In recent years, discussion about homelessness has been circumscribed around a set of premises acceptable to progressive opinion. The homeless were thrown onto the streets, we’re told, because of rising rents, heartless landlords, and a lack of economic opportunity. Activists, journalists, and political leaders have perpetuated this line of reasoning and, following it to its conclusion, have proposed investing billions in subsidized housing to solve homelessness.

But new data are undermining this narrative. As residents of West Coast cities witness the disorder associated with homeless encampments, they have found it harder to accept the progressive consensus—especially in the context of the coronavirus epidemic, which has all Americans worried about contagion. An emerging body of evidence confirms what people see plainly on the streets: homelessness is deeply connected to addiction, mental illness, and crime.

Homeless advocates argue that substance abuse is a small contributor to the problem, and that no more than 20 percent of the homeless population abuses drugs. Last year, when I suggested that homelessness is primarily an addiction crisis—citing Seattle and King County data that suggested half of homeless individuals suffered from opioid addiction—activists denounced me on social media and wrote letters to the editor demanding a retraction. But according to a recent Los Angeles Times investigation, 46 percent of the homeless and 75 percent of the unsheltered homeless have a substance-abuse disorder—more than three times higher than official estimates from the Los Angeles Homeless Services Authority.

In the interest of preventing “stigmatization,” progressives downplay the connection between schizophrenia, severe bipolar disorder, and homelessness. In general, cities have claimed that roughly 25 percent to 39 percent of the homeless suffer from mental-health disorders. As new data from the California Policy Lab show, it’s likely that 50 percent of the homeless and 78 percent of the unsheltered homeless have a serious mental health condition. For residents of cities like San Francisco, Portland, and Seattle, this should come as no surprise. The people smashing up property and yelling in the streets are clearly suffering from mental illness. The numbers confirm the ground-level reality.

The relationship between homelessness and crime has been the strongest taboo in the public discourse. Activists and political leaders insist that the homeless are ordinary neighbors who commit crimes at rates comparable with that of the general population. Not so: according to new data from the Downtown Seattle Association, the homeless represent 45 percent of all bookings into the King County Jail system, which means that homeless individuals are nearly 100 times more likely to commit crimes and get booked into jail than the average citizen. Public fears about homeless encampments are not a symptom of “mean-world syndrome,” as some commentators suggest, then, but a rational response to the increased probability of crime.

Residents in the most progressive enclaves of West Coast cities have quietly begun to demand policy changes to address the obvious causes of the homelessness crisis. In San Francisco, city leaders have launched a new initiative to focus on the 4,000 individuals who suffer from the “perilous trifecta” of homelessness, addiction, and mental illness. Mayor London Breed has spoken frankly about the human causes of homelessness, and Anton Nigusse Bland, a physician and director of mental health reform for the city, has pledged to “develop a strategic approach to mental health and substance use services for people experiencing homelessness in San Francisco.”

This is a small but promising step. Especially now, with the threat of an infectious disease becoming a national crisis, it is imperative that city leaders come to grips with the dangers of letting people live in encampments that lack even rudimentary sanitation. We can only hope that this new awareness extends to other cities. For now, more than 100,000 people in California, Oregon, and Washington continue to languish in the streets.

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