatient forced medicating. Yet the province’s high rates of homelessness and drug overdoses still equal or surpass virtually everywhere else in North America.

All of which is to say…. If we’re wanting to “clean up” streets, then be aware that more aggressive involuntary commitment has been consistently demonstrated over decades in BC to “improve” absolutely nothing. The evidence is stronger that aggressive policing, coercive abuses, and over-medicating against people’s will, on the whole, backfire and make everything worse.

Nevertheless, the BC government has been pushing still more aggressive involuntary commitment as the “solution” for homelessness, just like governments in Los Angeles, New York, Toronto and elsewhere have been doing in recent years. (Search on it if you didn’t know this and are interested—I can’t bear to link to the promotional news reporting.)

Yet there’s another important reason why forced mental health and addiction treatments don’t reduce homelessness, besides how harmful these often are: The largest and fastest-growing group of homeless people has absolutely no history of mental disorders or drug use, anyway. And these people almost never get so much as a passing mention in those news stories.

The fastest-growing demographic among homeless populations

The largest and fastest-growing group of people becoming unhoused isn’t “the severely mentally ill” and isn’t “drug addicts.”

It’s elderly people.

That’s right: Retirees and older adults—some even still holding down low-paying jobs—are simply getting priced out of their housing. The evidence and numbers are eye-opening—and downright scary if you’re already fifty-five plus, as a massive percentage of us are.

The famous “baby boom” generation has begun retiring, and our society is not prepared for this “silver tsunami.” In Canada, already one in five people are 65 years or older, and by 2030, that’s projected to be one in four. Many low-income retiring people don’t have much in savings, because the real value of the minimum wage declined dramatically relative to inflation from the 1970s onwards. Worse, government pensions have not kept pace with decades of rising housing costs and declining investment in and availability of public housing.

The upshot? In BC, one in four seniors have incomes less than $23,000 annually, while the average cost of a one-bedroom apartment is now $18,700 annually – and in Vancouver over $28,000. Even an aging Vancouverite still working full-time for BC’s minimum wage would spend 85% of their income on a one-bedroom apartment—or get driven into low-end, dangerous flats that are often not much cheaper, anyhow. Predictably, then, the most recent data show that 21% of homeless people in BC are aged 55 or older—more than doubling from 10% in 2008. And about half of these people, some still working, became homeless for the first time in their lives after age 55.

This trend is continent-wide.

Not the new asylums—the new retirement homes

University of California-San Francisco medical doctor and researcher Margot Kushel – who also co-authored the widely cited 2023 survey of homelessness in California – calls urban streets “America’s Hidden Retirement Home.”

Kushel’s op-ed is filled with links to research and is well worth reading—especially because she highlights how these issues intersect with government policies, structural racism, and so on. But for example, Kushel found that, over several decades, homelessness among older adults in San Francisco has nearly tripled from 11% of homeless populations to 32%. Her 2023 survey put the number California-wide at 44%, and about 40% of these older homeless people reported having never been homeless before.

The U.S. National Alliance to End Homelessness (NAEH) cites data showing that, across America, “34 percent of older adult renters spent 50 percent or more of their income on rent in 2021, higher than any other age group. Renters aged 75 and older were the most likely age group to be severely housing cost burdened.” As a result, in the U.S., about 1 in 4 people who are now living outside are over the age of 55. Again, many are actually still working. Kushel points out that, for example, using state averages, there’s nowhere in the U.S. where people earning minimum wage can afford a two-bedroom apartment unless they work much more than full-time. Homelessness among older adults is expected to triple by 2030, most of that among people aged 65 and older.

These aging seniors most definitely do not fit the clichéd, prejudicial caricature drawn by media and politicians of severely mentally ill, drug abusing, violent homeless people who’ve no one but themselves and their own avoidance of forced treatment to blame. As NAEH explains, research shows that those who first become homeless at age 50 and older have typically landed there simply due to a financial or health crisis, loss of a partner who was sharing home costs, or encountering age-related barriers to getting work. Basically, they’re just suddenly poorer, and isolated.

