Photographs by Whitney Curtis

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My Great-Aunt Mary rarely left the house. Her sister supported them both financially; Mary stayed home, cooked, cleaned, gardened. In summer, she’d pack a wicker basket with frozen Cokes, ham sandwiches and Snickers bars and lower it from the upstairs porch into the yard where we were playing. She’d had meningitis and breast cancer, lost one eye, was never quite right—but she took such great care of everyone, we barely noticed her strange stubbornness, her fears and flights of fancy. The sudden thought chills me: Without family? I can see Aunt Mary on the street. And it would have swung her into madness.
 

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“Some people don’t really understand what it’s like to live on the edge,” Broderick says. “How one little thing can create a disaster. If you have family, savings, buffers, things will work. But if you don’t have that, man, it can all fall apart.” Decisions get clouded, hard to understand. For some people, homelessness actually feels freer: nobody pressing in on you, no hopes to be crushed, only the stars overhead.

Al and Laura craved a place to live, though, and when they made some money selling copies of Whats Up Magazine, published by Jay Swoboda as a way to give homeless people “a hand up, not a handout,” they rented a room at the Economy Inn for $50 a night. My brow furrows at the math: $1,500 a month? Surely they could have found an apartment that was cheaper? “Yeah,” Al shrugs, “but you need two months’ rent ahead of time.” Plus furniture, money for utilities …

Alcohol’s easier comfort. If advocates for the homeless could wave one magic wand, they’d close the 7-Eleven at 17th and Pine. Its walls are lined with refrigerated cases: tallboys of Olde English 800 malt liquor and Miller Lite in one, cartons of Boulevard Pale Ale for the loft residents in the next. I watch a young couple buying sandwiches at 10 a.m. The girl strokes the guy’s tattooed shoulder, asking worriedly, “How’d you get those scratches on your back?” Are they homeless? A woman with long, gray, flyaway hair comes in carrying a satchel and a stuffed grocery bag. She’s wearing a coat on this warm, sunny day, and she walks with the slow deliberation of someone trying to prove that she can. Is she homeless? The woman behind the cash register looks me up and down when I ask for a bathroom, then says decisively, “I will take you,” and leads me to a bathroom marked Staff Only.

Drink and drugs eat up people’s lives, their brains, their rent money. According to the 10-year plan, 57.2 percent of St. Louis’ homeless people are leaning hard on some kind of substance. Often they are, in that smug phrase used by people who don’t have to do it, “self-medicating,” because more than a third are mentally ill. They prefer life on the street, with $637 to spend every month, to that sensible Department of Mental Health shelter-plus-care voucher.

More than 40 percent have physical health problems, too. “What they forget is that without a place to live, it’s very hard to be healthy,” notes Dr. Fred Rottnek, a professor at Saint Louis University’s medical school who treated the homeless for years. “Homeless people get raped, beat up, don’t eat well, get diabetes, hypertension, are exposed to the elements, get psychologically numbed. There’s no place to go to relax, feel safe, be yourself.”

For those with serious mental illness, a “shelter” feels more like a 19th-century asylum. “Our folks have a hard time being around a lot of people,” Broderick explains. “They get paranoid, they get anxious, they can’t always follow the rules, some talk to themselves or laugh, and the staff think they’re being smartass.”

Wallensak says people get dropped off from hospitals two or three times a month. “One just had his hospital gown on. Another was wearing hospital booties and open sneakers, laces removed.” A cab had left him at a shelter that wasn’t yet open, so he’d walked in 100-degree heat to the HRC parking lot. There he sat, with $1.50 and six unfilled prescriptions in his pocket and a jagged piece of glass in his hand, slowly and methodically cutting himself.

Not only do hospitals dump, whole counties dump, Siedhoff says: “More than 20 percent of the city’s homeless come from St. Louis County; others from Jefferson, Warren, St. Charles and Metro East. Somehow the city of St. Louis is expected to provide for all the region’s people.” He pauses. “It would be nice,” he adds pointedly, “if there were some cooperation.”

Dana McAuliffe, director of homeless services for St. Louis County, says they’re trying. But calls from county residents to the homeless hotline shot up 12 percent between October 2007 and October 2008. Capacity did not increase. And while the county has four shelters for women, it has none for men. McAuliffe buys a few beds for men from two city agencies.

“We are not as far along in the 10-year plan as we’d like to be,” she admits. “I have money for programs, but not to build permanent supportive housing. Historically, services are concentrated in the city. And treatment has to be comprehensive; homeless people have too many pieces of their lives broken.”

Talking to them, you hear a litany of danger: the man who was beaten to death by two teenagers, ribs crushed and lungs lacerated, because he refused to buy them beer … Al’s friend, who got “stabbed up” at Kiener Plaza, 20 or 30 times in his face and head … John Bell, known as “Radio,” who was stabbed to death near Broadway … The guy who used to walk up and down Chippewa, beaten to death just as Places for People set out to find him.

Since 1986, Peter & Paul Community Services has run an emergency shelter in Soulard focused on exactly the group the 10-year plan now targets: men who’ve been on the street for years. Now Peter & Paul is opening permanent supportive housing, and Burnham expects the residents to be wary, test him a bit. “They’re used to being surrounded by chaos and jolted by adrenaline,” he says. “They don’t know how to go to a restaurant and just sit down and eat; they’re self-conscious shopping, because they’re so used to being told to move on.”

