Addressing the Intersection of Homelessness & Mental Health: A Conversation with Dr. Jonathan Sherin

A recent LATimes investigation found that about 67% of the homeless population in Los Angeles County has either a mental illness or a substance abuse disorder. Yet, Dr. Jonathan Sherin wrote in a December op-ed, mental health policies are failing those who most need services. Dr. Sherin, the director of the LA County Department of Mental Health, joins Then & Now this week to discuss this challenge. He sits down with Dr. Kirsten Moore-Sheeley and Jessica Richards, two authors of LCHP’s forthcoming report on the history of homelessness, to discuss the lack of adequate services for people experiencing homelessness, his suggestions for engaging with those reluctant to receive mental health care, and his department's approach to th multifaceted stressors of our time, from the COVID-19 pandemic to racial inequity.

This episode is the second in a multi-part series examining the history and present state of homelessness in LA County. Find the first episode here.

Transcript

Narrator 0:02

Welcome to Then and Now, brought to you by the UCLA Luskin Center for History and Policy. We are dedicated to studying change in order to make change, linking knowledge of the past to the quest for a better future. Every other week we interview thought leaders, historians, researchers, and policymakers about what happened then and what that means for us now.

Kirsten Moore-Sheeley 0:27

Welcome to Then and Now, a podcast sponsored by the Luskin Center for History and Policy at UCLA. The goal of the center is to bring the past into conversation with the present and in doing so to understand how we got to where we are so that we can imagine alternative and better futures. My name is Kirsten Moore-Sheeley. I'm a postdoctoral fellow in the history of medicine at Cedar Sinai and a visiting assistant professor of history at UCLA. I'm joined by Jessica Richards, a doctoral candidate in the Department of Community Health Sciences at the UCLA Fielding School of Public Health. We are both research fellows with the Leskin Center for History and Policy. Our guest this week is Dr. Jonathan Sharon, Director of the Los Angeles County Department of Mental Health. As director, he oversees the largest public mental health system in the United States with an annual budget approaching $3 billion. Prior to joining LA County's Department of Mental Health, Dr. Sharon served for over a decade at the Department of Veterans Affairs, where he held a variety of posts, most recently as Chief of Mental Health for the Miami VA healthcare system. Welcome, Dr. Sharon.

Jonathan Sharon 1:39

It's great to be here.

Kirsten Moore-Sheeley 1:40

It's great to have you.

Jessica Richards 1:42

No one in LA County is stranger to the homelessness crisis that permeates our city and county. Rates of homelessness increased by 13% in Los Angeles County last year, despite renewed attention and funding directed at addressing homelessness. And COVID-19 has only exacerbated this issue. The magnitude and visibility of Los Angeles' homeless crisis have many wondering how did we get here? We co-authored a new Leskin Center report that traces the history of homelessness in Los Angeles to examine factors that have shaped our contemporary crisis and to inform policy solutions to homelessness that avoid the many mistakes of the past. In particular, our report found that mental health policy and practices are critical for addressing homelessness in Los Angeles. According to the Los Angeles Times, 67% of homeless adults in Los Angeles have either a mental illness or substance abuse disorder.

Kirsten Moore-Sheeley 2:35

So, Dr. Sharon, you wrote an op-ed recently for the LA Times on issues of mental health and mental illness among people experiencing homelessness. And there you mentioned that there are people with serious mental illness who are unable or unwilling to accept services. So to help understand where we go from here in terms of mental health policy, let's first look back at one influential policy, the Lanterman Petra Short Act of 1967. So, Dr. Sharon, what was the effect of this law on the mentally ill and how did this law contribute to homelessness?