Living on the streets, of course, is brutal on the body, and ultimately harsh and dangerous for the brain and mind. Imagine how much more brutal to be suddenly thrown out there on your own when you turn 65. Or 70, 80… And then imagine getting surveilled and harassed by police wherever you try to rest, ridiculed and attacked in the media, losing your last belongings during an encampment sweep, losing sleep and living on the edge to the point of anxiety, depression, and hallucinations, and then getting locked up in a jail or psychiatric hospital to boot—and then just getting spit back out again to the street, because punishment and psychotropics do not miraculously increase pensions or create affordable homes.

Is this really what our politicians and news media are promoting, and what people are voting for?

Yet the real solutions are simple.

A little support can go a long way

While I was in Vancouver’s Downtown Eastside that day, I saw many elderly people out on the street—many in obvious states of serious physical distress. I walked by on my way, at the invitation of a local nonprofit organization, to a nearby apartment building for a visit and tour. The building had small, humble-but-decent independent rooms and apartments, rented to seniors at below-market rates. Operating independently but with the support of the building owner, the nonprofit was providing a variety of supports and services. Based on each tenant’s needs and requests, on any given day support workers might help do anything from grocery shopping or apartment cleaning to managing finances and helping connect the senior to vital community, home care, or health services.

Many of these elderly tenants were formerly homeless, and some of them had early dementia, serious physical problems, drug use issues, diagnosed mental disorders, or all of these things at once. Nevertheless, in the vast majority of cases, all of this was manageable, with decent housing and these relatively small but immensely valuable personal daily supports and re-connecting to community and health services. The tenants themselves helped each other out, too—sometimes in crucial ways.

It wasn’t rocket science. It was affordable housing provided thanks to a well-intentioned building owner (or via government-provided rent supplements) and practical supports with daily living for aging adults who’d otherwise be struggling to get by on their own and potentially end up homeless. Basically, it was “Housing First”—and it was working. Everyone I encountered was quick to smile and chat and was obviously glad to be there—while we knew that, just outside the door, other folks were unfortunately still stuck on the street.

And the cost? The operator told me that, alongside the subsidized housing, they were providing the support services for, on average, about $5 per day per client across multiple buildings. Housing operators, agencies, or organizations that help house the most challenging of troubled clients certainly require more funding—still, compare this to the hundreds of dollars per day per person for a long-term care facility, group home, or jail, or the thousands of dollars per day for psychiatric hospitals.

How complicated is this?

It’s not at all complicated. Kushel points to large-scale examples of such successes with Housing First-type approaches leading to relatively quickly reducing homelessness among veterans by half and cutting homelessness in Houston by two-thirds.

What’s difficult to understand is why these approaches aren’t being more hailed and much more heavily funded by our governments.

One reason, highlighted by Housing First founder-advocate Sam Tsemberis in an interview with me for my book, is that there are well-heeled, well-organized, influential lobby organizations pushing for more psychiatric institutions, group homes, long-term care facilities, and so on. There are no comparable big-time lobbyists pushing for rent vouchers that could be flexibly used anywhere, and for individualized home-based practical supports.

But I also worry that this same gut-wrenching feeling that hit me when I walked through Vancouver has driven too many in government, the news media, and general public in the opposite direction from where I went—into a visceral, ideological anger at “the homeless” that now steers such people more than rationality does.

It’s certainly telling that, when the latest encampment sweeps are being promoted, this horrifying trend of senior retirees being thrown into homelessness is rarely if ever even mentioned.

Maybe that’s because we cannot bear the shame. After all, some people appear to find it easy to discount the value of the lives of people who’ve been labeled as addicts or mentally ill. But can anyone possibly convince themselves a society that treats its frail elderly this way is still moral and sane?