Dr Cameron Parsell, from the Institute of Social Science Research at the University of Queensland (UQ), addressed the St Vincent de Paul Society of Australia’s National Congress held in October. Dr Parsell spoke about the research project he has been involved in with the Society in Queensland since March. The research aims to provide an evidence base for ‘good works’ and explore how assistance may be more effectively targeted to reduce prolonged disadvantage. Dr Parsell told congress delegates that early results from the research project have shown the immense benefits of home visitation and localised support. The final findings are expected to be completed in 2018.
The following is an edited excerpt from a paper co-authored by Dr Parsell and Beth Watts from Heriot-Watt University, Edinburgh on effective altruism and ethical responses to homelessness. The paper was published in September in the European Journal of Homelessness. The article primarily focusses on the long-term implications of initiatives such as mobile washing facilities and it also mentions the distribution of free food. The Society does not necessarily agree with or endorse all the ideas raised in this article; however, we do believe that, while there is value in providing food and company to all those we assist, it is also beneficial to examine and reflect on our practices. In doing so, the Society may rise to the challenge set by Blessed Frederic Ozanam, who said: ‘Charity is the Samaritan who pours oil on the wounds of the traveller who has been attacked. It is justice’s role to prevent the attack.’
Readers are warned that they may find the article confronting, especially as it challenges some aspects of how charities currently respond to homelessness and poverty. If you wish to have your say in response to this article, we invite you to write a letter to the editor (details on page 2) and a counter-response can be published in the next issue of The Record.
Ethical responses to homelessness
What constitutes an ethically just response to homelessness, and in particular its starkest and most lifelimiting manifestation, rough sleeping? We propose that ‘effective altruism’ (MacAskill, 2015; Singer, 2015) offers one useful framework to consider this question. Effective altruism calls on those wishing to ‘make a difference’, to ‘do good better’, by using evidence and reason to maximise impact. Though often employed to encourage donors to target their contributions towards effective charities tackling the most extreme suffering globally (for the classic statement of this position, see Singer, 1972), the core prescriptions of effective altruism have relevance within advanced western economies. Of key relevance here, effective altruism offers a frame within which to challenge the profile and support given to well-intentioned but ineffective, or even counterproductive, non-profit responses. Donors, volunteers and social entrepreneurs should not receive praise for their good intentions, but for investing their time and money into interventions that do the most good (Pummer, 2016). Enthusiasm and support for interventions that fall short of this standard ought to be redirected toward systemic policy changes and evidence-led interventions that can substantially and sustainably reduce levels of homelessness and dramatically improve the life chances and wellbeing of those experiencing it.
There is a robust body of contemporary and international evidence that demonstrates ‘what works’ in this area. A core part of this evidence reports the effectiveness of the Housing First model, which combines rapid access to affordable and secure housing, with appropriate, flexible and if necessary long-term support (Padgett et al., 2016). The model stands in stark contradistinction to traditional and in many places still dominant responses to homelessness based on progression up a ‘staircase’ of provision or along a ‘continuum of care’ from emergency shelter, to supported accommodation, to mainstream ‘normal’ housing. In sum, the Housing First movement has solidified evidence from examples globally that show that housing-led responses can sustainably resolve homelessness for a group historically considered hard (even impossible) to help. People can sustain mainstream housing if given the support to do so, but many will struggle to navigate the staircase of support that traditional models expect them to.
Housing-led solutions are not just effective, they are also efficient. Since Dennis Culhane’s (2008) watershed work, a substantial body of knowledge has shown the financial costs of homelessness and cost offsets of housing solutions. Across countries with very different housing markets, welfare systems and social institutions, this work shows that providing affordable housing and linked support services, compared to the homelessness, health and criminal justice service use associated with street homelessness, constitutes sound fiscal public policy and a better use of government funded resource allocation (Ly and Latimer, 2015; Parsell, Petersen and Culhane, 2016). One authoritative analysis suggests that people who experience unsheltered homelessness— the very people mobile washing facilities target—can successfully exit homelessness, sustain housing, and for some of these people the costs of providing housing and support are offset by the reduction in their use of other publicly funded services (Padgett et al., 2016). Though such cost-benefit reasoning might be judged to be dispassionately economistic, it is in fact far from it. It reflects an attempt to ensure that resources are directed most effectively to address life-limiting and indeed life-threatening forms of disadvantage. Even in the absence of clear cost-benefit reasoning, there are compelling arguments for housing-solutions focussed responses to homelessness: as Kertesz et al. (2016) argue, even in cases where providing housing will cost more than ‘maintaining’ a person in homelessness on the street, housing remains the clear route to that individual’s future wellbeing and participation in society.
