The University of California, San Francisco (UCSF) Benioff Homelessness and Housing Initiative (BHHI) has released the largest representative study of homelessness in the United States since the mid-1990s. The California Statewide Study of People Experiencing Homelessness (CASPEH) provides a comprehensive look at the causes and consequences of homelessness in the state, offering crucial insights to guide policy changes and shape effective programs in response.
Uncovering the Realities of Homelessness in California
Designed to be representative of all adults 18 years and older experiencing homelessness in California, the CASPEH study included nearly 3,200 administered questionnaires and 365 in-depth interviews with individuals across eight regions of the state, representing urban, rural, and suburban areas. The findings paint a clear portrait of homelessness in California, where 30% of the nation’s homeless population and half of the unsheltered population reside.
The study revealed that for most participants, the primary driver of their homelessness was the unsustainable cost of housing. Participants reported a median monthly household income of just $960 in the six months prior to becoming homeless, and the majority believed that either rental subsidies or one-time financial assistance could have prevented their homelessness. “The results of the study confirm that far too many Californians experience homelessness because they cannot afford housing,” said Margot Kushel, MD, director of the UCSF BHHI and principal investigator of the study.
Contrary to common misconceptions, the study found that the vast majority of participants lost their last housing within California, and 75% were living in the same county where they were previously housed. Additionally, nine out of ten spent time unsheltered since becoming homeless, with a median length of homelessness of 22 months.
The study also revealed that California’s homeless population is aging, with 47% of all adults aged 50 or older. Alarmingly, Black and Native American individuals were found to be dramatically overrepresented among the state’s homeless population.
Navigating the Complexities of Homelessness
Beyond the demographic data, the CASPEH study delved into the complex experiences and challenges faced by those experiencing homelessness in California.
Health Impacts and Barriers to Care
The study highlighted the devastating impact of homelessness on individuals’ physical and mental health. Two-thirds of participants reported current mental health symptoms, and more than a third had experienced physical or sexual violence during their episode of homelessness. Additionally, more than a third had visited an emergency department in the prior six months.
Despite these pressing health needs, the study found significant barriers to accessing care. One in five participants who reported substance use also expressed a desire for treatment, but were unable to obtain it. “Having experienced homelessness firsthand, I vividly recall the relentless fight for survival, the pervasive shame that haunted me, and my unsuccessful endeavors to overcome homelessness on my own,” shared Claudine Sipili, a member of the study’s Lived Expertise Board. “The study holds great significance for me because it aims to provide a more comprehensive understanding of homelessness and inform the development of effective strategies, policies, and programs to support individuals in their transition from homelessness to housing stability.”
Trauma, Disconnection, and Resilience
The CASPEH study found that participants had experienced multiple forms of trauma throughout their lives, increasing their vulnerability to homelessness and contributing to their mental health and substance use challenges. Many were disconnected from the job market and essential services, with 60% of those who hadn’t been in an institution coming from situations where they weren’t leaseholders, such as doubling up with family or friends.
Despite these daunting circumstances, the study revealed that nearly half of the participants were actively seeking employment, demonstrating their resilience and determination to overcome their homelessness.
Informing Policy and Practice Responses
The comprehensive data collected through the CASPEH study has already begun to inform policy changes and programmatic responses to address the homelessness crisis in California. “As we drive toward addressing the health and housing needs of Californian’s experiencing homelessness, this study reinforces the importance of comprehensive and integrated supports,” said Dr. Mark Ghaly, Secretary of the California Health and Human Services Agency.
The study’s findings have highlighted the critical need for a multifaceted approach that addresses the root causes of homelessness, such as the lack of affordable housing, as well as the complex health and social needs of those experiencing homelessness.
Some of the key policy recommendations stemming from the CASPEH study include:
- Expanding affordable housing options and rental subsidies to prevent homelessness
- Enhancing access to mental health and substance use treatment services
- Improving the delivery of care outside of traditional healthcare settings
- Addressing the disproportionate representation of marginalized communities among the homeless population
- Strengthening cross-sector collaboration and coordination to provide comprehensive support
The CASPEH study represents a significant milestone in the understanding of homelessness in California. By shedding light on the lived experiences and challenges faced by those without stable housing, this groundbreaking research will play a crucial role in guiding the development of more effective and compassionate solutions to address the homelessness crisis in the state.
As Dr. Kushel emphasized, “The results of the study confirm that far too many Californians experience homelessness because they cannot afford housing. Through thousands of survey responses and hundreds of in-depth interviews, the study’s findings reflect the incalculable personal costs of homelessness. Our policy recommendations aim to inform solutions to the homelessness crisis.”
To learn more about the CASPEH study and its findings, visit the UCSF Benioff Homelessness and Housing Initiative website. Additionally, the Unhoused CA project, a documentary initiative produced in support of the CASPEH study, offers a powerful visual and narrative exploration of the homelessness crisis in California.
