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The Intersection of Trauma and Homelessness []


By Michelle Schneidermann, Photo: Jessica Brandi Lifland, California Health Care Foundation, September 15, 2023

While working as a physician at San Francisco General Hospital several years ago, I met a young woman I’ll call Kacey. At just 28 years old, Kacey had been admitted with congestive heart failure, which was probably caused by methamphetamine use. It was far too serious an illness for someone so young.

Kacey was experiencing homelessness at the time. She had a reputation among the medical staff for being “noncompliant,” and angered doctors whenever she would leave the hospital against medical advice.

I met Kacey during her fifth admission over a two-month period. As I got to know her, I learned that she was a survivor of unspeakable violence during a childhood of physical and sexual victimization. As a teen, she was sold for sex. The violence followed her into adulthood, and at the time we met, her partner had become her latest abuser. Kacey told me that using methamphetamines helped her cope.

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