Seen in this light, dedicating time, resources and money to models that simply ameliorate homelessness, looks increasingly like a distraction from the substantial evidence now available demonstrating how homelessness can be effectively prevented and resolved. Those intending only to ameliorate the suffering of those on the street should face legitimate questions about their poverty of ambition, not uncritical praise. Providing mobile washing facilities to people who are homeless risks shifting the debate away from different forms and models of housing, and other evidence-informed responses. When we provide people who are poor with the means to temporarily wash themselves and their clothes in public spaces we are not thinking through, much less lobbying for, the necessity of housing as part of the solution.
(No) harm done
n response to our position that effectiveness and efficient use of scarce resources should be at the front of the minds of donors, commissioners and social entrepreneurs, defenders of interventions like mobile washing facilities and other such novel services might make several arguments. They may concede that mobile washing facilities do not contribute in any substantial way to resolving homelessness, but nevertheless do no harm. They are benign, well-meaning interventions, which leave experts working in commissioned services to get on with the real job of tackling homelessness. It might be added that public donations accruing to these interventions do not really have an ‘opportunity cost’, in that if they weren’t given to these charities, they would not be invested in alternative evidence and housing-led responses to homelessness. Defenders may claim that interventions like mobile washing facilities have positive consequences for those sleeping rough that while falling short of resolving homelessness are nevertheless significant, including not only the health and self-esteem related gains associated with being able to maintain personal hygiene, but also perhaps opportunities for social interaction and empathic connection with those running the facilities and others using it. These social gains might be seen to have intrinsic value quite separate from their impacts on homelessness.
We consider there to be a number of reasons to be cautious about these ‘no harm’ and ‘marginal positive benefit’ arguments. First, there is a possibility of genuine harm resulting from these kinds of interventions. An ongoing and highly polarised debate of relevance here surrounds the distribution of free food to those on the streets, e.g. via soup kitchens (Shelter, 2005; Watts et al., 2017). Those involved in such interventions see them as offering a highly vulnerable population the means of survival, as well as empathic care and support. Critics, however, argue that such ‘subsistence provision’ enables highly vulnerable individuals to sustain damaging, even life-threatening, patterns of behaviour, and thus represent abnegation—rather than a realisation—of moral responsibility. An example of the potential harm of such interventions played out in Belfast, Northern Ireland in the winter of 2015/16. Public dismay in response to a series of deaths among the city’s street homeless population prompted spontaneous community-led provision of food and other assistance. This, however, was claimed by local stakeholders to have had the unintended consequence of drawing vulnerable individuals away from existing specialist outreach and support services that could offer more substantial assistance (Fitzpatrick et al., 2016b). Similar risks might well be associated with mobile washing facilities, particularly in cities where washing machines and showers are already provided by specialist support organisations. The actual impact of these kinds of interventions requires empirical investigation. These are not matters that can be settled a priori or with reference to the intentions (however noble) of those running, investing in or otherwise supporting them. In a recent article, Watts et al. (2017) propose a normative framework intended to aid the robust and dispassionate assessment of the ethics of varied responses to rough sleeping. They argue that even seemingly benign interventions like soup kitchens must be assessed in relation to the legitimacy of their aims and their effectiveness in achieving legitimate aims.
