“We cannot solve our problems with the same level of thinking that created them.” — Albert Einstein

Our unhoused neighbors came to Mass & Cass from environments that were toxic and traumatizing to them. They stayed because we haven’t yet provided a better place to meet their core needs of community, housing, healthcare, emotional and physical pain management, hygiene, connection to services and resources, and freedom from retraumatizing force and control. The public health crisis at Mass & Cass often feels never-ending, not because homelessness and substance dependence are actually unsolvable, but because our “solutions”, like the recently passed ordinance that criminalized homeless encampments in Boston, have been rooted in stigma, misinformation, and false assumptions, rather than lived experience, evidence, compassion, and best practices.

What we believe about a problem determines how successful we’ll be in solving it. And unfortunately, many of us have been wrongfully taught that homelessness and substance dependence are conscious choices and permanent afflictions. So we typically control, punish, and isolate people experiencing these traumas, retraumatizing and forcing them into institutions or otherwise out of public view, into danger, and even farther away from what they need to stabilize, heal, and thrive. Since Boston's ordinance was recently passed, there has already been an unconfirmed increase in murders of people who were forced out of their tents and into dangerous sleeping environments to escape the cold. Instead of investing even more money in policing https://www.wgbh.org/news/local/2022-09-26/boston-police-run-up-millions-in-overtime-at-mass-and-cass-homeless-encampment and imprisonment, which have been shown to only perpetuate homelessness instead of solve it https://www.bu.edu/ioc/2023/05/31/policy-brief-policing-and-the-punitive-politics-of-local-homelessness-policy/, we need to demand that our elected leaders finally instead invest in proven best practices for preventing and ending homelessness: Permanent Supportive Housing fully aligned with Housing First and Harm Reduction principles, along with optional self-determined compassionate supportive services to promote healing and holistic wellbeing, enabling people to finally become and remain stably housed.

Housing costs and rates of lethal overdose are at an all-time high, and there aren't currently enough shelter beds for adults https://www.wbur.org/news/2023/11/20/massachusetts-adult-homeless-shelters-full-capacity or families https://www.wbur.org/news/2023/11/09/family-shelter-capacity-waitlist to meet current and projected need . Additionally, with housing and other costs of living increasing far  more rapidly than pay or benefits, more and more of us are just one crisis away from not having a roof and bed to call our own. And yet, in response to public “Not In My Back Yard” pressure, the Boston’s City Council recently voted to pass Mayor Wu's ordinance criminalizing encampments, offering very limited shelter and no investment in the only real solution to homelessness, which is Permanent Supportive Housing and ample deeply affordable housing to meet current and projected need, for individuals and families.

If we want to see our unhoused neighbors finally thriving rather than in desperation, we need to abandon our inhumane and punitive homelessness policies like Boston's new ordinance, and instead substantially invest in and guarantee Permanent Supportive Housing, deeply affordable housing, harm reduction, and compassionate solutions designed, implemented, and evaluated by people with lived experience. We benefit most when all of our neighbors are healthy and thriving; imagine the kind of transformational environment we can nourish and enjoy right in our own back yard, if we finally invest in meaningfully supporting our unhoused and housed neighbors with what we need to truly thrive.

With winter and subfreezing temperatures now making it potentially fatal to sleep outside, sign this petition to tell all of Massachusetts' elected officials that you strongly urge them to immediately invest sufficient funding in deeply affordable housing, wraparound healing-centered supportive services, and temporary non-congregate adult, youth, and family shelter, instead of forcing our unhoused neighbors further into the shadows and harms way.

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Evidence-Based Recommendations for “Mass & Cass” From the Mental Health & Substance Use Special Interest Group of the Massachusetts’ Chapter of the National Association of Social Workers

o   Significantly Increase Low-Threshold Permanent Housing: Research shows that the primary cause of homelessness is a lack of affordable & accessible housing and mental health care https://doi.org/10.2307/800641 Many people sleeping near “Mass & Cass” are unsafe or unwelcome in their families’ and friends’ homes, are unsafe in shelters, and are unable to access or afford other housing. For instance, most landlords/property managers require birth certificates, state ID’s, and Social Security cards from prospective tenants, but many people sleeping near Mass & Cass have nowhere to safely store any of their belongings, so their vital documents are often lost or stolen and are often very difficult to replace. Most landlords also require clear criminal record checks, and because of the criminalization of substances and houselessness, most people who have slept near “Mass & Cass” have extensive criminal records that bar them from most housing for many years. And because people experiencing houselessness often don’t have access to laundry, showers, or storage, they are often not allowed inside many establishments. In other words, people often stay near Mass & Cass because they literally have nowhere else to go. Ample, affordable, safe, low-barrier, permanent housing is an essential part of restoring Mass & Cass once and for all, and all stakeholders, especially people who have slept outside near Mass & Cass, need to be brought together to build an effective solution, modeled after other successful Housing First cities.

