SKID ROAD JOSEPHINE ENSIGN

In this first episode of my Skid Road podcast, I introduce listeners to the situation of health and homelessness in my hometown of Seattle.

On March 8, 2024, I sat down with Tamara Bauman to discuss her work, experiences, and perspectives on homelessness, domestic violence, and frontline staff burnout.





This project received funding support from a 4Culture Heritage Award, a Jack Straw Cultural Center Artist Award, and a Humanities Washington Stories Fund award. I want to thank these important arts and culture agencies and all the people who have talked with me about their work.

I first worked with Casey Trupin soon after I moved to Seattle almost thirty-two years ago. At the time, I was working on applied policy research on improving access to health care for teens and young adults experiencing homelessness (while working as a nurse practitioner providing primary health care at a Seattle clinic specifically for our houseless young people). Along with Seattle and King County Department of Health Health Care for the Homeless, Casey and I worked on a project to clearly interpret Washington State laws impacting what types of health care could be provided to teenagers without necessitating the legal consent of parents/guardians--a source of confusion for teens and healthcare providers and a major barrier to care. I think this was when Casey was a recent law school graduate. I've followed his amazing work over the decades and was glad to talk with him recently about his work.



As he points out in this conversation, preventing youth homelessness is one of the best ways to prevent adult and chronic homelessness. A recent report from the Office of Homeless Youth for Washington shows that a concerted effort by multiple agencies and people (including young people with the lived experience of homelessness) reduced homelessness among young people ages 12-24 in Washington by 40% (between 2016 and 2022). Proving that it can be done.

Dr. Michael Copass, Seattle native, neurologist, Vietnam Army veteran/physician, and long-time head of the Harborview Medical Center's Emergency Department, is a living legend in the Seattle area and in emergency medicine in our country. On July 26, 2015, I traveled to Sequim, Washington, to the home of Dr. Copass. Harborview physician Dr. David Carlbom and his wife, Dr. Judith Rayl (a retired physician and abstract photographer), accompanied me. I recorded this interview with Dr. Copass and his wife, Lucy, at their kitchen table. He spoke about his philosophy of care ("everyone is a gold coin"; about how the Seattle of the 1970s (as, perhaps, now) had "no organized plan for dealing with sadness"; about the creation of Harborview's pioneering sexual assault center in 1972 by social worker Lucy Berliner, saying she did this by "churning through masculine indifference"; about the creation of King County's stellar Medic One system of pre-hospital emergency care; about many other aspects of his long professional medical career.

Social worker Krystal Koop talked with me about her lived experience of homelessness as a young teenager, her work in homelessness, harm reduction, and criminal justice. Krystal helped start the University District Street Medicine Project (UDSM), a University of Washington interprofessional student-run organization that still operates today (and for which I am a huge fan and faculty preceptor). This conversation occurred in the summer of 2015. Today, Krystal Koop works as a grief counselor. She talks about her first-hand experiences trying to work within broken systems, including child protective services, behavioral health, and the carceral system (and our continued and increasing criminalization of homelessness). She speaks to the importance of working with people currently or formally experiencing various forms of homelessness, with community-based frontline service providers, and providing interprofessional "learning by doing" opportunities for our health science students. This interview mentions the nurse-led Housing Health Outreach Team (HHOT) and the Downtown Emergency Service Center's housing first 1811 Eastlake, among other Seattle service providers.

On June 24, 2022, I sat down with Noah Fey, director of the Downtown Emergency Service Center (DESC) Housing Programs, at the DESC building in Pioneer Square. We discussed his work, first as a volunteer at DESC, then as an outreach worker, and now in DESC administration overseeing all of their varied housing programs. That morning, I had walked past tent encampments on the sidewalk just north of DESC. Noah talked about his nuanced views of encampment clearances (sweeps), encampments that grew exponentially in Seattle during the COVID-19 pandemic. Noah said, "I am not a fan of sweeps, but I am not a fan of simply saying, 'We need to leave people where they are and leave them be.' Neither of those are good alternatives and neither of those are informed by what we know works for people. Sweeps on their own are highly disruptive for people. (...) There's already such a feeling of insecurity when you don't have a place to live. Losing it time and time again is inherently pretty traumatic. (...) But I also think we're shortsighted (...) if we are just adamantly saying, 'No sweeps,' and not saying what should come instead."



Various cities around the country, including the Seattle area Burien, enforce stricter "anti-camping" bans, allowing more encampment sweeps and legal fines for unsheltered people. Many people and advocacy groups, including the National Health Care for the Homeless Council, point to the mounting evidence that sweeps harm people experiencing homelessness. Other groups like the National Homelessness Law Center have the campaign, "housing not handcuffs," highlighting the fact that encampment sweeps are a form of criminalizing homelessness and poverty.



This past Monday, April 22, I conducted a workshop on homelessness in a large medium-security correctional facility in a rural area of Washington. The forty-five men who attended wanted to discuss the just-opened Supreme Court case, City of Grants Pass, Oregon v. Johnson, which will decide whether laws regulating camping on public property constitute 'cruel and unusual punishment' prohibited by the Eighth Amendment. Many of the men had experienced homelessness and had family members still living on the streets. Obviously, they were in prison for other crimes, but homelessness had complicated their lives. They asked me for resources on re-entry programs for when they are released from prison to reduce their chances of becoming homeless and churning through the homelessness, jail, and prison pipeline. Through the librarians at the facility, I was able to provide some of these resources. The Central Library of Seattle Public Library has a list of re-entry services, as does the Emerald City Resource Guide from Real Change. Seattle University's Homeless Rights Advocacy Project, which advocates for legal and policy changes to prevent homeless people from entering the criminal justice system, also has a list of sources. My experience with the men at the prison made me even more grateful for the dedicated work of people like Noah Fey in providing compassionate, evidence-based housing and support services in our region.