Second, it is not at all clear that mobile washing facilities offer the ‘added extra’ to homelessness provision that might optimistically be claimed, but rather that they draw both attention and money directly away from demonstrably effective services. Such headline-grabbing but non-evidence informed ventures often seem to grab public attention and in doing so can also attract the attention of not just big business and celebrities, but also politicians (for example, see Watts, 2016). With such notoriety, there is a concern that hype, rather than robust evidence and expert (academic and practice) opinion, will begin to exert an influence over the direction of public policy and investment. Indeed, in several Australian states, mobile washing facilities are enabled through philanthropic donations, which are tax deductible (and thus result in a loss of tax revenue), as well as through funding from direct government grants. This charitable response is therefore funded with money that could have otherwise supported housing and evidence-led responses to homelessness. In addition to these financial and policy impacts, we would add that such ventures may have a concerning psycho-social impact, in not just normalising but encouraging a celebration of responses that soothe rather than solve homelessness. When confronted with the individuals providing free access to washing machines, the response appears to be a warm hearted endorsement of the good intentions of the ‘provider’ of these services, rather than horror that the ‘beneficiaries’ are forced to rely on the benevolence of strangers for access to the very basics of survival and dignity.
Third, the view that mobile washing facilities and other such interventions offer dignity and meaningful social connection to the vulnerable individuals who use them, neglects the reality of relationships structured by charitable giving/receiving. Homelessness is often experienced as reliance on the benevolence of others, especially where people lack any entitlement to the assistance they receive (Watts, 2014), and can thus subvert a person’s capacity to take control of their lives, leading to a feeling of life ‘being on hold’ during homelessness. For example, without the material resources that housing provides, people are not only exposed to social conditions that cause ill-health (Marmot, 2005), they are unable to take control of their health care (Parsell et al., 2017) and are reliant on emergency and crisis health systems that are both expensive and ineffective at promoting positive health (Kertesz, 2014). The provision of mobile washing facilities is likewise a form of reliance directly caused by exclusion from the resources required to act autonomously.
Exclusion from housing forces people into a position of dependence on the hospitality and benevolence of altruists, and in so doing denies them not only autonomy, but the makings of self-worth, given that those in receipt of charity are rarely able to honour the highly valued social norm of reciprocity (Spicker, 1984; Watts, 2014). It is these considerations that lead the critics of charity to ask whether in fact the ‘givers’, rather than the ‘receivers’, benefit most from the charitable interventions (Allahyari, 2000). In 1920, the British Prime Minister Clement Attlee raised exactly these concerns as Britain abolished the Poor Laws:
The evil of charity is that it tends to make the charitable think that he has done his duty by giving away some trifling sum, his conscience is put to sleep, and he takes no trouble to consider the social problem any further … Very many do not realise that you must be just before you are generous home
Watts et al. (2017) remind us that our assessment of the appropriateness of charity is mediated by whether we identify most with the receiver or giver: if the former, we are confronted with both their material deprivation and their experience of being reliant on charity to fulfil their basic needs; if the latter, we may be buoyed by the display of virtue and good intentions, regardless of the consequences. In the case of mobile washing facilities, it is reasonable to ask whether the warm glow of ‘making a difference’ and the esteem of onlookers have had more lasting effects on the wellbeing of those responsible for this intervention than the temporary impacts on rough sleepers benefiting from clean clothes that soon become dirty again.
Rather than mobile washing facilities, people experiencing homelessness require housing in which they can decide when and how to wash themselves and their clothes. When people who have exited homelessness describe their housing as home, home is described as a place of privacy (Parsell, Petersen and Moutou, 2016); they articulate one small constitutive component of which the independence of having the means to wash their clothes and themselves away from the public gaze (Parsell, Petersen and Moutou, 2016). Deborah Padgett’s (2007) work with people who exited homelessness found that the routine and control over life that housing enabled constituted a marker of ontological security. Housing not only meant that people achieved safety and control, but it promoted conditions for people to develop self-narratives and identities that extended beyond their former state of material deprivation (Padgett, 2007). Housing is a means to construct, and have socially validated, an identity distinct from one’s former housing status i.e. homelessness.
