Homeless Identity Issues Overseas
Japan- "No Identity" leaves homeless with less than nothing
In the United States, the emergency room experience our homeless individuals encounter is influenced by a great variety of factors including their lack of accurate identification. When speaking in terms of culture, the United States and Japan are vastly different. That said, when considering approaches to create more equal healthcare for homeless in either country, a lack of identity links these human experiences and bridges the cultural divide. Homeless in Japan seek to hide their identities - through influences of a different kind.
Homeless individuals have already suffered so much loss. They have very little to call their own. In Japan, the influence of culture is so strong that many homeless who are offered financial assistance and an improved life will decline the opportunity due to internalized pressures they feel.
In Japanese culture, those who are homeless are not pitied or offered a hand; they are harshly judged to be lazy and unable to care for themselves. They are covered in shame as individuals and they bring shame to the collectivist culture of the country. The families of homeless individuals are judged as harshly.
In the United States, homeless individuals who live on the street are legally able to assimilate and are not outwardly chastised for their status. In Japan however, it is common for homeless to expend great effort during the day attempting to blend into the crowd. They do this in order to fool the general population into believing they are average working class people. At night, they hide within the shelters they have constructed under bridges so they are not spotted. The effort homeless need to put into hiding their identities strips them of self and removes hope of ever emerging from their circumstance.
"In August 2002, pressure from various campaign groups led to the enactment of the Special Act in Regards to Supporting the Autonomy of the Homeless Population. This marked the first time government had acknowledged its responsibility to help local authorities deal with the homeless. The legislation guaranteed assistance in seeking employment, finding public or private housing and accessing medical facilities for people who were wiling to work."* Because the deeper issue of shame which causes homeless to hide their identities was not addressed as the root of the problem, this governmental effort fell into a vicious cycle. The legislation spoke of "dealing with" the homeless, not helping them overcome their shame and restoring their freedom of identity.
Under the program, individuals are eligible to receive monetary aid, housing and access to medical facilities. To register for the program, an individual must file a report with the government stating that they are homeless. After registering, the next step toward qualifying for federal aid requires the government to conduct a search for any family members or friends who are financially able to support them. If any are found, the individual would receive no aid. The government says nothing of whether such people would agree to help - only that they are "able". Through such a search, an individual would become exposed to further public shame and bring shame upon the people they are hiding from.
As in the United States, homeless people feel motivated to hide their identities, and the first step toward creating an improved life for them lies in addressing their shame and fear. In Japan, homeless individuals intentionally forego their opportunity to receive aid because they will endure anything in order to avoid burdening their relatives or disgracing their own name or those who know them personally. Not only do they forgo aid, they surrender their own identities for life. The very few who know they have no family or friends to disgrace and thereby decide to enroll are still eventually failed by the system. They are placed into group housing which most find so uncomfortable that they abandon the program altogether.
Fingerprinting homeless in Japan and referring to them through Medical Record Number rather than given name could become a better first step. Accounting for these individuals though record number would allow them to maintain the anonymity they desire. The Japanese government becomes colored by shame simply by acknowledging that homeless exist within their culture. It isn't impossible that they have created a system which is intentionally set up to fail so that they don't have to admit that homeless people exist at all. If the shame of homeless becoming exposed is part of the plan, then they must realize homeless individuals will carry on trying to camouflage themselves during the day and hiding themselves at night. By this right, Japan could pretend its own circumstances are other than they actually are as well and save themselves the burden of financial responsibility at the same time. It is Japan's burden to acknowledge its own imperfection and accept its own true identity in order to provide aid and repair what it perceives to be imperfect.
In both the United States and Japan, homeless individuals seek to hide their identities. This singular behavior leads to unequal healthcare and invites dangerous risk into homeless people's lives.
* The Japan Times- March 2, 2019
Norway's 36% decline in homelessness over 4 years Overlaps The Pledge and Proposed Solution of This Site
In 2012 the number of Norwegian homeless individuals was 6,259 and in 2016 the number of homeless in Norway reduced to 3,909; this shows a 36% decline over a short period of time. "The most important explanation for the sharp decline is long-term and broad focus on residential social work and the opportunity for homeless to play an active role in choosing where they want to live." * In 2012 a dozen municipalities in Norway tried out an approach to housing homeless individuals. They "based their model upon an American one which placed primary focus on the establishment of trust and stability in a homeless person's life". *
In Norway, when a homeless client of the health and welfare system enters into the housing system, they are first engaged by outreach initiatives run by Assertive Community Treatment Teams (ACT). These teams lack psychiatrists or doctors; most of the teams are comprised of social workers, authorized social educators, nurses and milieu therapists (Milieu therapy involves the use of therapeutic communities where people are encouraged to take responsibility for themselves and others). The Norwegian research institute FAFO found that "a criterion for success appears to be whether a multidisciplinary team is on hand, working closely with the participants, creating ongoing trust and guidance. In addition, homeless persons being given the opportunity to decide where they want to live gives them pride and a greater feeling of responsibility regarding taking care of their dwelling." ** Homeless individuals actually attend viewings of available flats and can choose among several nice apartments. These flats are placed within normal quiet communities and most tenants who receive them have never lived with as much calm and respect surrounding their life. One such example spoken of in Trondheim Norway was "a veteran heroin addict whose biography included years behind bars and moving from place to place on the streets.... This man was piloted by social workers through suitable channels of help and treatment. He experienced trust, was provided essential care and choices". **
The failed system in Japan entirely overlooks and intentionally avoids respect, care and the positive assimilation of homeless into the culture. The success of the Norwegian model greatly reflects The Pledge and Proposed Solution of this website.
*Housing first for Homeless in Norway - www.sciencenorway.no
** FAFO Researcher Mette I. Snertingdal