Jones Marian Moser
University of Maryland School of Public Health.
Milbank Q. 2015 Mar;93(1):139-78. doi: 10.1111/1468-0009.12108.
POLICY POINTS: A retrospective analysis of federally funded homeless research in the 1980s serves as a case study of how politics can influence social and behavioral science research agendas today in the United States. These studies of homeless populations, the first funded by the National Institute of Mental Health, demonstrated that only about a third of the homeless population was mentally ill and that a diverse group of people experienced homelessness. This groundbreaking research program set the mold for a generation of research and policy characterizing homelessness as primarily an individual-level problem rather than a problem with the social safety net.
A decade after the nation's Skid Rows were razed, homelessness reemerged in the early 1980s as a health policy issue in the United States. While activists advocated for government-funded programs to address homelessness, officials of the Reagan administration questioned the need for a federal response to the problem. In this climate, the National Institute of Mental Health (NIMH) launched a seminal program to investigate mental illness and substance abuse among homeless individuals. This program serves as a key case study of the social and behavioral sciences' role in the policy response to homelessness and how politics has shaped the federal research agenda.
Drawing on interviews with former government officials, researchers, social activists, and others, along with archival material, news reports, scientific literature, and government publications, this article examines the emergence and impact of social and behavioral science research on homelessness.
Research sponsored by the NIMH and other federal research bodies during the 1980s produced a rough picture of mental illness and substance abuse prevalence among the US homeless population, and private foundations supported projects that looked at this group's health care needs. The Reagan administration's opposition to funding "social research," together with the lack of private-sector support for such research, meant that few studies examined the relationship between homelessness and structural factors such as housing, employment, and social services.
The NIMH's homelessness research program led to improved understanding of substance abuse and mental illness in homeless populations. Its primary research focus on behavioral disorders nevertheless unwittingly reinforced the erroneous notion that homelessness was rooted solely in individual pathology. These distortions, shaped by the Reagan administration's policies and reflecting social and behavioral scientists' long-standing tendencies to emphasize individual and cultural rather than structural aspects of poverty, fragmented homelessness research and policy in enduring ways.
政策要点:对20世纪80年代联邦政府资助的无家可归者研究进行的回顾性分析,可作为一个案例研究,以说明政治如何影响当今美国社会和行为科学研究议程。这些对无家可归者群体的研究是美国国立精神卫生研究所资助的首批研究,表明只有约三分之一的无家可归者患有精神疾病,而且经历无家可归的是一群多样化的人。这个开创性的研究项目为一代研究和政策奠定了模式,将无家可归主要描述为个人层面的问题,而非社会安全网的问题。
在美国城市中破旧街区被拆除十年后,20世纪80年代初无家可归问题再次作为一个卫生政策问题出现。当活动人士倡导政府资助项目来解决无家可归问题时,里根政府官员质疑联邦政府应对此问题的必要性。在这种氛围下,美国国立精神卫生研究所(NIMH)发起了一项开创性项目,以调查无家可归者中的精神疾病和药物滥用情况。该项目是社会和行为科学在应对无家可归问题的政策中所起作用以及政治如何塑造联邦研究议程的一个关键案例研究。
本文通过对前政府官员、研究人员、社会活动家及其他人的访谈,以及档案材料、新闻报道、科学文献和政府出版物,考察了社会和行为科学研究在无家可归问题上的出现及影响。
20世纪80年代由美国国立精神卫生研究所和其他联邦研究机构赞助的研究得出了美国无家可归者群体中精神疾病和药物滥用流行情况的大致情况,私人基金会支持了关注该群体医疗需求的项目。里根政府对资助“社会研究”的反对,以及私营部门对这类研究缺乏支持,意味着很少有研究考察无家可归与住房、就业和社会服务等结构性因素之间的关系。
美国国立精神卫生研究所的无家可归者研究项目增进了对无家可归者群体中药物滥用和精神疾病的理解。然而,其主要研究重点放在行为障碍上却无意中强化了一种错误观念,即无家可归完全源于个人病态。这些由里根政府政策塑造并反映社会和行为科学家长期以来强调贫困的个人和文化而非结构性方面倾向的扭曲,以持久的方式使无家可归研究和政策碎片化。