The role of charity
Our argument is not a universalised position against charities, social entrepreneurs, community and faith-based groups responding to homelessness per se. On the contrary, there are many examples of such groups meaningfully contributing to society, and specifically to the wellbeing of people who are homeless. William Beveridge (1948) advocated for the continued role of charity when designing the modern Welfare State:
Voluntary action is needed to do things which the State is most unlikely to do. It is needed to pioneer ahead of the State and make experiments.
Charities are well positioned to push new boundaries and innovate and can be at the vanguard of developing effective interventions, in particular when they take into account and build upon existing lessons from past forms of provision. Providing a service that washes people’s clothes on the streets, by contrast, reflects neither a pioneering attempt to better respond to homelessness, nor an attempt to step in where the state is failing its citizens. The latter would surely require a higher level of ambition than the provision of showers and washing machines. It reflects instead a poverty of ambition for the lives of the group it targets, only possible when people who are homeless are seen as limited, deficient or (at the very least) not the same as ‘us’ (Lister, 2004).
Celebration of these kinds of interventions arguably reflects an acceptance that those who are homeless are simply the embodiment of their deprivation (Parsell, 2010), so justifying this low bar of resource provision. ‘We’, the ‘normal housed people’, would after all never tolerate the idea of having to wash ourselves and our clothes at mobile washing facilities provided by charities; this response can only be justified as appropriate when we perceive homeless people as less than us, as ‘other’.
Support, especially through taxes, for social interventions that enable people who are homeless to be clean, but still homeless, endorses homelessness as a social fact. Mobile washing facilities send the message that there will always be people in society who will be without their own housing, and that society’s responsibility is only to ensure that they have the immediate and highly limited dignity of being clean. We can only conclude that individual donors and supporters of such programs, and (more worryingly) governments directing public money to support mobile washing facilities or similar ameliorative interventions, have accepted the social injustice represented so starkly in homelessness as normal. We can and should hold ourselves to higher standards.
Doing good, better
‘Effective altruism’ offers one answer to the question ‘how can we help others?’, and one that is directly applicable to both individual and policy responses to homelessness. Both an ethical framework and now a social movement, the ideas associated with effective altruism force an examination of the impact of our charitable efforts and, importantly, direct these efforts only to initiatives that concretely and profoundly improve people’s lives. These ideas provide a helpful corrective to the intuition that altruistic intent in and of itself deserves praise. Singer (2015) reminds us that many (perhaps the majority of) people who give to charity do so for the ‘warm glow’ that giving entails and because of the emotional lure of responding (somehow, anyhow) to suffering when confronted with it (see also Bloom, 2017). The ethical response, however, is to direct these empathic motives effectively, not only to a good cause but to an effective solution (MacAskill, 2015; Pummer, 2016).
Support for mobile washing facilities conflates the unambiguous need for access to resources to promote hygiene, with an uncritical assumption that any charitable response is desirable and advantageous for the recipient. Through government grants, philanthropy, awards and media coverage, the social position of the provider of mobile washing facilities—and the fundraisers that support them—are lauded and given precedence. The short and longer term impacts on the homeless individuals using these facilities do not receive attention, despite being a crucial arbiter of whether these programs are a helpful addition to the landscape of homelessness services or not. Relentless attention to understanding the experiences of people who are homeless, and crucially the trajectories that allow some individuals to escape homelessness, forces a focus that extends far beyond mitigating the symptoms of this particular injustice. The innovation that Beveridge was optimistic charities would drive does not involve celebrating and funding activities that tolerate and normalise the highly inequitable distribution of one of the core building blocks of a well-lived life: housing.
Dr Cameron Parsell is Executive of the Institute for Social Science Research at the University of Queensland. He is an Australian Research Council DECRA Senior Research Fellow and Postgraduate Coordinator.
To read the paper in full, visit the European Journal of Homelessness published by the European Observatory on Homelessness website at: http://www.feantsa.org/
For more information on the research project Dr Parsell has been involved in contact the St Vincent de Paul Society in Queensland: firstname.lastname@example.org