What do you think would happen if you invited an individual who had been living on the street for many years, had mental health issues and was an alcoholic to move directly from the street into housing? We had heard this was being done in New York City, and it was called the Housing First model. We wondered if it would work in Utah.
如果你邀请了一个 露宿街头很多年,有着精神问题, 并且酒精成瘾的人, 直接从街头搬到 到屋子里居住, 你觉得接下来 会发生什么? 我们听说纽约市已经 把这种设想付诸实践, 把它叫做“住房优先”计划。 我们曾思考这一计划 是否对犹他州也适用。
So to make that determination, we decided to create a pilot, and Keta was one of the 17 chronically homeless individuals we included in this pilot. She had been on the street for 20-plus years, had mental health issues and was a severe alcoholic. The first night in her apartment, she put her belongings on the bed and slept on the floor. The next three nights, she slept out by the dumpster near the apartment building. With the aid of her case manager, she moved back into her apartment but continued to sleep on the floor for several nights. It took over two weeks for her to develop enough trust and confidence that this apartment was hers and would not be taken away from her before she would start sleeping in the bed.
为了坚定对这一计划的决心, 我们决定先开展一项试验。 柯塔就是我们选择 的长期无家可归 的 17 名试验者之一。 她已经在街头露宿超过 20 年, 有着精神问题, 并且嗜酒如命。 在搬进公寓的第一晚, 她把所有的破烂放在床上, 自己却睡在地板上。 在接下来的三个晚上, 她走出家门,睡在了公寓附近 的垃圾箱旁边。 在她的负责人的帮助下, 她返回到公寓, 但是继续在地板上 睡了几个晚上。 她花了差不多两周时间才确信 公寓是她的, 并且不会被抢走, 然后才开始安心的睡在床上。
Homelessness is a continuing challenge for many cities throughout our country. Our homeless population falls into three major categories: those that are temporarily homeless, about 75 percent; those that are episodically homeless, about 10 percent; and those that are chronically homeless, about 15 percent. Chronic homelessness is defined as an unaccompanied adult who has been continuously homeless for a year or more or more than four times homeless in three years that totals 365 days. This small 15 percent of the homeless population can consume 50 to 60 percent of the homeless resources available in a community. In addition, they can cost the community 20,000 to 45,000 dollars a year per person in emergency services costs, such as EMT runs, emergency room visits, as many of you will be aware, addictions, interactions with the police, jail time. Simply put, this small population costs a lot.
在全国的很多城市,无家可归都是 一个持续的问题。 我国的无家可归人口 可以分为以下三大类型: 暂时性流浪者 占比约 75%; 偶发性流浪者 占比约 10%; 长期性流浪者 占比约 15%; 长期性无家可归的人 被定义为无人陪伴之人, 这些人已经持续 无家可归至少一年。 或者在三年内已经流浪超过四次, 总数超过 365 天。 这区区 15% 的流浪人口 却能够消耗社区可发放的 50%-60% 的资源。 除此之外, 他们在紧急服务开销方面, 每人每年消耗掉社区 约 2 万至 4.5 万美元, 诸如急诊, 你们都知道流浪人员 经常需要去急诊室, 药物上瘾,和警察打交道, 以及服刑。 总的来说,这一小部分人 占用的公共资源很多。
Based on this reality, the US government began an initiative in 2003 inviting states and cities and counties to develop a plan to end chronic homelessness in a 10-year period. The state of Utah accepted this invitation, and I was asked to lead this effort. In 2005, we approved a 10-year plan, and 10 years later, in 2015, we reported a reduction in our chronic homeless population of 91 percent statewide.
基于这一现实,美国政府 于 2003 年开展了一项倡议, 邀请各个州,各个城市和社区 开展一项计划, 在十年内终结长期 的无家可归问题。 犹他州接受了这一邀请, 并且我被派去领导这一举措。 在 2005 年,我们通过了 一项十年计划, 弹指一挥间,在 2015 年, 我们报道了在全州范围内 长期无家可归人口 下降了 91% 的消息。
(Applause)
(掌声)
That's amazing. When I began this process, and we began this process, I realized that I had a limited understanding of homelessness and the factors that impacted it, and that I needed a fairly major change in my belief, in my thinking, because I had been raised with the theory of rugged individualism and "pull yourself up by the bootstraps." That philosophy came from being raised on our family's cattle ranch in a small town in the western desert of Utah. On the ranch, you learned that nothing takes priority over caring for the cattle, something always needs fixing and most importantly, hard work makes the world right. It was through that lens that I would see homeless people. When I was a teenager, our family would go into Salt Lake City, and I would see these homeless people -- "hobos" we called them then -- sitting around on the street, and I would think, "You lazy bums, get a job. Pull yourself up by the bootstraps."
