Steve Jobs attained unprecedented success in business thanks to his holistic approach to innovation. Therefore a holistic approach to homelessness will produce unprecedented results that are beneficial to all. The way we relate to one another is instrumental to our well-being and survival. So we must join forces and work together to reduce and/or end homelessness. Many argue that holistic strategy (i.e. holistic approach to business) sounds abstract - but the chronic silo mentality in organizations reduces efficiency and contributes to more failure than success in the long run. Moreover, I believe that business must encompass the human experience since it is run by humans for humans. As Plato puts it: “The Part Can Never Be Well Unless the Whole is Well."

1. Yves Augustin
Holistic Strategist

2. Table of Contents
 Who are the Homeless?
 Becoming Invisible
 Surviving the Streets
 Healthcare Cost
 San Francisco’s Ten-Year Plan
 The Big Picture
 Holistic System of Care
 My Holistic Care Approach
 Lessons Learned
 Human Interconnectedness

3. Who are the Homeless?
 Primary homelessness: they are rough sleepers
 Secondary homelessness: they stay in shelters,
refuges or with relatives
 Tertiary homelessness: e.g., they stay at boarding
houses, SROs, motels, hotels (Butterfield, 1999)

4. Who are the Homeless, cont.
 Around 580,000 and
800,000 people are
considered homeless in the
U.S. - while there are about
18 million vacant homes
around the country.
 For every homeless person
in U.S., there are between
20 and 24 vacant homes
(Gibson, 2015).
 Across Europe, 400,000
individuals are homeless
on any given night – and
the numbers continue to
rise (Hwang & Burns,
2014).
 Around 150,000 people are
considered homeless in
France - while there are
about 2 million vacant
properties around the
country (McPartland,
2014).

5. Who are the Homeless, cont.

6. Becoming Invisible
 Homeless people are
de-humanized and
become invisible to
the point we are
unable to even notice
our own family
members if they are
living on the streets.

7. Becoming Invisible, cont.

8. Surviving the Streets
 Addiction treatment studies
are one popular option
among homeless people to
survive on the streets.
 Many take drugs just so they
can qualify for those studies –
which are for psychiatric
drugs: antipsychotics,
antidepressants, anxiety
drugs, and stimulants.
 Drug study recruiters often
park outside shelters and
approach residents on
sidewalks.
 Volunteers are typically paid
$40 to $50 per visit.

9. Surviving the Streets, cont.
 Homeless Man #1: “I used to take Risperdal. That drug will
turn you into a zombie. I couldn’t sit up without falling
asleep.”
 Homeless Man # 2: “I was on Depakote and I almost killed
someone out of anger. It made me a wrecking machine.”
 Homeless Man #3: “I only do schizophrenic research
studies, even though I’m schizophrenic and bipolar…I tried
to do the one for severe patients but they wouldn’t let me
in. You have to hear voices every day of the week, and I only
hear once or twice a month.”
 Shelter Program Supervisor: “These guys have no job, no
home, and a habit. You have people at their lowest state,
and they’ll say yes to anything.”

10. Surviving the Streets, cont.
 In 2007, Bristol Myers Squibb settled federal charges
over the illegal marketing of Abilify.
 In 2009, Eli Lilly pled guilty to criminal & civil charges,
and paid a $1.4 billion penalty for illegal marketing of
Zyprexa.
 Large settlements or penalties against AstraZeneca (for
Seroquel), Pfizer (Geodon) came later.
 In 2013, Johnson & Johnson paid $2.2 billion for
illegally marketing Risperdal (Elliott, 2014).

11. Surviving the Streets, cont.
 Homeless people are the sickest in our
society:
 Their rates of tuberculosis infection are at
least 20 times higher than the general
population.
 Their rates of depression and psychosis
are up to seven times higher in the
homeless population than the general
population.
 They are also 2 to 5 times more likely to
die prematurely than the general
population.
 They are old decades before the rest of
the population because of their poor
health (Hwang & Burns, 2014).

