如果我們意識到無家可歸的真正代價，我們會在一夜之間解決它

: By 薇薇安·斯金納（Vivienne Skinner）和菲利帕·卡內莫拉（Phillippa Carnemolla）

感謝造訪 InnerSelf.com，哪裡有 20,000+ 宣傳“新態度和新可能性”的改變生活的文章。所有文章均翻譯為 超過30種語言. 訂閱每週出版的《內在自我》雜誌和瑪麗·T·拉塞爾的《每日靈感》。 InnerSelf雜誌 自 1985 年起出版。

圖片由 Apollo22

暫停驅逐（在澳大利亞，計劃於2020年XNUMX月結束）。有一些國家有擴展 the moratorium, but when it ends that's likely to force even more into housing insecurity and outright homelessness.禁令，但是當它結束時，這可能會進一步加劇住房的不安全感和徹底的無家可歸。 The moral and health arguments for housing people are clear, but many people are unaware of the financial cost we all bear for not fixing homelessness.住房人的道德和健康論點很明確，但是許多人不知道我們所有人為解決無家可歸而付出的經濟代價。

社會評論員Malcolm Gladwell寫了一篇文章，百萬美元的默里，這是2006年《紐約客》的故事。這是兩個內華達州警官一天中大部分時間都與無家可歸的人打交道的故事，例如六英尺高的前海軍陸戰隊員和長期酗酒的默里。 They regularly picked up Murray and drove him to hospital, drying-out clinics, the police lock-up and mental health facilities.他們定期接送默里，並將他送往醫院，乾燥診所，警察拘留所和精神衛生設施。

His bills were so legendary the policemen worked out, based on his health care alone, it would have been cheaper to house him in a hotel with his own private nurse.僅憑他的醫療保健，警察就制定了他的帳單，這真是傳奇般的傳奇，將他與自己的私人護士安置在旅館中會便宜得多。 When not drunk, Murray was a charming, smart, talented chef.不醉時，穆雷是一位迷人，聰明，有才華的廚師。 By the time he died of intestinal bleeding, they calculated the cost of Murray's homelessness over a decade was US$1 million.當他死於腸道出血時，他們計算出默里十年來無家可歸的代價是一百萬美元。

Those two Nevada policemen did something that is rarely done anywhere – they calculated (OK, roughly) the cost to the taxpayer of one man's homelessness.內華達州的那兩名警察做了一件幾乎在任何地方都做不到的事情–他們計算（大致上是）納稅人為一個人無家可歸所付出的代價。 And, in doing so, they showed, as Gladwell pointed out:而且，正如Gladwell所指出的，他們這樣做表明：

解決無家可歸問題所需的資金很可能少於忽視這一問題所需的資金。

沒有人跟踪成本

在澳大利亞，儘管政府的努力至房子疫情期間，我們仍然看到許多人在人行道上提著行李，舉著乞討的牌子。他們大多是男性。女性傾向於尋找其他方式管理他們的無家可歸，例如沙發衝浪或與成年子女或大家庭住在一起。

Beyond the human tragedy, what most passers-by fail to see is the cost of homelessness to us all.除了人類的悲劇，大多數路人沒有看到的是無家可歸給我們所有人帶來的代價。 It includes the bills for police and ambulance call-outs, prison nights, visits to emergency departments, hospital stays and mental health and drying out clinics.它包括用於警察和救護車調遣，監獄之夜，拜訪急診室，住院和精神保健以及乾clinic診所的賬單。

These expenses are rarely collated and tabulated to find the true cost of homelessness to the public.這些費用很少經過整理和製表，以找出公眾無家可歸的真正成本。 The costs are dispersed over so many government agencies and facilities that they are managed in a piecemeal way, as they always have been in Australia.成本分散在如此眾多的政府機構和設施中，以至於像往常一樣在澳大利亞進行零星管理。 The result is a hefty hit to the public purse.結果是對公共錢包的沉重打擊。

安置無家可歸者的經濟理由很明確

To understand this further, we did a global scoping review of research since 2009 that examined the value of providing a secure, stable home for formerly homeless people and the wider taxpaying community.為了進一步理解這一點，我們對100年以來的研究進行了全球範圍界定，以審查為以前無家可歸的人和更廣泛的納稅社區提供安全，穩定的房屋的價值。 In total, we examined XNUMX research papers and analysed outcomes across a range of domains including physical and mental health, emergency department use, substance use, well-being, community integration, mortality, criminal justice interaction, service use and cost-effectiveness.我們總共審查了XNUMX篇研究論文，並分析了各個領域的成果，包括身體和精神健康，急診室使用，物質使用，福利，社區融合，死亡率，刑事司法互動，服務使用和成本效益。

