Resource Center

In the year since the U.S. Supreme Court made it easier for cities to remove homeless encampments, California cities have redoubled enforcement efforts. For people caught up in sweeps in cities like Berkeley, Oakland, and Vallejo, the same question echoes again and again: “Where do I go now?” “The biggest problem with criminalization...[is] that criminalization worsens homelessness,” says BHHI Director Dr. Margot Kushel. “The public should...say, ‘Why are you taking expensive efforts to worsen a problem? This problem is 40 years in the making.”

As cities work to clean up homeless encampments under increasing pressure from Gov. Gavin Newsom and housed residents, RV communities present a distinct — and notoriously difficult — challenge, especially with more and more Californians taking up residence in them. UCSF Benioff Homelessness and Housing Initiative Director, Margot Kushel, found in her research that people living in RVs are reluctant to give them up for anything short of permanent housing — a dilemma when there’s little to offer. Berkeley officials designed their strategy with that in mind. To get the program to work, city staff and nonprofit outreach workers spent roughly three months coaxing residents, explaining their offer, listening to concerns and making accommodations to the shelter policies where possible. A one-dog-per-person rule stretched to allow four dogs in one room; friends were allowed to bunk together.

In January 2025, the City of Berkeley launched an innovative program to resolve the 2nd Street encampment by combining a low-barrier motel shelter with cash payments for residents’ RVs. Outreach workers built trust and tailored policies—allowing pets, partners, and friends—to boost participation. So far, 36 people and 26 animals have moved into the Capri Motel, and only three RVs remain on site. “The city designed this to really gain people’s trust and to make sure that people were not left worse off than they were when they started,” said Dr. Margot Kushel, calling the program “quite innovative.” BHHI is independently evaluating its impacts to inform future strategies.

Latine Californians represent more than one-third of the state's homeless population. Yet their experiences are too often left out of research, policy, and service design. To better understand these experiences, we examined data from the California Statewide Study of People Experiencing Homelessness. This report, based on the California Statewide Study of People Experiencing Homelessness (CASPEH), examines who experiences homelessness in the Latine community, their experiences while homeless, and offers evidence-based policy and program solutions.

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines Latine Californians' experiences of homelessness and makes recommendations for policymakers and practitioners.

Californians experiencing homelessness have poor health, struggle to access care, and face high ER and hospitalization rates—despite high rates of insurance. In this cross-sectional, representative study of adults experiencing homelessness in California, we found poor access to health care and high rates of short-term health care utilization that reflected how homelessness is negatively associated with health care access. Predisposing contextual and need factors, including being unsheltered, using illicit drugs, and having functional impairments, were associated with reduced access to care and increased use of short-term care. These findings underscore the necessity for health care and housing interventions that are tailored to the needs of people experiencing homelessness.

Latine Californians represent more than one-third of the state's homeless population. Yet their experiences are too often left out of research, policy, and service design. The UCSF Benioff Homelessness and Housing Initiative (BHHI) held a discussion of Toward Equity: Latine Experiences of Homelessness in California, the latest report from the California Statewide Study of People Experiencing Homelessness (CASPEH) series. This webinar highlights key data on how structural anti-Latine racism, housing exclusion, and administrative barriers shape pathways into homelessness, and explores what policy, service, and community leaders can do to close equity gaps.

Homelessness and behavioral health issues (mental health and substance use) are intertwined. The UCSF Benioff Homelessness & Housing Initiative held a webinar about this complex bidirectional relationship, along with solutions to this crisis. Margot Kushel, MD, Claudine Sipili, Darrell Steinberg, JD, and Stephanie Welch, MSW, discussed findings from the California Statewide Study of People Experiencing Homelessness (CASPEH), highlighted key policy recommendations, and answered audience questions. Marc Dones moderated the webinar.

Behavioral health challenges both contribute to and are exacerbated by homelessness. To better understand behavioral health and homelessness, we examined data from the California Statewide Study of People Experiencing Homelessness. Our latest report examines the relationship between homelessness, substance use, and mental health, providing critical insights for policymakers, program leaders, Continuum of Care leaders, and healthcare systems.