12. Surviving the Streets, cont.
 Consequences of Homelessness include:
difficulty recuperating from illness
exposure to gratuitous violence, theft of possessions
social isolation, malnutrition
exposure to extremes of weather
low self esteem, poverty and poor continuity of
needed health care
mental illness: from distress to disorders

13. Surviving the Streets, cont.

14. Healthcare Cost
 Homeless individuals make about 1 million hospital visits
per year in US, which is the equivalent of $6.7 billion in
‘unnecessary’ health care expenditures, according to the
federal Agency for Healthcare Research and Quality
(Pearson, 2012).
 In the UK, homeless people are around four times more
likely to use emergency hospital services than the general
population, costing the National Health Service around
£85 million a year (Hwang & Burns, 2014).
 Repeated emergency room visits and nights in jail by that
chronically homeless people in US cost around $30,000 to
$50,000 per person, per year – approximately $3 billion
annually (Gibson, 2015).

15. Healthcare Cost, cont.
 San Francisco Fire Dept. reports that 201 frequent
fliers, use an ambulance 4 or more times in 1 year;
50 of those use the service 10 or more times and
about 20 have taken ambulance rides between 30
and 120 times.
 Alameda County officials report: 82 frequent
users who rode in an ambulance 11 times or more
in 1 year. The top frequent flier used the service 73
times (Noyes, 2012).

16. San Francisco’s Ten Year Plan
 In 2004, San Francisco
launched an ambitious
effort to end chronic
homelessness.
 In 2014, this 10-year effort
has had limited successes
and many failures at
moving people off the
streets (Knight, 2014).

17. San Francisco’s Ten Year Plan, cont.
 SF homeless population is
up 3% since 2005.
 In 2004, SF had 1,910 shelter
beds, and now it has 1,145. It
has half the drop-in centers
for homeless people during
the day than it did 10 years
ago.
 SF has about 74 shelter
spaces for families. There is a
6-month wait to secure one
of them. Currently, about
200 families are on the
waiting list(Knight, 2014).

18. San Francisco’s Ten Year Plan, cont.
 From 2004 t0 2014, SF spent roughly $1.5 billion to
move around 19,500 homeless people off its streets.
But the homeless population hasn't budged, showing
that as one homeless person is helped, another takes
his place.
 SF spends $165 million a year on homeless services,
about half of which funds supportive housing. That's
one of the highest levels of per-capita spending on
homelessness of any American city (Knight, 2014).

19. The Big Picture  “A lot of people in our
industry haven't had very
diverse experiences. So
they don't have enough
dots to connect, and they
end up with very linear
solutions without a broad
perspective on the
problem. The broader
one's understanding of the
human experience, the
better design we will have.”
~Steve Jobs

20. The Big Picture, cont.
 Steve Jobs attained
unprecedented success
in business thanks to his
holistic approach to
innovation.
 A holistic approach to
homelessness will
produce unprecedented
results that are beneficial
to all.

21. The Big Picture, cont.
 The more you understand
the big picture, the more
you can use your personal
journey in your healing
process and/or to inspire
others.
 Australian motivational
speaker, Nick Vujicic ,
shares his journey of
hardships with a young
audience.

22. The Big Picture, cont.

23. The Big Picture, cont.
 The relationship
(between client &
service provider) also
involves sharing
vulnerability to create
safety and foster
personal connection.
 Brené Brown’s talk :
The power of
vulnerability.

24. The Big Picture, cont.

25. Holistic System of Care
 Holistic medicine practitioners believe that
the whole person is made up of
interdependent parts (body, mind, spirit, and
emotions) and if one part is not working
properly, all the other parts will be affected.
 “The Part Can Never Be Well Unless the Whole
is Well” ~Plato

26. Holistic System of Care, cont.
 Holistic System of Care
provides behavioral
health care, promotes
health, and prevents
disease.
 The holistic model
links treatment,
prevention, and
recovery.

27. Holistic System of Care, cont.
 Well-being refers to the medical, social, economic,
psychological, spiritual and/or environmental
state of an individual or group.
 High well-being means that, in some sense, the
individual or group's experience is positive, while
low well-being is associated with negative
happenings.
 Healing is related to wholeness, and wholeness is
experienced in connection with others.

