Police crackdown in Kensington won’t help people dealing with homelessness, substance use

“They’re after me,” she confessed. It was a sentiment not uncommon here in the inpatient psychiatric unit in West Philadelphia where I rotated as a medical student, usually in reference to spying neighbors, spouses who had turned evil, the Mafia, or even aliens.

Tears streamed down her face as she continued talking to me: “They push me out of the shelters each day. They push me off the benches each night. I wake up to their bright lights in my eyes and my things thrown all over the ground.”

The “they” in her story, of course, were police. “Why can’t they just leave me alone?” she asked me.

I didn’t have an answer for her.

This month, the U.S. Supreme Court will rule on the case of Johnson v. Grants Pass, considered the most important case about the rights of unhoused people in four decades. It will decide whether people can be punished for sleeping in public, including in cities like Philadelphia, which has struggled to provide adequate and supportive shelter for people experiencing homelessness.

Already in Philadelphia, the city is planning to triple the number of police in Kensington this week. But based on what I’ve seen, criminalization doesn’t help. Especially not for people struggling with homelessness or substance use.

» READ MORE: Current plans to ‘fix’ Kensington won’t work. Here is what will. | Opinion

Mainstream discourse about homelessness has long been mired in the specter of violent crime and unhinged personalities. At the double-locked psychiatric facility in West Philadelphia where I began my medical training, most of the unit’s patients — grappling with clinical psychosis, housing instability, and substance use — were exactly those sensationalized on the news and feared by the public.

I remember the safety instructions racing through my mind on my first morning: Don’t back yourself into the corner of any room. Don’t wear anything you could be strangled in, like a tie or a lanyard.

But I quickly felt at ease once the patients and I began talking. They told me about family photo albums, nostalgic horror movies, and pets they needed to get back to. Sometimes, I’d get cussed out in a rage — it stung but didn’t mean I was in danger.

On the contrary, I began to learn more about the dangers my unhoused patients faced while living on the street.

Across the unit, people shared stories about random assaults and aggressive police confiscations, consistent with research that unhoused people are more likely to experience violence than perpetuate it. They told me about tragic psychiatric episodes and opioid overdoses when they could not access important medical and social resources while unsheltered.

I heard about how incarceration ripped people from their lives and forced them to start over again when they got out, disrupting whatever tenuous progress they had made, social connections they had, and limited resources they could access.

When you add constant displacement, sleep deprivation, and contempt from passersby, it is no wonder this systemic discrimination blurred into the paranoid persecution that brought people to the hospital in their lowest moments.

“They’re after me,” I heard again and again. And they were right. Society — in the form of police, punitive policies, and defunded social safety nets — was after unhoused people. Their visibility on the street — just their existence, in the absence of another sustainable place to go — was the crime.

‘They’re after me,’ I heard again and again.

Motivated by what I’ve seen, I’m now part of one of the many street medicine teams across the city that aim to provide health-care services where people are — on street corners, in local parks, and under bridges. Our work is supported by a local nonprofit, Bridge Beyond.

And I’m worried.

Along with the impending Supreme Court decision, Philadelphia has made some recent choices that suggest homelessness may be criminalized more than before. Last month, Mayor Cherelle L. Parker began her campaign to dismantle homeless encampments in Kensington, offering a choice between coerced treatment — which does not work — or forced relocation. Eventually, the plan for the additional police being sent to Kensington is to clear the neighborhood and make arrests for low-level crimes, all in the name of public health and safety.

I’m not denying the reality of violence, but my experiences have challenged me to ask if anyone’s safer when we punish individuals for struggling with homelessness and substance use, which are the consequences of systemic injustices, yet leave the root causes of those injustices unresolved.

Instead, we should invest in nonpunitive systems of care, namely resources for substance use, mental health, housing, and other case management services that can ultimately bridge people to lasting support.

We’re not doing nearly enough of this. It’s hard to imagine an effective substance use treatment center after Philadelphia has cut $1 million in funding for evidence-based harm reduction strategies such as syringe exchanges. These strategies have proven for decades to reduce overdose, long-term substance use, and community presence of needles without increasing nearby crime.

To expand affordable housing with supportive services, the city should consider innovative models like Housing First, which works to provide permanent housing without requiring participants to remain sober or engage in treatment for substance use and has reduced homelessness by almost 90% compared with traditional programs in other major U.S. cities.

Even if Johnson v. Grants Pass is overturned, what I’ve learned is that homelessness will not be solved by “sweeping” or “clearing” people like dirt. We need to care for our neighbors as human beings.

Tyler Lian is a rising fourth-year medical student at the University of Pennsylvania Perelman School of Medicine, where he walks with the Homeless Outreach Project. He is also a member of the Street Medicine Institute Student Coalition.