o Transition from Criminal Justice to Transformative Justice: Advocate to pass the Treatment not Imprisonment Act, 9-8-8, and ACES Act, Reform/End Section 35’s, and also approve Equitable Approaches to Public Safety (EAPS) and other funding for Non-Police Crisis Response programs. The Criminal Justice system serves as a revolving door for people who are experiencing houselessness and/or substance use. The Criminal Justice system not only fails to treat the unhealed trauma, desperation, and a lack of needed resources that is at the heart of substance dependence, theft, violence, and other criminalized behavior, but in fact the process of being arrested, shamed, isolated, incarcerated, and released with insufficient resources is in itself extremely traumatizing. Additionally, involvement with the Criminal Justice system creates a significant and lasting barrier to accessing and maintaining housing, employment, etc., making it almost impossible for people who have been incarcerated to ever stabilize, let alone become self-sufficient. Transformative justice, instead, involves fluid policy and aims to meaningfully address the causes and resulting harms of currently criminalized behaviors, to help all affected parties heal, and to prevent the harmful behavior from occurring again. Additionally, research shows that a warm, non-judgmental, collaborative relationship, the opposite of the criminal justice approach, is the single most important factor in successful therapeutic outcomes https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3198542/ We currently spend a very large sum on sectioning, policing, incarceration, conditional release, etc. to try to force people to abstain from criminalized behaviors, but criminalized behaviors continue. We could, however, invest a much smaller amount in Transformative Justice, evidence-based treatments, and supportive resources and see a significant and sustained reduction in harmful and criminalized behaviors. 

o   Significantly Increase Access to Medically Assisted Treatment (ie. Suboxone/Methadone): Medically Assisted Treatment like Suboxone, Sublocade, Vivitrol, and Methadone are proven to significantly reduce harmful substance use, and in time often lead to some form of abstinence-by-choice. Despite how effective MAT has been at helping many people build healthy and self-sufficient lives, archaic rules and regulations make MAT extremely difficult to access. In fact, if recipients of Methadone weren’t forced to come daily to the Mass & Cass area to access their Methadone, many would prefer to stay away from the area permanently. Substance users, medical professionals, politicians, and legal experts need to collaborate to end excessive regulation of Medically Assisted Treatment and make Suboxone, Methadone, and similar life-saving medication much easier to access, and at doses that safely and meaningfully reduce cravings https://doi.org/10.3390/ijerph8104102 Many people would be very glad to stop using unregulated and harmful substances if they could easily access sufficient MAT.

o   Easily Accessible, Warm, Trauma-Informed, Non-Judgmental Mental & Physical Healthcare and Substance Dependence Treatment:  Research shows that a majority of people dependent on illicit substances have trauma histories, and that many people with trauma histories use substances to manage their untreated trauma symptoms. Additionally, research shows that access to warm, trauma-informed, non-judgmental emotional and physical healthcare and substance dependence treatment often leads to sustained housing and a significant reduction in harmful substance use https://doi.org/10.1037/h0094748 However, safe permanent housing and trauma-informed emotional and physical health care are three of the most difficult things to access for people who have slept outside near Mass & Cass, who often have MassHealth. Because MassHealth has far more rules for providers and requires far more paperwork than other health insurances, and because of how much student debt most emotional and medical health professionals carry, people with MassHealth often have to wait on waitlists for months if not years to access effective mental health providers willing to take MassHealth. And because of how expensive and time-intensive it is to pursue a mental health education and become licensed, there is currently a widespread and severe shortage of effective mental health professionals. To ensure that people experiencing houselessness and/or substance dependence have access to mental and physical healthcare, the peer-support model should be expanded so that many more people can use their lived experience to help others in their community heal, and without a massive investment of time or money. In fact, one of the most common refrains in the Mass & Cass community is “I want to heal so that I can help others.” Providing substantial training and preparation to people who have experienced houselessness, substance dependence, etc., would fulfill two goals: a rapid increase in trauma-informed supportive care, as well as a meaningful and accessible career path and source of income for people with lived experience. Peer-support trainers, licensing boards, schools of Social Work, people with lived experience of homelessness and substance dependence, etc. should create a plan to rapidly expand the peer-support model and increase the number of people with lived experience who can provide trauma-informed supportive services.

