Vikki Vickers says she became homeless after her schizophrenia medication stopped working, sleeping on the streets of Santa Monica for four and a half years.

“Not realizing what was happening, I became paranoid, and I ran away from everyone I’d ever known,” she told reporters this morning at Los Angeles’s Downtown Women’s Center. “For me, homelessness was hopelessness.”

Vickers eventually found housing at the center and now works as a member of the staff. A new report released by the Women’s Center, written in collaboration with researchers at the University of Southern California, highlights the struggles faced by women like Vickers who experience homelessness in Los Angeles.

“Living on the streets in Los Angeles is dangerous and traumatic,” says Downtown Women’s Center incoming CEO Amy Turk. She explains that trauma can have profound psychological effects on homeless residents that make it difficult to find longterm housing.

“Imagine if you experienced childhood trauma, domestic violence, or the trauma of street-living and when you came to get help you weren’t treated with compassion,” she says. “How in the world could you take advantage of services intended to help?”

Just under one-third of the nearly 60,000 homeless residents in Los Angeles County are women, but the report makes the case for a “crisis within a crisis” affecting homeless women in particular.

Drawing from surveys of more than 300 women, the report finds that 60 percent experienced violence in the last year, with more than 25 percent experiencing it “often” or “always.” More than one in four were sexually assaulted in the last year, and nearly 10 percent reported human trafficking experiences in their lifetimes.

This can become a vicious cycle. As the report notes, “a lack of stable housing also increases women’s vulnerability to violence.”

Nearly 75 percent of those surveyed in the report slept on the streets for at least some of the last year. Just over half spent time in an emergency shelter, though roughly one quarter reported disrespectful staff, uncomfortable living spaces, or bedbugs.

The report represents the latest in a series of “needs assessments” on women experiencing homelessness conducted periodically since 2001. But the new document draws on surveys from women across the Los Angeles area; previous surveys had been confined to the Downtown area.

Los Angeles County Supervisor Hilda Solis called it a “great road map” to identifying the specific needs of homeless women in particular.

“The picture isn’t as rosy as we would like,” Solis acknowledged. “We have to face this up front. We have to take responsibility.”

The report outlines several steps for how local officials and community members might do that—including financial support for new supportive housing construction and rental assistance.

It also points to the need for “safe spaces” for those without shelter and makes the case that sanitation “sweeps” and criminalization of “‘quality of life’ crimes” like sleeping on the sidewalk are counterproductive.

Turk stresses that it’s important for service providers and others who regularly interact with homeless women to be aware of the effects of trauma on homeless women in particular. For six years, she says, the Women’s Center has been training people on trauma-informed practices to ensure “better outcomes” for homeless women.

”We see things through the lens not of what’s wrong with you but what happened to you,” she says.