I can't tell you how they landed in the situation they are in, but I can safely say that 9/10 appear (and I'm not a doctor, so I can't obviously say for certain) to have at minimum a substance abuse issue, which could be masking or exacerbating a mental health disorder. As such, I choose not to give cash to any of the homeless near my home and only ever give food. Having seen first hand with my father and step-mother the pull of substance abuse, I'd rather know any donation I give helps them sustain life, not speed up their demise.
All that being said, I constantly struggle with what is the right moral thing for us to do as a collective society about homelessness. On the one hand, these are cognitive human beings who have a right to self-determination. On the other hand, their self-determination comes with the detriment of my neighborhood. I get harassed a few times a week, mostly just yelling incoherently at me, but sometimes following me. I've had garbage thrown at me as I walked past an encampment. And, I've had my dog come up limping a few times from shattered glass that gets up into her paws.
To me, every community in LA, whether you're in the richest part of Beverly Hills, or the Watts housing projects, deserves clean & safe streets. I'm unconvinced that we can have that while we allow people to live arbitrarily on them day in and day out.
So, what do we do?
[1] We shouldn't send these people to jail, as incarceration is just a revolving door of negative reinforcement.
[2] We should detain individuals indefinitely in mental health and substance abuse facilities, and give those facilities the time it takes to start the process of recovery and treatment (we're talking months, not days or even weeks).
[3] We should provide indefinite housing & treatment for those who are unable to take that next step and fully re-enter society and take care of themselves.
[4] We should repeat the cycle as many times as necessary, given that we know substance abuse relapses are common, and going off medication for those who are mentally ill is a common issue as well.
This is expensive. This is complicated. And, in many states, this wouldn't be legal. We've decided that humans have the right to self-determination (which is a good thing), but we've lost sight of the fact that when a human being is in the grips of an addiction or mental health disorder, they have already lost control. The addiction is what is now determining their behavior, not their own personal choice.
When I tried to get my father hospitalized in 2015 during the final days of his alcohol addiction, he was unable to walk, rarely ate, and spent the entirety of his day in bed drinking. We were finally able to get the local sheriff to pink slip him (72 hour hold) at a hospital in Columbus, where they kept him alive while the alcohol left his system. It took 10 days for the hospital to choose to release him because of how poor his health was, and their primary recommendation was that he go into a nursing home (for context, he was 61 at the time). While he initially refused, we convinced him to give it a try, but that lasted only 48 hours before he returned back home.
Once home, he was able resume his drinking, and was dead 5 months later. Less than three years later, my step-mother would be dead as well from the same issues.
In neither case did I, or the state, have any legal authority to get him into real rehabilitative care. Lawyers reaffirmed that even given his diminishing cognitive state, Ohio's laws made it clear that he had a right to drink himself to drink himself to death. I contend that his addiction was the one making that choice, not him, and that our laws are enabling addiction, rather than defending independence.
While my father was not homeless, that was just a byproduct of his early good fortune. If he had come from lessor means, he would have been on the street for years and potentially died more rapidly. In both cases, the state would have (and did) protected his right to be homeless and drink himself to death.
I recognize how reasonable people can disagree heavily on this topic. I recognize how I very well may be wrong (massively wrong) in my vantage point. However, I can tell you that whatever we are doing as a society right now is not working, and it feels worth trying something new at this point.