Jonathan Sharon 3:17

Well, I mean, to be honest, I think there's this is a very small piece in a much, much larger puzzle. And I do hope that we get a chance to dig in on that. And the op-ed I wrote and Landerman Petra's short are really, I think, ultimately targeting a very small portion of the population that's homeless. And that due to the severity of their illness, the chronicity of their illness, their lack of insight, and frankly, some of their perhaps bad experiences with the system in the past renders them very reluctant to engage. And there are scenarios where we, you know, as a society based on humanitarian grounds, really have to figure out ways to help engage those individuals and get them on a recovery path. And at times that needs to be a bit more paternalistic than we might like. The LPS law going back really was an important law, and I think at some level very forward thinking and really in place to protect civil liberties. And it was on the heels of the deinstitutionalization movement, which really was kind of triggered by our wonderful president John F. Kennedy, not just here but around the world. Unfortunately, here and in the vast majority of other countries, our uh response to develop adequate community-based mental health care and treatment, in addition to recognizing and resourcing the social determinants, has been abysmal. And we're paying for that. Um we have not built up um the type of resources across uh the arc um that uh are needed to support people. Uh you know, and um the LPS Act when it was put forth was done, I believe, in the context of having adequate community belt uh community-based treatment options, having enough capacity and access so that could people could get health, uh, sorry, could get help and become healthy.

Kirsten Moore-Sheeley 5:40

Yeah, but it's a really fascinating history that we do delve into a little bit in the report. Um, and so thank you for expanding on that uh for us. Um and I do want to get back to your point about this uh act being a small piece of a larger puzzle. Um, but before we do that, I did want to return to uh the LPS Act. Um, so it has been over 50 years since this act was passed, and as you uh mentioned, kind of in this different context. Um, in your op-ed, you suggest uh having a range of different stakeholders, including formerly homeless individuals with mental illness who are now in recovery, uh redefined gravely disabled. Um so maybe you can also explain how gravely disabled and that definition fits into the LPS Act. But how do you think redefining this categorization of gravely disabled would improve mental health care for those experiencing homelessness?

Jonathan Sharon 6:48

Well, um, I would say that that op-ed is actually much more about engagement than it is LPS law and grave disability. So if I could just start there, what I'm suggesting and have been for some time is that we need to have tools of engagement across a continuum for uh individuals who are reluctant to engage in care. Um, and that no matter what we're doing, we always start with um figuring out ways to engage people voluntarily. And if we can engage them voluntarily, and I say doing that with resources first, and resources first means not just treatment, uh, you know, in a 24-7 type team, but also guaranteed housing and guaranteed access to open and locked residential treatment. Um, you bring that to the table and you try to engage someone relentlessly in a voluntary fashion. If it doesn't work, you step up the continuum. Um, there are uh things that exist, there's something called shared decision making, which is used in other jurisdictions. There's um uh, or I should say uh countries, I'm not sure about the states. There's the the psychiatric advanced directive, there's uh Laura's law, assisted outpatient treatment. Um, those are all engagement tools. Um, as you step it up across the continuum, depending on someone's you know level of reluctance to engage, you move towards um temporary conservatorship and conservatorship, which is really when LPS law and grave disability come into play. Um grave disability really, um, if you go back to its roots as I understand it, and I am a doctor, uh not a legal scholar um or um a legislator, but that law was really generated to say, hey, if there's someone who is so uh ill um and um really incapable of looking after themselves and refusing care, right? So it's an engagement challenge at the outset, and they're not able to live safely in the community, we have to do something about it. It's our duty to take care of that person based on humanitarian grounds, and then you have to move towards more and more paternalistic approaches, and one of the ideas around grave disability is that it's an example, food, clothing, and shelter. These are indicators of the inability to live safely in the community. But when it comes to practice, whether it's a frontline provider or whether it's a court, very, very difficult to implement and all over the map. Plus, it's not really a comprehensive set of indicators because there are many things that are missing. You know, the thing that people mostly focus on is the inability to get to access or uh medical care or to get medical treatment for a physical condition. Um because the fact of the matter is that a lot of people die in the street, and that number's going up dramatically. I think it's gone from about 800 to I don't know, 12, 13, 1400 per year in the time I've been here, which is very disturbing. Um so the idea about modifying grave disability is simply to say, hey, how do we create a set of indicators that is um got more fidelity with the person's real life and their ability to live safely in the community for our frontline providers, for our courts to make decisions and identify people more effectively, and to streamline uh really a process, uh, which in its current state is quite difficult for many, many reasons, including I would say the bakery of food, clothing, and shelter and the fact that it's not really a comprehensive um set of indicators that that I believe we need, and getting to your point about lived experience, the people who really the engineers of essentially everything we do, and certainly things that are this important and this sensitive, need to be individuals with lived experience. So to say to them, well, what was it about you that why why were you when did you not live safely in the community? What were things that you did, and what were indicators, and what did you see around you, you know, for that month or that six months or that two years or that 10 years that we ought to be using to say, hey, you know what? That person who's so sick, who's unwilling to accept care, can't live safely in the community, is someone that we can go and help.

