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7 mental health. 19 Additional research also links the adverse impacts of experiencing homelessness such as stress, anxiety, isolation, and sleep loss to worsening mental health problems.20 People Impacted by Criminal Justice System Involvement Homelessness and incarceration are often correlated. Individuals without stable housing are at greater risk of criminal justice system involvement, particularly those with mental health issues, veterans, and youth. Individuals with past incarceration face significant barriers to exiting homelessness due to stigmatization and policies affecting their ability to gain employment and access housing opportunities. Research has found that formerly incarcerated people were almost ten times more likely to experience homelessness than the general public.21 Nine percent (9%) of respondents to the 2019 Homeless PIT Count survey reported being on probation at the time of the survey, and 3% reported being on parole. 3. Needs Assessment and Housing Pathways People experiencing homelessness have a variety of needs but the one commonality among all is the need for a home. The CRE found that Alameda County’s homeless response system does not have the interventions needed to permanently rehouse all people experiencing homelessness, and that reducing disparities and improving outcomes for the racial and ethnic groups most impacted by homelessness will require adding new types of programs to the homeless response system, increasing all programs’ availability, and improving program design and delivery. Opportunities identified to increase racial equity in the homeless response system include:22 • Increasing the availability of homeless housing and subsidy models for people with extremely low incomes and a range of service needs; • Creating a variety of more flexible resources including homelessness prevention and rapid resolution resources and target these resources to those who can resolve their homelessness without indefinite supports; • Increasing access to housing and other programs by lowering entry and participation barriers that unnecessarily impact privacy or independence, and ensuring resources are spread throughout the county; and • Communicate clearly about available resources, eligibility criteria and the process for accessing resources. The process to inform the CRE identified a set of pathways that would be available in an optimal homeless system to allow every person to exit homelessness, recognizing different levels of need – from those who can self-resolve to those who will need ongoing subsidies and services. The pathways envisioned for adults and for families are similar but somewhat different, based on the generally lower 19 American Public Health Association. Structural Racism is a Public Health Crisis. APHA Policy Statement. October 24, 2020. https://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2021/01/13/structural-racism- is-a-public-health-crisis 20 Mental health problems are often a consequence—not a cause—of homelessness. KALW San Francisco. Published December 7, 2016. https://www.kalw.org/show/crosscurrents/2016-12-07/mental-health-problems-are-often-a- consequence-not-a-cause-of-homelessness#stream/0 21 EveryOne Counts! Alameda County Homeless Count & Survey. Applied Survey Research (ASR). 2019. 22 Oakland-Berkeley-Alameda County Continuum of Care. Centering Racial Equity in Homeless System Design. January 2021. P.26-28. https://everyonehome.org/centering-racial-equity/