o   Replace Forced Abstinence with Harm Reduction and Client Self-Determination: In many communities and systems, substance use is met with stigma, isolation, punishment, and judgment, which are some of the root causes of trauma and substance use. In those communities and systems, substance users often are forced to achieve total abstinence from all substances before being allowed to access needed resources like housing, mental health care, substance treatment, and income, an approach that can make it nearly impossible to ever stabilize or thrive. Harm reduction, on the other hand, supports people in doing whatever most helps them lessen the behaviors that cause them the most harm, often substituting the most harmful behaviors with less harmful behaviors that serve a similar neurobiological purpose. Research shows that shifting policy away from forced-abstinence and towards Harm Reduction leads to a significant improvement in public health outcomes, survival, and quality of life for people experiencing substance dependence https://www.scielosp.org/article/ssm/content/raw/?resource_ssm_path=/media/assets/bwho/v91n2/a13v91n2.pdf

o   Create Overdose Prevention Centers (OPC’s): Many people who spend time near Mass & Cass have experienced substance dependence as a result of untreated and extensive trauma. Our unhoused neighbors often lack sufficient resources to be able to stop using substances, and also lack anywhere to use substances safely and discreetly. Overdose Prevention Centers (also known as Safe Consumption/Injection Sites) ensure that people who use substances are able to do so in a safe, private, indoor environment, and not out in the open near Mass & Cass. Research shows that OPC’s reduce overdose deaths, substance use–related harms, public drug consumption, litter, and crime, and also result in improved public health outcomes and an increase in linkage to other needed services https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2794326

o   Easy Access to Solo & Community-Based Activities that Improve Mood and Regulate the Nervous System: Substances are often the only thing that trauma survivors can easily access to regulate their extensive fear, anxiety, loneliness, boredom, etc. https://doi.org/10.1177/10783903211036496 Harmful substance use can be reduced by creating ample & free opportunities for alternative methods of mood regulation, like dance, singing, yoga https://doi.org/10.3122/jabfm.2021.05.210175 swimming, biking, meditating, art & music making, etc.

 

o   Skill-Based Employment Assistance, Free Marketplaces, Low-threshold Employment, and Assistance Starting Small Businesses: Research shows that homelessness results from income inequality https://journals.sagepub.com/doi/full/10.1177/0002716220981864 Because many people in the Mass & Cass community have criminal records as well as educational and professional histories that don’t meet many employers’ hiring requirements, earning an income to cover Boston area rents can be nearly impossible for this community. However, many people experiencing houselessness and/or substance dependence have many abilities and interests that could help them achieve financial self-sufficiency, and could also benefit our community. Connecting people with jobs and hobbies they enjoy and are good at not only helps to ensure a steady income source to maintain housing, but also helps to prevent isolation and boredom as well as the harmful substance use that those feelings often trigger.

 

o   Transportation: Research shows that transportation disadvantage contributes to homelessness https://doi.org/10.1080/10530789.2019.1582202 Rideshare services, cars, bicycles, taxis, the MBTA, etc. can all be very cost-prohibitive for our unhoused neighbors, which can make it difficult to access employment, daily methadone treatment, doctor’s appointments, etc., and can cause people to congregate near areas like Mass & Cass where they receive desperately needed services, rather than leaving the area. Providing the Mass & Cass community with MBTA cards, taxi vouchers, bicycles, etc. can reduce the number of people who stay by Mass & Cass because they can’t afford to travel elsewhere and can also help people to consistently attend their appointments.

o   Increased Access to Naloxone, both Nasal and Injectable: Naloxone is a life-saving medicine that reverses opioid overdoses https://doi.org/10.1111/add.15887 To prevent lethal overdoses, nasal and injectable naloxone should be made much easier for substance users and their loved ones to access, and in large quantities and with free trainings on proper administration. Many people experiencing substance dependence are extremely resilient, capable, thoughtful, funny, and kind, and easily accessible Naloxone can help to prevent the tragic and premature deaths of people who possess an immense capacity to meaningfully help others and brighten the world around them.