Kirsten Moore-Sheeley 11:28

Yeah, um, it's really um interesting to think about the this as one of multiple tools, as you mentioned, um, for engaging with this community who uh which your department is trying to help. Um and so I'm curious, I think you mentioned a couple of obstacles to engagement uh with this uh community. Do you want to expand at all on the types of obstacles uh your department faces in um engaging with this population of people experiencing homelessness with mental illness and anything you are thinking about, anything else you are thinking about uh in terms of tools uh for engagement?

Jonathan Sharon 12:17

Well, we probably don't have enough time to go into all the things that I'm thinking about and that we're working on, but I'll try to be selective. Um and one thing I'll say is that we have to look at what it is we're trying to solve and how that evolves. So, what's the ideology of homelessness? And what I would say is that the minority of people who are homeless are are homeless uh uh and and and actually in many cases getting into trouble legally and ending up in jail because of the severity and criticity of their mental health challenges and their addictions. And um which which conspire more so than anything to create really, really unfortunate and completely unacceptable uh scenarios that we see every day. Um but that the vast majority of people who are homeless really are homeless because of socioeconomic factors as well as trauma. You know, so there's almost like a nature-nurture piece here. And what I would say about the Department of Mental Health, since I've been here, I've been laser focused on saying to my department, we are gonna take ownership of the responsibility for those who are so ill and so vulnerable that they end up in the street as a result of their condition in a very direct way. We're not gonna say, oh, that person, for example, meets criteria for Medicaid. And so we're gonna go for that person where we select someone that's easier to take care of than someone uh who might be uh you know uh more ill, have more challenges, and frankly have been homeless for a longer period of time. And the reason I say that is it's only if we do a really if we take a strategic approach where we uh have responsibilities and accountability that we can go after any type of solution that's gonna be um effective and that where we can lobby for the resources to take care of that piece of a larger puzzle. Um when you think about that, I'll tell you here's an example. The state comes to the county mental health departments and it says, Are you adequate? What they mean by that is they say, Do you have an adequate network through a thing that they call network adequacy? And they'll say to me, based on the fact that we see so many people and they have a certain amount of wait time to get care that we're adequate or we're juxtaquate, and we have to do a couple things to be adequate. Some counties are not adequate according to this scenario. The fact of the matter is the people in the street who are sick, really sick, and the people in the jails who are really sick are not accessing care. So we're nowhere near adequate. And not only do we not have enough resources, and when I say that, I'm not just talking about treatment. I'm a, you know, I'm a psychiatrist, I'm a neurobiologist, but I am a humanitarian first and foremost, an advocate and an activist. And I'll say that the social determinants of health and the resources that support them are super critical here. So we do not have enough resources to address the problem. Whether you're talking about the smaller piece of the puzzle, which are the people who end up homeless no matter what, because of the the the etiology of their illness, of their condition being based on their, you know, I'm just gonna say kind of their endogenous likelihood to develop an illness based on genes and epigenetics, versus socioeconomic factors. And I'm not saying that there's a it's a two-piece puzzle, there's multiple pieces, but those are very important categories that are not well understood, they haven't been studied well through our public partnership in the California Policy Lab. We are studying that. Um, and that when we know what we're trying to solve more effectively, and then we can set out a strategy to deploy resources and programs that go after the different challenges in a more uh orchestrated way, we're going to be more effective.

Jessica Richards 16:25

Dr. Sharon, I have a follow-up question for you. You had mentioned that we lack a real good comprehensive set of indicators and that it's important to return to folks who have experienced homelessness firsthand to identify indicators that are relevant to them. Can you share what some of those indicators are?

