Many of them won't accept help and can be difficult or impossible to work with.
I had a rough adolescence and young adulthood. Whenever I was sharing a house or apartment I was that strange roommate. At times I lived in my car. For about a year I lived in the garden shed of a Vietnam war vet who mostly left me alone. I did not leave on good terms with him. I was really good at burning all my bridges and hurting anyone who tried to help me.
People frequently thought I was on drugs -- that's always the first thing they asked me, and the first thing they tested for -- whenever I ended up in the emergency room or, if I was enrolled in school, the student health center. I wasn't.
When my mind goes sideways the first thing that flies out the window is my ability to judge my own mental state.
In college I had a really bad psychotic break caused by one of my prescribed meds. My English professor noticed when I turned in a paper that was completely deranged, even for me, so she pulled me aside after class and walked me to the student health center. The staff there eventually sorted it out, but not before the usual interrogations and tests for drug abuse. I'm not sure what would have happened to me if my professor hadn't pulled me aside. I had a working car so I could have ended up anywhere. I might not have come back to finish the school term.
One of my grandmothers was crazy. She was able to hold it together at work, and retired with a pension, but outside of work she was a mess. She self-medicated with cigarettes and alcohol. Retirement did not go well for her. She eventually had to be removed from the home she owned as a danger to herself and others. She could be sweet, and she could be mean, even violent. No nursing home or assisted living place would tolerate her for long so she'd live with my parents. That was awful.
I'm a quarter crazy as my grandma, maybe more. My grandma was basically a bag lady who didn't happen to be homeless. She was lucky. Many people are not so lucky. They don't have any social safety net to catch them when they fall. They've burned through family and friends and there's nothing left.
Part of the problem is we expect people to be grateful when we help them. I was rarely grateful to anyone who tried to help me until my mind was back on track but by then it was usually too late. Those bridges had already been burnt.
Dealing with the homeless problem isn't going to be easy or cheap and it's going to require some muscle. But for now we are dealing with the problem in horribly inhumane and very expensive ways. Emergency rooms, cops, jails, and prison cells are expensive. Homelessness causes public health problems for everyone.
Once we get homeless people into stable living situations, in safe comfortable housing, then we can address the mental health and/or addiction issues that made them homeless. And we have to be realistic about our definitions of "success." Many people are never going to be employable, may never even be grateful, but housing, healthy food, appropriate medical care, and some level of supervision will keep them out of trouble.
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