The Housing First approach to homelessness | Lloyd Pendleton

翻译人员: Shengzhe Yan 校对人员: Kevin Fang

What do you think would happen

如果你邀请了一个

if you invited an individual who had been living on the street

露宿街头很多年，有着精神问题，

并且酒精成瘾的人，

for many years,

had mental health issues

直接从街头搬到

and was an alcoholic

到屋子里居住，

to move directly from the street

你觉得接下来

into housing?

会发生什么？

We had heard this was being done in New York City,

我们听说纽约市已经 把这种设想付诸实践，

and it was called the Housing First model.

把它叫做“住房优先”计划。

We wondered if it would work in Utah.

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,

为了坚定对这一计划的决心， 我们决定先开展一项试验。

and Keta was one of the 17 chronically homeless individuals

柯塔就是我们选择 的长期无家可归

we included in this pilot.

的 17 名试验者之一。

She had been on the street for 20-plus years,

她已经在街头露宿超过 20 年，

had mental health issues

有着精神问题，

and was a severe alcoholic.

并且嗜酒如命。

The first night in her apartment,

在搬进公寓的第一晚，

she put her belongings on the bed

她把所有的破烂放在床上，

and slept on the floor.

自己却睡在地板上。

The next three nights, she slept out by the dumpster

在接下来的三个晚上， 她走出家门，睡在了公寓附近

near the apartment building.

的垃圾箱旁边。

With the aid of her case manager,

在她的负责人的帮助下，

she moved back into her apartment

她返回到公寓，

but continued to sleep on the floor for several nights.

但是继续在地板上 睡了几个晚上。

It took over two weeks for her to develop enough trust and confidence

她花了差不多两周时间才确信

that this apartment was hers

公寓是她的，

and would not be taken away from her

并且不会被抢走，

before she would start sleeping in the bed.

然后才开始安心的睡在床上。

Homelessness is a continuing challenge for many cities

在全国的很多城市，无家可归都是

throughout our country.

一个持续的问题。

Our homeless population falls into three major categories:

我国的无家可归人口 可以分为以下三大类型：

those that are temporarily homeless,

暂时性流浪者

about 75 percent;

占比约 75%；

those that are episodically homeless,

偶发性流浪者

about 10 percent;

占比约 10%；

and those that are chronically homeless,

长期性流浪者

占比约 15%；

about 15 percent.

Chronic homelessness is defined as an unaccompanied adult

长期性无家可归的人 被定义为无人陪伴之人，

who has been continuously homeless for a year or more

这些人已经持续 无家可归至少一年。

or more than four times homeless in three years

或者在三年内已经流浪超过四次，

that totals 365 days.

总数超过 365 天。

This small 15 percent of the homeless population

这区区 15% 的流浪人口

can consume 50 to 60 percent of the homeless resources

却能够消耗社区可发放的

50%-60% 的资源。

available in a community.

In addition, they can cost the community

除此之外，

20,000 to 45,000 dollars a year per person

他们在紧急服务开销方面， 每人每年消耗掉社区

in emergency services costs,

约 2 万至 4.5 万美元，

such as EMT runs,

诸如急诊，

emergency room visits, as many of you will be aware,

你们都知道流浪人员 经常需要去急诊室，

addictions, interactions with the police,

药物上瘾，和警察打交道，

jail time.

以及服刑。

Simply put, this small population costs a lot.

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

基于这一现实，美国政府 于 2003 年开展了一项倡议，

inviting states and cities and counties

邀请各个州，各个城市和社区

to develop a plan to end chronic homelessness

开展一项计划， 在十年内终结长期

in a 10-year period.

的无家可归问题。

The state of Utah accepted this invitation,

犹他州接受了这一邀请，

and I was asked to lead this effort.

并且我被派去领导这一举措。

In 2005, we approved a 10-year plan,

在 2005 年，我们通过了 一项十年计划，

and 10 years later, in 2015,

弹指一挥间，在 2015 年，

we reported a reduction in our chronic homeless population

我们报道了在全州范围内 长期无家可归人口

of 91 percent statewide.

下降了 91% 的消息。

(Applause)

（掌声）

That's amazing.

这太神奇了。

When I began this process, and we began this process,

当我和其他人 开始实施这一项目时，

I realized that I had a limited understanding of homelessness

我意识到我对无家可归问题 以及其影响因素

and the factors that impacted it,

的理解非常有限。

and that I needed a fairly major change in my belief, in my thinking,

因此，我需要一个 观念上的极大转变，

because I had been raised with the theory of rugged individualism

因为我从小就信奉个人主义，

and "pull yourself up by the bootstraps."