Jonathan Sharon 16:44

Well, I mean, I could I can share indicators that I would be thinking about. And by the way, although I am the director of this very large bureaucratic department, um I do street psychiatry. I actually was out this morning in Skid Row. Um not nearly as much as I want to or really ought to. It's probably about once or twice a month, but it informs my understanding. Um and it also keeps me connected to the challenges of our front lines and the mission. Um food, clothing, and shelter, as I had said, are examples. They're kind of examples of exposure. Because if you know, and if and if you if you're if those are in if those are things that you're not able to kind of provide, that's not good. Um, and it suggests that you're not living safely in the community. If you have either acute or even chronic medical conditions, healthcare conditions that are evolving and and will become life-threatening and ergo not you're not living safely in the community, those are other indicators that are not on the board. We have people who have uh who develop ulcers and deep infections and become and get gangrenous. Well, gangrene will kill you or it'll take your limb. Uh, so do we allow what do we do about that? I mean, those those are indicators. And there's many, many other kind of medical indicators. Do you, because of your mental illness, fall prey to people in the homeless encampments who put your life at risk? They steal your money, they sexually assault you, they physically assault you otherwise. Is that living safely in the community? Um, I don't know. I it depends who you ask. I I would say no. The other thing, and this is super controversial, and I'm assuming that there will be people in this podcast who probably will reach out to me. It's not just about it's not just about living safely as an individual, it's also living safely in the community. So individual people actually who have profound illness and behavioral patterns can pose a risk to the public. Is that okay? I mean, do we not have a responsibility, a duty to help that person engage uh in care, provide them treatment so that they can live safely in the community as an individual, but also in the context of the public? And there are examples of that. You have people that have repeat um, I'm trying to not try not to be too graphic here. There are examples of things that people do that that pose um threats to the public, uh, the public safety and the public health, whether it's through infectious agents of their own, uh, whether it's pushing people into traffic. Um and you know, we uh we have to recognize that um these are these are issues that must be uh attended um in the context of um of mental health, of challenges from mental illness and from addictions. And we have to move past the um you know the black and white of autonomy versus paternalism and find a middle ground that's driven by humanity and that always engages with resources first. Because if you don't have resources, you got no business interfering with someone's civil liberties for a second.

Jessica Richards 20:09

Thank you. Thank you, Dr. Sharon. Thinking now, we're in the midst of a pandemic, which has a host of economic and housing consequences. How do you see economic factors, including housing insecurity, as impacting mental illness?

Jonathan Sharon 20:25

Oh well, I mean, you know, anything that is stressful is gonna have an impact on people's mental health and their well-being by by nature. The question would be, or by nurture. The question would be um, how do you respond to that? And I will say that there's uh there are um descriptions of post-traumatic stress injury and post-traumatic stress growth. And a lot of what we have to do as a culture is recognize pathways and platforms for people to grow in the context of stress. But I mean, look at you got the virus, you got the economic impact of the virus, you've got uh other things that you know are currently pressing on our public, including social unrest, which is actually you know, at this level, long overdue. Um, yeah, you've got I I what I consider like an information war where there's too much information and the information's conflicting and that's confusing. You know, and then I mean most recently we have a threat to kind of our own democratic way of life. These are all major league stressors. The unfortunate thing that we're seeing is a spotlight on inequity. And we're seeing disenfranchised uh populations suffering way, way more uh than others. Um and that's true um of uh mental health impacts, um, economic impacts, you know, the psychosocial impacts of uh of our of our Time. And this department, again, with UCLA and the Leskin School, has been doing a lot of mapping, mapping of areas that are most impacted across a number of different indices to demonstrate in really objective ways the inequities and then allowing us to funnel resources where they're the most needed.

Jessica Richards 22:29

I want to follow up on something you said, which is that there's the PTSD stress and there's PTSD growth. And what can what's the role of the Department of Mental Health in helping to make sure folks go down a growth trajectory? How can we make that more common?

