Robynne Rose-Haymer wants health care professionals to know that “you are a part of someone’s day that can send them on a trajectory to success and to being housed.”

Ms. Rose-Haymer shared these thoughts, as well as her personal experience of being unhoused, as part of a panel of experts at Sunday’s Fran Comi Keynote Lecture, “Providing Health Care for Unhoused Individuals.” The panel examined the logistics of working with unhoused individuals and challenged the medical community to advocate for housing policies as the most effective and urgent health care prescription for unhoused patients.

Lived Experience

Robynne Rose-Haymer is a vice president at Capital Impact, Sacramento, and serves as a member of the Lived Expertise Survival Board of the California Statewide Study of People Experiencing Homelessness (CASPEH).

Her personal experience with homelessness began as a young teen mother. Her second encounter with homelessness came after she had graduated from University of California, Davis, and faced challenges from generational poverty and the fallout of the national mortgage crisis.

Relying on friends and herself, Ms. Rose-Haymer eventually secured housing for her family.

Having worked as a housing advocate for several years, Ms. Rose-Haymer urges clinicians and other health care professionals to realize the power of empathy when encountering unhoused individuals.

“Empathy doesn’t mean you accept or agree with that person’s life, or choices, or decisions,” Ms. Rose-Haymer said. “Empathy means that you understand that they are a human being and deserving of care.

Two Questions, One Solution

Margot Kushel, MD, presented insights from her work as lead investigator of the landmark California Statewide Study of People Experiencing Homelessness.

The June 2023 statewide study revealed, among other insights, that California’s unhoused population was disproportionately Black (26 percent of the unhoused population, while only 7 percent of general statewide population) and that 41 percent of single adults who were homeless became homeless after age 50.

Dr. Kushel, professor of medicine at the University of California, San Francisco, and division chief at the Division of Health Equity and Society at Zuckerberg San Francisco General Hospital and Trauma Center, said that the best solution for the nation’s approximately 770,000 unhoused individuals has been proven by numerous studies.

“You can draw a beautiful, linear line between the availability of housing that is affordable for the lowest incomes of households in a community and the rate of homelessness in that community,” Dr. Kushel said.

For this reason, Dr. Kushel noted, “homelessness is a housing problem.”

California Case Study

Undersecretary at the California Health and Human Services Agency, Corrin Buchanan, said she agreed with Dr. Kushel’s assertion and added another important lesson that she learned from her work providing state services for housing.

“The data is clear: Housing programs are health care,” said Ms. Buchanan.

Ms. Buchanan said affordable housing and supportive social services have been proven to lead to permanent housing when backed by political will and leadership, citing innovative state programs during the COVID-19 pandemic that created 16,000 units of interim housing.

Dr. Kushel noted that with such clear evidence, health care providers should use their positions and respect “to stand up and say that homelessness is a housing problem, that there is no medicine as powerful as housing.”

She added that this advocacy should be continued even if it is personally difficult to treat unhoused individuals.

“Many of you, particularly those working in ICU or in a hospital, are going to see a disproportionate number of people experiencing homelessness,” said Dr. Kushel. “You might see someone in crisis from their substance abuse or mental health disorder and their decisions or behaviors may make no sense to you. It is important to remember that these people have been deeply traumatized.”

While these patient interactions might require more personalized and extensive care on the part of the provider, they can also lead to an outsized impact for the patient, Ms. Rose-Haymer concluded.

“You have absolutely no idea what kind of hell someone might have had to go through to see you. It is probably one of the worst moments of their life,” she said. “So, you have a challenge: How do you show up as your best self while the person you are with is showing up as their worst self? It takes a superhuman effort on your part. And if no one ever acknowledges this to you after this day, please remember that I said, ‘Thank you.’”