以及“自己的事情自己干”。

That philosophy came from being raised on our family's cattle ranch

这一哲理缘于我从小 在犹他州西部沙漠

in a small town in the western desert of Utah.

一个小城镇的家庭牧场长大。

On the ranch, you learned that nothing takes priority

在牧场里，你会明白没有什么事情

over caring for the cattle,

比照顾小牛犊还重要。

something always needs fixing

永远有要修理的东西，

and most importantly,

并且最重要的是，

hard work makes the world right.

努力工作才是 放之四海皆准的真理。

It was through that lens that I would see homeless people.

我就是以那样的标准 看待无家可归人口的。

When I was a teenager, our family would go into Salt Lake City,

在我十几岁的时候， 我们一家人会去盐湖城，

and I would see these homeless people -- "hobos" we called them then --

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，

sitting around on the street,

我会想，

and I would think,

“你们这些懒鬼，快去工作。 自己的事情自己干。”

"You lazy bums, get a job. Pull yourself up by the bootstraps."

After high school, I left the ranch,

上完高中后，我就离开了农场，

graduated from college,

大学毕业以后，

went to work for Ford Motor Company for several years,

我去福特汽车公司工作了几年，

then got a job at the Church of Jesus Christ of Latter Day Saints

然后担任了一座教堂的牧师，

and moved back to Salt Lake City.

又搬回了盐湖城。

During that employment, I had the opportunity to be loaned out

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，

to the state's largest homeless shelter

to assist them in developing and improving

去帮助他们发展，并改善

their financial and management capabilities.

他们的经济和管理职能。

While there, I became aware of a new approach

同时，我也注意到了处理

to dealing with homeless individuals

流浪者和瘾君子问题

and drug addicts.

的一项新举措，

It was called the harm reduction model,

叫做“危害减轻”模型，

and it consisted of passing out clean needles and condoms.

包括发放洁净的针头和避孕套。

And I thought, "Now that is one stupid idea."

当时我在想， “这真是一个愚蠢的想法”。

(Laughter)

（哄笑）

"That's just going to encourage them to continue that behavior.

“这只会鼓励他们继续这种陋习。

Just tell them to stop."

直接让他们停止吧。”

Several years later, I read some of the early 10-year plans

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

to end chronic homelessness

promoted by the federal government.

的十年早期计划。

As I read through those plans, and I thought,

我边读这些计划边琢磨，

"Pfft! This is unrealistic.

“这根本不现实，

You can't end homelessness.

你根本无法终结无家可归问题。

There's too many personal choices and factors beyond our control."

有太多个人选择和因素 超出了我们的控制范围。“

My perspective changed, however,

然而，在 2003 年 参加了一项会议之后，

when I attended a conference in 2003,

我的观点改变了。

where I learned the reason behind the 10-year plan.

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。

First was this small population of the homeless group

首先，这区区 15% 的无家可归人口

that was 15 percent and were very expensive.

会消耗大量资源。

That made sense

对一个像犹他州这样

for a conservative state like Utah.

保守的州而言，这就说得通了。

The second insight was learning about this Housing First,

第二，我了解到了这项“住房优先”

or low-barrier housing.

或者叫做低门槛住房计划。

There had been an agency in New York City

在纽约市曾有一个部门

邀请了有心理疾病的流浪人群

that had been inviting mentally ill homeless individuals

to move directly from the street into housing.

直接从街头搬进房子里。

And they were also allowed to continue to use drugs and to drink,

他们仍然被允许吸毒和饮酒，

just like we can in our homes.

就像我们在家里可以做的一样。

They were, in addition, offered services -- not required to use them --

除此之外，他们还得到了 个案负责人提供的一对一服务——

by on-site case managers

当然这不是强制性的——

to assist them to adjust to their new living arrangements

以帮助他们适应新的居住安排，

and to stabilize their lives.

让他们的生活稳定下来。

They were using the harm reduction model.

他们正在使用“危害减轻”模型。

And despite my initial low expectations about hearing about this model,

尽管听到这一模型后， 我最初期待不高。

they were having an astonishing success rate:

但是他们正在塑造 一个令人惊讶的成功率：

85 percent were still housed after 12 months.

一年以后，85% 的人仍在居住。

The third insight

第三，

was the importance of developing a trusting relationship.

我发现了发展信任关系的重要性。

Because of the abuse these individuals have had

因为这些人在人生的大部分时间中

throughout most of their lives,

曾经历过虐待和伤害，

they hardly trust anybody,

他们很难信任任何人，

and the clean needles and condoms and low-barrier housing

而洁净的针头，避孕套 和低门槛的住房条件

was a means to begin to develop a relationship of trust.