The overriding consensus among the 100 peer-reviewed studies and agency reports was that housing stability brought a raft of benefits to formerly homeless individuals.在XNUMX篇同行評審的研究和機構報告中，最普遍的共識是，住房穩定給以前無家可歸的人帶來了很多好處。 Reducing the cost of non-shelter services also saved the public money.減少非庇護服務的成本也節省了公共資金。

穩定的住房通常是通過房屋優先模型。 The first priority is to find people a safe and permanent home, with no strings attached.當務之急是為人們找到一個安全，永久的家，沒有附帶條件。 Wraparound support services are provided, which are critical in helping them adjust to a new life in a stable and permanent home.提供環繞式支持服務，這對於幫助他們適應穩定和永久的家中的新生活至關重要。

節省始於健康

The most researched measure was health.研究最多的措施是健康。 Almost all the research found positive changes when people moved into permanent, secure housing.當人們搬進永久，安全的住房時，幾乎所有的研究都發現了積極的變化。 Almost one-third of the studies looked at the fall in use of hospital wards and emergency services once people were housed.幾乎有三分之一的研究著眼於人們被安置後醫院病房和急救服務使用率的下降。

作為一個澳大利亞的研究 found, people sleeping rough are less likely to have their own GP.發現，睡眠粗糙的人不太可能擁有自己的家庭醫生。 When symptoms become too severe to ignore they go to hospital emergency wards.當症狀變得嚴重到無法忽視時，他們會去醫院急診室。 They are admitted to hospital more often and stay longer.他們被送往醫院的頻率更高，並且停留時間更長。

In the 12 months after the 44 clients in this Perth-based study were housed, emergency admissions were reduced by 57% and overnight stays by 53%.在基於珀斯的這項研究中安置了404,028位客戶之後的XNUMX個月內，緊急入院人數減少了XNUMX％，過夜時間減少了XNUMX％。 The overall health-care saving was A$XNUMX.總體而言，醫療保健節省了XNUMX澳元。

收容後，人們對清醒服務和心理健康診所的使用也下降了。加拿大的一項研究研究了安置在永久住所是否是患有嚴重精神疾病的人的解決方案。研究人員發現，有了正確的支持，這些人基本上能夠管理自己的住房。

They were able to sleep better.他們能夠睡得更好。 They were more likely to take medications as prescribed.他們更有可能按處方服用藥物。 Continuity of care for health problems was better and infection rates were lower.健康問題的護理連續性更好，感染率更低。 And they experienced less psychological distress, depression and anxiety.他們的心理困擾，沮喪和焦慮感也有所減輕。

刑事犯罪也大大減少

所有 18 項研究犯罪率的研究都報告稱，一旦人們擁有穩定的住所，犯罪率就會有所改善。他們在監獄裡度過的夜晚、被捕和再次逮捕以及與警察遭遇的次數都減少了。

2013年的加利福尼亞人研究發現一旦人們得到安置並提供適當的支持服務，警察聯繫就會減少 99%。醫療費用下降了 85%。

再兩年加拿大研究對五個城市的 2,000 人進行的調查發現，在公共場所睡覺、在公共場所小便和在公共浴室洗澡等公共滋擾犯罪行為大幅下降，這一點並不令人意外。

All 19 studies measuring cost-effectiveness found housing people produced savings across a broad range of areas – including crisis accommodation, the justice system, sobering clinics and hospitals.所有XNUMX項衡量成本效益的研究都發現，住房居民在許多領域都產生了節餘，包括危機處理，司法系統，清醒的診所和醫院。 Even after deducting the cost of housing, a即使扣除住房成本， 2011年澳大利亞研究 268位參與者在2,182個月後發現每人節省了$ 12。

Our review found a clear economic case for governments to take a systematic approach to ending homelessness.我們的審查發現，政府可以採取系統的方法消除無家可歸現象，這是一個明顯的經濟案例。 While this argument might be seen as a capitulation to the “financialisation of everything”, the darkening economic cloud of the pandemic might provide just the right cover for government decision-makers to act on the catastrophe of homelessness.儘管該論點可能被視為“一切金融化”的首推，但疫情的黑暗經濟雲可能為政府決策者應對無家可歸的災難提供正確的掩護。