这太神奇了。 当我和其他人 开始实施这一项目时, 我意识到我对无家可归问题 以及其影响因素 的理解非常有限。 因此,我需要一个 观念上的极大转变, 因为我从小就信奉个人主义, 以及“自己的事情自己干”。 这一哲理缘于我从小 在犹他州西部沙漠 一个小城镇的家庭牧场长大。 在牧场里,你会明白没有什么事情 比照顾小牛犊还重要。 永远有要修理的东西, 并且最重要的是, 努力工作才是 放之四海皆准的真理。 我就是以那样的标准 看待无家可归人口的。 在我十几岁的时候, 我们一家人会去盐湖城, 当我看到这些流浪的人—— 我们当时叫他们'hobos"—— 在街头各个角落闲坐时, 我会想, “你们这些懒鬼,快去工作。 自己的事情自己干。”
After high school, I left the ranch, graduated from college, went to work for Ford Motor Company for several years, then got a job at the Church of Jesus Christ of Latter Day Saints and moved back to Salt Lake City. During that employment, I had the opportunity to be loaned out to the state's largest homeless shelter to assist them in developing and improving their financial and management capabilities.
上完高中后,我就离开了农场, 大学毕业以后, 我去福特汽车公司工作了几年, 然后担任了一座教堂的牧师, 又搬回了盐湖城。 在那段时期,我有机会向州内最大 的流浪庇护中心发放贷款, 去帮助他们发展,并改善 他们的经济和管理职能。
While there, I became aware of a new approach to dealing with homeless individuals and drug addicts. It was called the harm reduction model, and it consisted of passing out clean needles and condoms. And I thought, "Now that is one stupid idea." (Laughter) "That's just going to encourage them to continue that behavior. Just tell them to stop." Several years later, I read some of the early 10-year plans to end chronic homelessness promoted by the federal government. As I read through those plans, and I thought, "Pfft! This is unrealistic. You can't end homelessness. There's too many personal choices and factors beyond our control."
同时,我也注意到了处理 流浪者和瘾君子问题 的一项新举措, 叫做“危害减轻”模型, 包括发放洁净的针头和避孕套。 当时我在想, “这真是一个愚蠢的想法”。 (哄笑) “这只会鼓励他们继续这种陋习。 直接让他们停止吧。” 若干年以后,我读到了一些 由联邦政府促成 的关于终结长期无家可归问题 的十年早期计划。 我边读这些计划边琢磨, “这根本不现实, 你根本无法终结无家可归问题。 有太多个人选择和因素 超出了我们的控制范围。“
My perspective changed, however, when I attended a conference in 2003, where I learned the reason behind the 10-year plan. First was this small population of the homeless group that was 15 percent and were very expensive. That made sense for a conservative state like Utah.
然而,在 2003 年 参加了一项会议之后, 我的观点改变了。 在这项会议中,我了解到了设立 这个十年期计划背后的原因。 首先,这区区 15% 的无家可归人口 会消耗大量资源。 对一个像犹他州这样 保守的州而言,这就说得通了。
The second insight was learning about this Housing First, or low-barrier housing. There had been an agency in New York City that had been inviting mentally ill homeless individuals to move directly from the street into housing. And they were also allowed to continue to use drugs and to drink, just like we can in our homes. They were, in addition, offered services -- not required to use them -- by on-site case managers to assist them to adjust to their new living arrangements and to stabilize their lives. They were using the harm reduction model. And despite my initial low expectations about hearing about this model, they were having an astonishing success rate: 85 percent were still housed after 12 months.
第二,我了解到了这项“住房优先” 或者叫做低门槛住房计划。 在纽约市曾有一个部门 邀请了有心理疾病的流浪人群 直接从街头搬进房子里。 他们仍然被允许吸毒和饮酒, 就像我们在家里可以做的一样。 除此之外,他们还得到了 个案负责人提供的一对一服务—— 当然这不是强制性的—— 以帮助他们适应新的居住安排, 让他们的生活稳定下来。 他们正在使用“危害减轻”模型。 尽管听到这一模型后, 我最初期待不高。 但是他们正在塑造 一个令人惊讶的成功率: 一年以后,85% 的人仍在居住。
The third insight was the importance of developing a trusting relationship. Because of the abuse these individuals have had throughout most of their lives, they hardly trust anybody, and the clean needles and condoms and low-barrier housing was a means to begin to develop a relationship of trust. Vital.
