Crossing the Border: Encounters Between Homeless People and Outreach Workers
University of California Press, 1999
In early outreach work, I observed the emergence of an occupational ethos in which values and technique were intertwined. Workers have visions of their roles that go beyond the work itself. For some, it is educating others by explaining “that people aren’t homeless because they want to be.” For others, it is “having someone see what you’re doing, maybe build up their curiosity to think of why you’re doing this.” One worker seemed to feel that his work partly compensated for the public’s isolationism:
We’ve gotten to a point where we’re so concerned about ourselves and our own orbit. I go home, my dad doesn’t know his next-door neighbor. When I was growing up we stayed over. People don’t reach out to each other. They’re leery of others. And they’re probably leery of you. It feeds on itself.
Human compassion, sometimes colored by the individual worker’s spiritual or religious beliefs. and social liberalism often went together. Bill talked about the need to move away from a deserving-undeserving dichotomy for doling out compassion and services:
There has to be something to revitalize the souls of people and their aspirations and dreams, to give them a sense of worthiness in society. I think the voice of the homeless person is not just their voice. Veterans are saying the same thing: “Listen to us.” The elderly . . . Look at the money that’s being wasted to process a criminal through the court system, jails, to imprison someone. We can use those monies for more effective approaches to our life. We just can’t keep having twin societies, the good and the bad. We’re all interlocked.
Bill believes that ultimate responsibility for the problem of homelessness rests in Washington, which has the political and moral power to set the national agenda. He also believes that people like himself can help to break down the split between putatively deserving and undeserving homeless persons:
I think everyone should have some cause to advance our society. If we can provide services to an individual who’s unable to care for themself, to be a productive person, not just in producing some great advancement, but to themself, it’s like throwing a stone into a pond. It has an affect on all of us.
This liberal vision of citizenship helps to shorten the cultural distance between worker and client and unite them in a mythical republic of personhood. Bill explained:
Homeless people have a past. A person’s history, their actions—it’s all information. Like, “He picked up a fork.” It might have been an individual who hasn’t used a fork in ten years. They’re giving us an opportunity to look into their world. It’s like a reflection, a mirror. It reflects what we are and what we hope not to be.
For workers, there is a specialness about outreach work and the people who performed it and a corresponding sense that many others cannot be counted on to genuinely care for homeless individuals. People-processing work, such as that performed by City Welfare caseworkers, breeds contempt for the client and identification with bureaucracy, workers feel. Ed, a formerly homeless outreach worker, spoke from experience:
When I was homeless, in the office they treated me like a client; everything was all right. When I saw them downtown, they acted like they didn’t know me. A lot of clients face rejection when they’re outside of the office. You have to be one way with them. Either you care about them or you don’t.
Some workers acknowledged that welfare caseworkers operate under severe constraints.
But splitting the client from the person, is not tolerated by outreach workers. “Someone who does not have compassion or understanding does not belong on this team,” said one. Another said simply, “We are different.”
Compassion and knowing your resources simultaneously give workers the heart to go on and fire their image of themselves as the people with heart:
Some nights we were off the clock, and on our way home we would go under the bridge. We would bring blankets, extra stuff that we had. Off the clock. One thing I learned from dealing with my clients and working in a position of this nature is that you have to have a heart, and you’ve got to know your resources.
Workers’ satisfaction comes from the practical aspects of the work: finding an apartment and money for a veteran who has lived under a bridge for years or taking a woman with a bad limp to get medical treatment that she has avoided for years. It also comes from seeing a spark of life in one who has worn the blank mask of desolation from too many years on the street. Bill talked about the change in one client after she moved into an apartment and accepted mental health treatment:
I’ve seen Andrea come to Columbus House and she seemed to be so oriented . . . You could feel some life force had come back into this woman’s life.
Outreach workers cherish another key principle in their early engagement with homeless persons and their later work with them as clients: “Don’t make promises you can’t keep.”:
If a client says he needs a blanket and you say “OK, I’ll get you one,” and then you don’t get it for a week, this client could freeze out there. I think a lot of these clients look at, “Can this person really come through? Does he have the contacts or the resources that he says?” Once they see you come through they build a confidence in you and they start dealing with you more.
More experienced workers eventually confront the contradictions of humanism and clinical persuasion. Compare Bill’s words with those of a veteran worker from an outreach project in another city:
I’m a salesman. I have a product to sell. And to sell I must have a gimmick. I’m not bringing food, I’m creating dependency. Goodies help people give up the freedom of street life and mental illness without medication and side effects. We think the emphasis is on the humane thing and it’s not. The humane thing is only a tool to make you successful in helping this person who is in that bad situation. This may sound opportunistic, that you’re manipulating. Guess what? You are.
The worker who made these comments also spoke eloquently about the “humane” approach but insisted that workers confront the impurities of outreach work . . . Workers are paid to be compassionate. Going off the clock means being on the clock most of the time, engaged in the business of empathy . . . But work with the poor outside the four walls of the institution seems to demand higher allegiance to the client and to push workers toward a purity of heart that is difficult to achieve or maintain in practice. [O]utreach work is simultaneously the most natural and the most contrived form of professional help . . . Workers must live with the contradictions of their friendly yet manipulative approach. They do so by faith in the clinical tenet that mentally ill homeless individuals are sometimes unable to make judgments that are in their own best interests. Rooted deep in this tenet are the images of a loss of humanity at the border of society, redemption through the loving intervention of rescuers, and finally, a return to society as a human being made whole again.
Forced on the streets by egregious public policies that have created a process one writer dubbed “musical chairs,” the homeless must fend for themselves without the rudimentary comforts and services of a place to call “home.” . . . Given the pain of homelessness, what must we, the housed, do to help? It is this question that sets the stage for Rowe’s reflective book . . . Out of this effort comes something that is ineluctably persuasive. We are led—rather than driven—to the margins of society and asked to consider what matters . . . Rowe has provided the reader with the rationale for engaging in the next conversation . . . as we move past the tokenism of the current system of shelters into a solution set of rehousing and reconnection.
— Mindy Thompson Fullilove, author of Root Shock and Urban Alchemy
In this admirable book, Michael Rowe succeeds in capturing the complexities of outreach work and in skillfully describing outreach from the perspective of both the worker and the homeless . . . This book makes a significant contribution, going much further than the existing literature in revealing the inner world of the worker and the client. Few other writers have been able to get into the heads of their subjects, and to write with sympathetic detail about subjective feelings, experiences, and motives . . .
— Social Development Issues
I fear that many health care professionals will glance at this book and decide it’s interesting but not directly applicable to their field. They will be wrong. This thoughtful examination of outreach to the homeless brings to light many of the assumptions about class, compassion, and otherness that underlie medicine as well as social work. Because it explores the interactions between “others,” as well as the relationship between concepts of illness and poverty, this book deserves the attention of health care workers and social service providers alike.
— Angela Lea, Medical Humanities Review
Rowe . . . is asking if we, as a society, can stretch the border so that those now at the edges can be included as first-class citizens without having to cross over entirely. Although this may be a near impossibility in the current social and political climate, it is one of many important questions raised by this thought-provoking work and worthy of consideration by those of us serving disenfranchised groups, homeless or not.
— Susan F. Grossman, Social Service Review