The University of California, San Francisco Benioff Homelessness and Housing Initiative (BHHI) today released a report that examines the issues of homelessness and behavioral health (substance use and mental health) and makes recommendations for policymakers and practitioners.

Join CHCF in Sacramento on Wednesday, March 12, 2025 for a briefing about these supports and their importance for helping people move from homelessness to housing. The briefing will begin with an overview of how homelessness impacts a person’s health by Margot Kushel, MD, professor of medicine and director of the Benioff Homelessness and Housing Initiative at UCSF. She will draw from the landmark California Statewide Survey of People Experiencing Homelessness. Following the presentation, Michelle Schneidermann, MD, director of people-centered care at CHCF, will moderate a discussion about the role Medi-Cal is playing in California’s homelessness response and how that role can be strengthened and improved through critical partnerships across the health, homelessness, and housing sectors.

A new UCSF BHHI study challenges common perceptions about homelessness and drug use in California, revealing that only 37% of surveyed unhoused Californians use drugs regularly, while 25% have never used them at all. Methamphetamine, not opioids, is the most commonly used drug, often as a means to stay alert while living on the streets. The study also highlights the complex relationship between addiction and homelessness—while drug use can increase the risk of losing housing, “Homelessness itself increases drug use because people use it as a coping strategy,” said Margot Kushel, MD. With homelessness on the rise and only 7% of respondents in treatment, experts stress that expanding affordable housing and accessible treatment options is crucial to addressing both crises.

KTVU's Heather Holmes and Frank Mallicoat talk to Marc Dones, Policy Director of the Benioff Homelessness and Housing Initiative, about the challenges unsheltered people face and what research says about barriers to resources.

Research from UCSF Benioff Homelessness and Housing Initiative reveals that most people experiencing homelessness in California are not illegal drug users—contrary to widespread public perception. These findings challenge common stereotypes and underscore the urgent need for better treatment options and housing solutions across the state. KCBS Radio news anchor Eric Thomas spoke with Margot Kushel, MD, Professor of Medicine and Chief of UCSF’s Division for Health Equity and Society, to dive deeper into the issue.

A new UCSF BHHI study challenges misconceptions about drug use among people experiencing homelessness in California. While only 37% of homeless individuals regularly use illicit drugs, lifetime use is high, and 27% began using after losing housing. The study highlights the difficulty of accessing treatment, with only 7% receiving care and 1 in 5 actively seeking help but unable to get it. Margot Kushel, MD, emphasized the complex relationship between drug use and homelessness, stating, “People are telling us that it helps them survive,” she said. “It keeps them awake and alert. They are using it either because they are traumatized, they have been assaulted, they are afraid or depressed, using it as coping to make it all go away.”

Domestic violence is a major but often overlooked driver of homelessness in Los Angeles, with 44% of unhoused women citing it as the primary cause, according to a 2023 Urban Institute survey. Yet, LA’s survivor support system is severely underfunded—only 10% of those seeking shelter secure a bed. A UCSF BHHI study found that 60% of survivors who fled abuse end up sleeping in cars, tents, or the streets, where they remain vulnerable to further violence. Experts and advocates warn that without integrating domestic violence services into homeless support systems—and vice versa—thousands will continue to face impossible choices and unsafe conditions.

A groundbreaking UCSF BHHI study challenges common perceptions about drug use among people experiencing homelessness. Researchers found that less than half of this population regularly used drugs, with methamphetamine being the most common substance, not opioids. Many respondents wanted treatment but struggled to access it, highlighting barriers to care. The study emphasizes that homelessness and substance use are interconnected and advocates for reducing barriers to treatment and prioritizing housing solutions. "We need to reduce barriers to substance use treatment, and that includes prioritizing people’s ability to return to housing,” said BHHI faculty member Ryan Assaf, PhD, MPH, the study’s lead author.

Most people experiencing homelessness in California are not regular drug users — and for some, substance use begins or worsens after losing housing. Some use drugs to stay awake and safe, coping with the trauma and danger of life without shelter. At the same time, many who want treatment can’t get it. This paper uses data from the California Statewide Study of People Experiencing Homelessness to show a comprehensive, representative look at substance use, overdose risk, and unmet treatment needs among people experiencing homelessness in California.