第三, 我发现了发展信任关系的重要性。 因为这些人在人生的大部分时间中 曾经历过虐待和伤害, 他们很难信任任何人, 而洁净的针头,避孕套 和低门槛的住房条件 是开始发展信任关系的一个方式。 这至关重要。
So as I flew home from this conference, sitting in the plane looking out the window, I realized that my understanding and perspective about homelessness was shifting. And as I stared out that window, this very strong feeling and thought came to me that if there's any state in the union that could end chronic homelessness, it was the state of Utah, because there's an underlying feeling and desire and willingness to collaborate to serve our neighbors, including those who are homeless. A new vision was becoming clear to me how this could be done.
所以当会议结束, 我坐在返程的飞机上朝窗外眺望, 我意识到我对无家可归问题 的理解和观点 正在转变。 当我盯着窗外看时, 这种强烈的感觉 和想法不断涌上我的心头, 如果说全国只要有一个州 能够消除长期贫困的话, 那么就应该是犹他州。 因为我们的内心深处有一种情感, 渴望和意愿,去让人们联合起来 为我们的邻居服务, 也包括那些无家可归之人。 一个新的愿景在我的脑海中 逐渐清晰起来。
Now, those of us that attended the conference said, "Yeah, these models will work in Utah." But when we got back home, there were many who said, "Nah, those aren't going to work. They won't succeed here." But there was, however, an affordable housing organization who was willing to build our first 100 units. But they had concerns about having 100 chronically homeless people in one location. To address that concern, we decided to create a pilot to test that idea while we built the first 100 units. We would use existing units scattered throughout Salt Lake City.
那些参加过会议的人说过 “这些方案将在犹他州收到成效。” 但是当我们回到家中, 也有很多人在说, “这没有什么用,他们不会成功的。” 但是,有一个保障性住房组织 乐意为我们建造 最初的 100 个住房单元。 但是他们也担心 让 100 个长期无家可归的人 居住在同一个地点是否妥当。 为了消除这种担忧, 我们决定开展一个试验, 边建造这 100 个单元, 边去测试这个想法。 我们会使用分散在 盐湖城各处的现有房屋单元。
Then we debated: Should we select fairly high-functioning homeless persons or the most challenging ones we could find? And this is where my background on the ranch came into play. Back then, my mother cooked our meals and heated the water for our weekly bath on a wood-burning and coal-burning stove. And after chopping wood for that stove all those years, I'd learned to chop the big end of the log first, when I had the most energy. We decided to use the "big end of the log first" approach and selected 17 of the most challenging, difficult, chronically homeless people we could find, because we knew we would learn the most from them. Twenty-two months later, all 17 were still housed, including Keta, who today, 11 years later, is sleeping in her own bed and is sober.
然后我们就争论: 是应该选择身体很健全的流浪者, 还是我们能找到 的最具有挑战性的一些人呢? 这时候,我在农场的背景 开始发挥作用了。 在那时候,我妈妈为我们做饭, 每周都用烧木头和烧煤的炉子 为我们烧洗澡水。 在为那个炉子劈柴多年之后, 我学会了,当我体能充沛时, 先劈木头的大节处。 我们决定采用 “先捡硬骨头啃”的策略, 选择了 17 名我们能找到 的最有挑战性的, 生活困难,长期流浪的人, 因为我们知道,他们能 为我们提供最重要的信息。 22 个月以后, 全部 17 个人仍然居住在房屋里, 其中就包括柯塔, 她仍然睡在她自己的床上, 头脑清醒, 到今天,已经 11 年过去了。
At the end of this pilot, one of the young case managers said, "We used to debate up at our university classes which theory of case management was the most effective. Now our theory of case management is: anything necessary to keep them housed." We became believers, and built hundreds of units over those next 10 years, leading to the reduction of our statewide chronic homeless population of 91 percent.
在这项试验临近尾声时, 一个年轻的个案负责人说道, “我们过去在大学的课堂上 展开过一场辩论, 关于个案管理是否是最有效的。 现在,我们对个案管理的理论是: 竭尽全力让他们有住的地方。” 我们开始对这个方法深信不疑, 在接下来的十年里 兴建了数百个住房单元, 导致整个州内的长期流浪人口 下降了 91%。
Now, who are homeless people? Many people just want them to go away, to disappear, not disrupt our lives. Through this 10-year, 11-year process, I gained many insights of why people become homeless. One of those insights came to me a few years ago when I was visiting with our medical outreach team. These are our frontline workers that go out and visit the street homeless and the prostitutes to check on their medical health. One of the team members mentioned that eight of the prostitutes had given birth to 31 children that had become wards of the state. They also shared that some of the pimps were their husbands, and worse yet, their parents. These prostitutes, in their late teens, 20s, early 30s, were expected to earn enough money a day to support a hundred-dollar-a-day heroin addiction, their living expenses and their pimp. And with unprotected sex, they were paid more, and predictably, this would lead to a pregnancy. Children born under these circumstances many times end up becoming homeless. And it's not helpful to look at those born under those circumstances, or a parent that makes their child a drug addict at age seven, or a generation of babies born through drug addiction, and not feel some despair. For me, I believe every person is of value, no matter who you are. And it's not helpful to look at somebody with this start in life and blame them for where they are.
