I've gone quiet for a while, since I'm finalizing my manuscript and the artwork for my book, "The Lost Subways of North America", which, God willing, will come out next year.
TL;DR: I've been traveling the country doing research for my book, and the low levels of homelessness in poor places with badly-funded mental health systems is shocking.
One of the things that's hit me most about traveling the country for my research is just how little of a connection there is between poverty and homelessness. Places like Detroit and West Virginia are dirt poor. If you drive around the city of Detroit on surface streets, you'll find that once you leave the city core you'll find entire blocks which have reverted to wilderness. West Virginia is beautiful but desperately poor - there, I noticed gas stations advertising that you can buy Gatorade with food stamps. We're definitely not in Los Angeles anymore.
The government doesn't generally work too well in places like this, and struggles to provide basic services. Detroit has made the choice to largely abandon its outer neighborhoods, and to allow them to empty out organically, because it no longer has the tax base to provide basic services. Detroit's one of the poorest, most dangerous cities in the United States, with a murder rate five and a half times that of Los Angeles. As for West Virginia, the state is synonymous with rural poverty and the opioid crisis. The richest county in West Virginia has the same median family income as middle-class, suburban Tustin in California.
These aren't places with well-developed social safety nets. These aren't fabulously wealthy world cities with tons of jobs, either. Compared to LA, the money just isn't there for that. But what you're not going to find in these places is a lot of homeless. I saw the figures before I went on my trip, but I wasn't prepared viscerally to see it. Because I expect to see panhandlers on the streets. I expect to see shopping carts filled with people's entire lives. As a Californian, it's something I grew up with - it was a fact of life, like palm trees and tamales.
The thing is, it doesn't have to be normal, because mental issues and homelessness really don't have to go hand in hand. Detroit and West Virginia have no shortage of schizophrenics, drug addicts, and alcoholics, and the government's far stingier in terms of the public services they provide. In some ways, the mental health crisis is worse, because there isn't the government funding to deal with the problem.
So what's the difference between LA, Detroit, and West Virginia? Why does wealthy LA, with its enormous social safety net, have a homelessness crisis, while poor, underfunded places like Detroit and West Virginia don't have them?
Well, it's simple: in LA, the rent is too damn high.
And why is the rent too damn high? Well, I've discussed this issue at length elsewhere, but one of the biggest reasons is that LA just doesn't build enough housing to match how many jobs it adds. Over the last ten years, greater LA has added 2.03 new jobs for every new home it builds, and people gotta live somewhere. Making matters worse, a disproportionate amount of housing has been built in places which aren't close to mass transit or jobs. Not enough housing near the office towers of the West Side, but there's a ton in exurban Riverside County, two hours away.
In contrast, places like Detroit and West Virginia have plenty of cheap housing. Partly, this is because of poverty. The average 1-br apartment in Detroit costs $1,020 a month. In Morgantown, WV, it's $700, and Morgantown is one of the most prosperous cities in West Virginia. But because these places are relatively poor, they've also got extremely loose development laws. (For example, in Detroit, if you want to open a bar on your front porch, the City will figure out a way to get you a permit. Good luck doing that in any LA residential neighborhood.) This means that it's relatively straightforward to build new things and the supply of new housing largely meets the demand.
Having enough housing won't solve a mental health crisis, but it's really good at solving a housing crisis. That's the point of all this: we in rich coastal cities like LA, we assume that homelessness has to go hand in hand with mental health and substance abuse issues. But they're not the same problem. The two problems make each other worse - it's a hell of a lot harder to treat an addiction or a mental disease if you're on the street. But if you have enough housing, full stop, they don't have to be part of the same problem.