是开始发展信任关系的一个方式。

Vital.

这至关重要。

So as I flew home from this conference,

所以当会议结束，

sitting in the plane looking out the window,

我坐在返程的飞机上朝窗外眺望，

I realized that my understanding and perspective about homelessness

我意识到我对无家可归问题 的理解和观点

was shifting.

正在转变。

And as I stared out that window,

当我盯着窗外看时，

this very strong feeling and thought came to me

这种强烈的感觉 和想法不断涌上我的心头，

that if there's any state in the union

如果说全国只要有一个州

that could end chronic homelessness,

能够消除长期贫困的话，

it was the state of Utah,

那么就应该是犹他州。

because there's an underlying feeling

因为我们的内心深处有一种情感，

and desire and willingness to collaborate to serve our neighbors,

渴望和意愿，去让人们联合起来 为我们的邻居服务，

including those who are homeless.

也包括那些无家可归之人。

A new vision was becoming clear to me how this could be done.

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,

那些参加过会议的人说过

"Yeah, these models will work in Utah."

“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，

But when we got back home, there were many who said,

“这没有什么用，他们不会成功的。”

"Nah, those aren't going to work. They won't succeed here."

But there was, however, an affordable housing organization

但是，有一个保障性住房组织

who was willing to build our first 100 units.

乐意为我们建造 最初的 100 个住房单元。

But they had concerns about having 100 chronically homeless people

但是他们也担心 让 100 个长期无家可归的人

in one location.

居住在同一个地点是否妥当。

To address that concern, we decided to create a pilot

为了消除这种担忧， 我们决定开展一个试验，

to test that idea while we built the first 100 units.

边建造这 100 个单元， 边去测试这个想法。

We would use existing units scattered throughout Salt Lake City.

我们会使用分散在 盐湖城各处的现有房屋单元。

Then we debated:

然后我们就争论：

Should we select fairly high-functioning homeless persons

是应该选择身体很健全的流浪者，

or the most challenging ones we could find?

还是我们能找到 的最具有挑战性的一些人呢？

And this is where my background on the ranch came into play.

这时候，我在农场的背景 开始发挥作用了。

Back then, my mother cooked our meals

在那时候，我妈妈为我们做饭，

and heated the water for our weekly bath

每周都用烧木头和烧煤的炉子

on a wood-burning and coal-burning stove.

为我们烧洗澡水。

And after chopping wood for that stove all those years,

在为那个炉子劈柴多年之后，

I'd learned to chop the big end of the log first,

我学会了，当我体能充沛时，

when I had the most energy.

先劈木头的大节处。

We decided to use the "big end of the log first" approach

我们决定采用 “先捡硬骨头啃”的策略，

and selected 17 of the most challenging,

选择了 17 名我们能找到 的最有挑战性的，

difficult, chronically homeless people we could find,

生活困难，长期流浪的人，

because we knew we would learn the most from them.

因为我们知道，他们能 为我们提供最重要的信息。

Twenty-two months later,

22 个月以后，

all 17 were still housed,

全部 17 个人仍然居住在房屋里，

including Keta,

其中就包括柯塔，

who today, 11 years later,

她仍然睡在她自己的床上，

is sleeping in her own bed

头脑清醒，

and is sober.

到今天，已经 11 年过去了。

At the end of this pilot, one of the young case managers said,

在这项试验临近尾声时， 一个年轻的个案负责人说道，

"We used to debate up at our university classes

“我们过去在大学的课堂上 展开过一场辩论，

which theory of case management was the most effective.

关于个案管理是否是最有效的。

Now our theory of case management is:

现在，我们对个案管理的理论是：

anything necessary to keep them housed."

竭尽全力让他们有住的地方。”

We became believers,

我们开始对这个方法深信不疑，

and built hundreds of units over those next 10 years,

在接下来的十年里 兴建了数百个住房单元，

leading to the reduction of our statewide chronic homeless population

导致整个州内的长期流浪人口

of 91 percent.

下降了 91%。

Now, who are homeless people?

谁才是无家可归的人呢？

Many people just want them to go away, to disappear,

许多人只想让他们滚开，消失，

not disrupt our lives.

不要打扰我们的生活。

Through this 10-year, 11-year process, I gained many insights

在这个 10 年左右的进程中， 我收获了许多领悟，

of why people become homeless.

关于为什么人们会变得无家可归。

One of those insights came to me a few years ago

几年之前，当我和 医疗外援组一起参观时，

when I was visiting with our medical outreach team.