谁才是无家可归的人呢? 许多人只想让他们滚开,消失, 不要打扰我们的生活。 在这个 10 年左右的进程中, 我收获了许多领悟, 关于为什么人们会变得无家可归。 几年之前,当我和 医疗外援组一起参观时, 我突然有了一个顿悟。 这些人是前线的工作者, 他们外出走访街头流浪汉 和性工作者, 以检查他们的健康状况。 一名团队成员曾提及, 八名性工作者共生出了 31 个孩子, 这些孩子都得到了很好的监护。 她们也分享说, 一些皮条客是她们的丈夫, 更糟糕的是, 她们的父母也是皮条客。 这些性工作者 年纪大多在十几岁, 20多岁,30岁出头, 她们都被指望每天能挣足够的钱, 支持她们一天一百美元 的海洛因成本, 她们的日常生活 和在皮条客身上的花销。 如果是无保护措施的性行为, 她们会得到更多的钱, 可以预测的是,这会导致怀孕。 在这些情况下出生的孩子 多数最终变得无家可归。 看着那些出生在 那种环境的孩子, 或是一个让孩子从七岁 就染上毒瘾的父母, 或是一代出生在毒瘾之中的宝宝, 只会让人感到绝望。 对我而言, 我相信无论你是谁, 每个人都有其价值。 看着某人的人生有着这种开端, 就因为他们所处的环境而谴责他们, 这么做毫无帮助。
(Applause)
(掌声)
No one grows up saying, "My goal in life is to become homeless." And that's the beauty of the harm reduction and Housing First model. It recognizes the complexities of the different factors that can shape a human life. These models meet people where they are, not where we are or where we think they should be.
没有人从小就立志要成为流浪汉。 这就是“危害减轻”和“居住优先”模型 的美丽动人之处。 它看清楚了能塑造一个人 的人生复杂性的不同因素。 这些模型在他们所在的地方 遇到了这些人, 而不是我们所在的地方, 或是我们认为他们应该呆在的地方。
The pilot we did with our 17 taught us many lessons. When people have been living on the street for many years, moving back into housing requires lots of things to learn. And Donald taught us some of these transition lessons. His case manager asked him why he had not turned up the heat in his cold apartment. Donald said, "How do you do that?" He was shown how to use a thermostat. The case manager also observed that he was heating the beans in the can on the stove, like he had done over the campfires for many years. He was shown how to use pots and pans. We also learned that he had a sister that he had not seen in 25 years, who thought he was dead. She was happy to learn otherwise, and they were soon reconnected. Hundreds of people like Keta and Donald are now housed and reconnecting with their families. Also, many of our communities are incurring fewer emergency services costs.
我们和 17 名无家可归人员进行的试验 教会了我们很多东西。 当人们已经在街头居住了很多年, 搬回住所里居住 需要学习和适应很多东西。 唐纳德 让我们了解了如何实现这种过渡。 他的个案负责人问他 为什么不在冰冷的公寓里 调高加热器的温度。 唐纳德问道“怎么做的?” 负责人展示给他如何使用恒温器, 同时也观察到 他把豆子装在空罐头里 放在炉子上加热, 就像多年间他在野火堆上 做过的那样。 负责人向他展示了 如何使用坛坛罐罐。 我们也了解到他有一个 25 年未曾谋面的姐姐, 她以为他已经死了。 她获悉了这一切后非常高兴, 他们不久就重新建立了联系。 成百上千的像柯塔和唐纳德一样的人 现在已经有了稳定的住所, 并且和他们的家庭取得了联系。 另外,我们的很多社区 目前申请的紧急服务经费 也在逐渐减少。
I have learned over and over again that when you listen to somebody's story with an open heart, walk in their shoes with them, you can't help but love and care for them and want to serve them. This is why I'm committed to continuing to bring hope and support to our homeless citizens, who I consider to be my brothers and sisters.
我不止一遍的了解到, 当你用一种开放包容的心态 倾听他人的故事, 感同身受, 你会禁不住去主动关爱他们, 想要为他们做些什么。 这就是为何我如此坚定, 继续为无家可归的公民 带来希望和支持, 因为我们情同手足。
Thank you.
谢谢大家。
(Applause)
(掌声)