28. Holistic System of Care, cont.
 “Holistic System of
Care: a ten-year
perspective” – a
published report by
Nebelkopf and
Wright in 2011.

29. Holistic System of Care, cont.
 490 adult substances abusers enrolled in this series
of studies from 2003-2008
 24% reported using alcohol or drugs in the prior 30
days at baseline – but 5 % decline 6 months later
 A decreasing rate of change from 47% to 23%
regarding experiences with stress, emotions,
depression, etc.

30. Holistic System of Care, cont.
 14 Social Determinants of
Health were determined at
York University Conference
in Toronto (Canada) in
2002.
1. aboriginal status
2. disability
3. early life
4. education
5. employment & working
conditions
6. food insecurity
7. health services
8. gender
9. housing
10. income & income distribution
11. race
12. social exclusion
13. social safety net
14. employment & job security

31. Holistic System of Care, cont.
 Immigration and
language barrier
must be added as
the 15th social
determinant of
health.
 Past and present
trauma are
inextricably linked.

32. My Holistic Care Approach
 I worked for a supportive housing program in
Berkeley-Oakland area (CA) from 2009 t0 2011.
 13 clients were enrolled. Twelve had around 5-10
years of chronic homelessness. The 13th client was
homeless for over 30 years.
 I developed and managed holistic education
projects to provide all clients with necessary life
skills, restore self-sufficiency, and foster social
reintegration.

33. My Holistic Care Approach, cont.
 12 clients kept their housing
during my 2 years of
employment despite ongoing
challenges: depression, anger,
alcohol & drug abuse,
eviction threats from
landlords, etc.
 Their frequent trips to the ER
and jail, prior to being
housed, were reduced
significantly from 10 times or
more per year to 3-4 times per
year.

34. My Holistic Care Approach, cont.
 13th client was Roland
Bacon – a 78-year-old
blind homeless man in the
Oakland-Berkeley for over
30 years.
 I placed him in a nursing
home 1 year after initial
contact. He died 3 months
later after he was placed
(picture on the right).

35. My Holistic Care Approach, cont.
 Many former homeless individuals, who live in
supportive housing, do not find those programs as
much supportive as they should be. As a result, their
housing becomes instantly in jeopardy.
 In 2007, a federal study reported that 80 to 85 percent
retention rates on average (Bridegam , 2007).
 The real question is: why did 15 to 20 percent fail to
keep their housing???

36. My Holistic Care Approach, cont.
 My holistic care approach
was successful thanks to
my combined ability to
both identify and meet the
multiple needs of each
client, such as: physical,
mental, social, financial,
educational, cultural,
emotional, recreational,
vocational, spiritual, etc.

37. Holistic Care Approach, cont.
 My holistic model
integrates primary care,
mental health, housing,
education, employment,
life skills education, life
coaching, community
building, art therapy,
animal-assisted therapy,
cultural competency,
spirituality, etc.

38. Lessons Learned
 Each of us needs a support
support system that
corresponds to the various
dimensions of our human
experience.
 Without a support system,
our development and
survival are in serious
danger.
 Our human expereince is
everything but linear –
although our social
programming keeps
teaching us the contrary.

39. Lessons Learned, cont.
 Questioning our social
programming is both a
right and a duty.
 The relationship “teacher-
student” is neither linear
nor one-way. It is always
present in every single of
our intereactions with
others. In reality, we play
both roles all the time,
even when we are not
aware of it.
 Failure teaches success
(Japanese proverb).

40. Lessons Learned, cont.

41. Human Interconnectedness
 Homelessness is a human problem , which
requires human-centered solutions.
 Key ingredients of my holistic care approach:
acceptance, compassion, commitment ,
consistency, empathy, faith, honesty, hope,
kindness and trust.
 My holistic care approach enables my clients
and me to see each other first as humans in
order to leverage our human
interconnectedness - despite our differences in
race, gender, age, creed, class, national origins,
sexual orientation, etc.

42. Human Interconnectedness, cont.

43. Human Interconnectedness, cont.
 giveer@yahoo.com
 https://www.linkedin.com/pub/
yves-augustin/1b/995/502