After 33 years of this work, Burnham knows the paradox: The worse off you are, the tougher it is to believe anything else is possible. Recent studies in neuroscience pinpoint the problem, showing that when primates are under stress, consumed by the need to survive, they stop growing new brain cells. Over time, the stress hormones that put the body on a heightened state of alert can become toxic, attacking the hippocampus and directly affecting our ability to learn and remember.

Depression—which can be either a cause or a consequence of homelessness—has a similar effect, killing brain cells and preventing new ones from being born. We spiral downward because our brain is losing its responsiveness, its very ability to change for the better. The old assumption, never proven, was that antidepressants worked by increasing serotonin; Dr. Ronald Duman at Yale University now believes they work because they stimulate the growth of new brain cells.

For most people who are chronically homeless, problems started back in childhood, when 25 percent were physically or sexually abused, 27 percent were in foster care or institutions, and 21 percent were already homeless (U.S. Department of Health and Human Services statistics). But new studies’ most promising finding is that, in a safe and peaceful environment, even the adult brain, stressed for decades, can heal itself, grow fresh cells, begin to learn again.
 

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“They say I’m bipolar, with ADHD. I know I have the problems, but deep down I try finding an excuse just so I don’t have to think about it. I just want to help the kids that are my age and on the street. Been there.
Done that.”    —Cassandra

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[Pictured: “I really can’t get the concept of how people like to stay homeless,” says Darrell Page, who’s now selling Whats Up and living in his own place. “I don’t like to be without, myself. But I’m seeing more on the street. New faces. Maybe they just fell into the homeless thing.”]

There are successes.

St. Patrick’s recently used federal grant money to turn 45 units in the old Days Inn at Washington and Market, now redeveloped as low-income housing, into a residence where vets struggling with mental illness or addiction can receive shelter, treatment and job training for two years. The first resident, Jeffrey Carl Williams, had been on the street for 18 years. “I woke up, and I was looking out ’cause I liked my view so much, and right below me was the doorway where I used to sleep when it was cold, lying in a, you might say, fetal position in the insanity of crack cocaine,” he says in a rush.

“The pain was all self-inflicted,” he adds, amazed, “and it’s gone now.”

Cassandra, 20, was put in foster care at age 7. “They said something about I was being beat. I had a bunch of bruises,” she says. “But my mom and dad never did hit me. Anyway, that’s when I started becoming my own person, because I got separated from the only thing that I had.” After a disastrous foster placement, she was sent to St. Vincent Home for Children, ran away, got put in lockdown at Edgewood, was returned to her parents, ran away and lived on the streets at 14. “I was carefree; I felt like I ruled. ‘Look at me now, Mom, look at me now.’ I started drinking and smoking and doing things I shouldn’t have done. Things I regret.”

Cassandra slept on the streets for three years, then in a car. At 18, she found her first place to live, through Places for People. A year later, she’s stable, taking meds and paying bills in a small apartment she shares with her fiancé.

Darrell Page wakes up in a clean apartment looking out on the new Lumière Place casino and thinks, “God’s got a whole lot more to do with me, but life’s good.” Before getting shot, paralyzed and, eventually, clean, he ran a flophouse on the North Side for fellow cocaine addicts. “I made it my loyal duty to put something in their stomach,” he says. “They called me Mr. Schnucks ’cause I was the friendliest person in town. But I was a functional addict; I’ve always been a hustler. I don’t see how people slip through the cracks—or jump through them, or fall. OK, so you go to Rev. Rice every morning. Put something else in your program. These are people who have lost their self-esteem. Their get-up-and-go has got up and left.”

Some are too sick to chase it. McAuliffe says, “More and more people are coming into emergency shelters with serious mental health problems. We don’t know if the cuts in Medicaid have anything to do with it or not. But the people are disruptive. They can’t function.”

Wallensak’s seeing the same phenomenon: “We have had more incidents this year than in the past five or six.” It’s bitter proof of success: People who could more easily be housed have been housed, and those who remain homeless have more intractable problems.

Those are precisely the people the 10-year plan was written for, and we’ve sifted our way to them—just in time for the new homeless to take the others’ places.

The private sector has to get involved, Burnham says: “The government, especially now, doesn’t have the money to generate the kind of housing that’s going to solve this. We need truly affordable housing for very-low-income people, and it can’t all be in the 4th and 7th Wards.”

Nobody—except the NIMBY neighbors—is arguing. But just as we realized how to create the right kind of housing, just as we began to make headway on the toughest cases, the economy got pulled out from under everybody’s feet.

Urban Strategies, for example, the nonprofit arm of developer McCormack Baron Salazar, had a huge complex planned for Martin Luther King Drive, with supportive housing gracefully inserted. Now the entire project’s on hold, Burnham says, his voice edged with disappointment.

There has been progress, he concedes—both cosmetic and real. We’re doing a lot more than unfolding cots and stirring soup. We now know exactly what it would take to end homelessness.

“But we’re at the beginning of the 10-year plan.”

Note: This article has been modified slightly since its print publication.