我突然有了一个顿悟。

These are our frontline workers

这些人是前线的工作者，

that go out and visit the street homeless and the prostitutes

他们外出走访街头流浪汉 和性工作者，

to check on their medical health.

以检查他们的健康状况。

One of the team members mentioned

一名团队成员曾提及，

that eight of the prostitutes had given birth to 31 children

八名性工作者共生出了 31 个孩子，

that had become wards of the state.

这些孩子都得到了很好的监护。

They also shared that some of the pimps were their husbands,

她们也分享说， 一些皮条客是她们的丈夫，

and worse yet,

更糟糕的是，

their parents.

她们的父母也是皮条客。

These prostitutes,

这些性工作者

in their late teens, 20s, early 30s,

年纪大多在十几岁， 20多岁，30岁出头，

were expected to earn enough money a day to support

她们都被指望每天能挣足够的钱，

a hundred-dollar-a-day heroin addiction,

支持她们一天一百美元 的海洛因成本，

their living expenses

她们的日常生活

and their pimp.

和在皮条客身上的花销。

And with unprotected sex, they were paid more,

如果是无保护措施的性行为， 她们会得到更多的钱，

and predictably, this would lead to a pregnancy.

可以预测的是，这会导致怀孕。

Children born under these circumstances many times end up becoming homeless.

在这些情况下出生的孩子 多数最终变得无家可归。

And it's not helpful to look at those born under those circumstances,

看着那些出生在 那种环境的孩子，

or a parent that makes their child a drug addict at age seven,

或是一个让孩子从七岁 就染上毒瘾的父母，

or a generation of babies born through drug addiction,

或是一代出生在毒瘾之中的宝宝，

and not feel some despair.

只会让人感到绝望。

For me, I believe every person is of value,

对我而言， 我相信无论你是谁，

no matter who you are.

每个人都有其价值。

And it's not helpful to look at somebody with this start in life

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，

and blame them for where they are.

这么做毫无帮助。

(Applause)

（掌声）

No one grows up saying, "My goal in life is to become homeless."

没有人从小就立志要成为流浪汉。

And that's the beauty of the harm reduction and Housing First model.

这就是“危害减轻”和“居住优先”模型 的美丽动人之处。

It recognizes the complexities of the different factors

它看清楚了能塑造一个人

that can shape a human life.

的人生复杂性的不同因素。

These models meet people where they are,

这些模型在他们所在的地方 遇到了这些人，

not where we are

而不是我们所在的地方，

or where we think they should be.

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.

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。

When people have been living on the street for many years,

当人们已经在街头居住了很多年，

moving back into housing

搬回住所里居住

requires lots of things to learn.

需要学习和适应很多东西。

And Donald

唐纳德

taught us some of these transition lessons.

让我们了解了如何实现这种过渡。

His case manager asked him why he had not turned up the heat

他的个案负责人问他 为什么不在冰冷的公寓里

in his cold apartment.

调高加热器的温度。

Donald said, "How do you do that?"

唐纳德问道“怎么做的？”

He was shown how to use a thermostat.

负责人展示给他如何使用恒温器，

The case manager also observed

同时也观察到

that he was heating the beans in the can on the stove,

他把豆子装在空罐头里 放在炉子上加热，

like he had done over the campfires for many years.

就像多年间他在野火堆上 做过的那样。

He was shown how to use pots and pans.

负责人向他展示了 如何使用坛坛罐罐。

We also learned that he had a sister that he had not seen in 25 years,

我们也了解到他有一个 25 年未曾谋面的姐姐，

who thought he was dead.

她以为他已经死了。

She was happy to learn otherwise,

她获悉了这一切后非常高兴，

and they were soon reconnected.

他们不久就重新建立了联系。

Hundreds of people like Keta and Donald are now housed

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，

and reconnecting with their families.

并且和他们的家庭取得了联系。

Also, many of our communities are incurring

另外，我们的很多社区 目前申请的紧急服务经费

fewer emergency services costs.

也在逐渐减少。

I have learned over and over again

我不止一遍的了解到，

that when you listen to somebody's story with an open heart,

当你用一种开放包容的心态 倾听他人的故事，

walk in their shoes with them,

感同身受，

you can't help but love and care for them

你会禁不住去主动关爱他们，

and want to serve them.

想要为他们做些什么。

This is why I'm committed

这就是为何我如此坚定，

to continuing to bring hope and support to our homeless citizens,

继续为无家可归的公民 带来希望和支持，

who I consider to be my brothers and sisters.

因为我们情同手足。

Thank you.

谢谢大家。

(Applause)

（掌声）