Jonathan Sharon 22:50

Well, I mean, the way to make it the way to make it more common, which is no easy thing to implement really, is is uh is empowering people as opposed to letting people become disempowered. Um not letting people become victimized by all of these stressors, but seeing them as kind of opportunities. Uh one of the one of the big programs that we've been working on, and that actually was in another op-ed, I think I wrote it in May, um, where I talk about the community ambassador network. Um, the community ambassador network is something which is really just hitting the ground right now, where we as a department um use prevention monies to essentially um as this as kind of a stimulus package into the communities of the most need to train, certify, and hire people of the community for the community to be ambassadors, um, agents of this department, um, who will uh have first of all have a great deal of knowledge of their neighborhood and street credibility and can identify people with the help of training and also other clinical supports to connect up those in need and to get them to the resources they need, whether it's mental health or not. It may be that someone's suffering and it's not due to a mental illness, it's due to some other factor. But we're saying that these are that stressors are stressors, they're bad for the brain, they're actually bad for all organ systems, and they're bad for the being, the human. And so we want to kind of go after them and with ambassadors who can engage with somebody, provide them education, help them navigate the mazes of our systems, which are just dense, and then advocate for them to get resources when they show up at the door for benefits or legal assistance or housing or mental health treatment, and then maintain contact with that person. Now, the reason I say that is that those people who are doing that work in a perfect world are the people who have lost their jobs in the context of this pandemic, who are in the neighborhoods where they're the needed the most. And it becomes a way for them to pay forward their experience of trauma and to be a part of the solution. I mean, I say it all the time when I speak to the schools, to the superintendents, to the teachers, to the administrators. This isn't about doing something to the kids and making the kids, you know, creating their environment. They are engineers, they have to help create the environment. They need to tell us what does it look like? What does it look like now? How does what we do now, uh in an additive way, create a brighter future where the education will be better? Because the kids that are actually engaged to do that and allowed and supported to do that and given a platform to do it, they're not going to have challenges with their mental health the way they would if they're put into a situation where they're told what's okay, what's not okay, and not allowed to participate and pay forward their experience. So that's that for me at a high level is really the road to growth as opposed to injury.

Jessica Richards 25:55

Thank you. I think it's really interesting how you are framing the pandemic in a different way to leverage these negative experiences in a different capacity. Um, and COVID-19 has certainly been very challenging. Could you tell me a little bit more about how COVID-19 impacts the Department of Mental Health's ability to address mental health needs among people experiencing homelessness? And when I say this, I often think that we when we are stressed, when we are sad, we gather, we spend time with other people. And often in the context of COVID-19, we are told you don't, you have to physically distance. So could you speak a little bit to some of the challenges that come and the constraints from the pandemic?

Jonathan Sharon 26:47

Well, it's a big question. I mean, I I talk a lot about the other LOL, which is the lethality of loneliness. And for me, the elixir and everything is really connectedness. And connectedness, I believe, really has two components, which are purpose and belonging. We were just talking about purpose. Um, and one of the reasons why kids will do so well in that scenario is that they're working together and they're problem solving. Um, same thing with the community ambassadors, and people that are doing that work are not going to be isolated. Um, and when it comes to the homeless population, you know, I thought you were gonna ask me about other silver linings because there are many. You know, we we've we've dramatically transformed the way that we deliver care from one that's required always face to face to one, for example, that leverages telehealth. And then the Contele mental health, and in the context of doing that, we're serving many more people more effectively. Um, we're actually drawing down more funding from the Fed and the state. Um, and our customer satisfaction, both in terms of our providers and those people we're serving, is going up. Um, you know, the homeless challenge, to be honest with you, is really um, I think, shining the light on a lot of things, including how messed up uh our health and human service systems are. Um, I don't want to get lost in the weeds here on the structure of uh mental health services in California and the payment um mechanisms, but I'll I'll just tell you a little bit. Um the Department of Mental Health and the departments of mental health across the state are funded by the uh through the state and have are and actually have what's called a plan or a contract to provide services to the serious mentally ill. So people that have mild to moderate mental illness, you know, anxiety, depression, lesser traumas, um, are actually not our purview. They're the purview of what are what are known as the managed care plans. And you can only imagine the challenges on the day-to-day basis between determining is that person mild or moderate, is that person serious? Depends who you ask on a given day. But one of the things that happens in the context of a disaster or a true crisis, and you can think of fires or earthquakes as examples, is that the Department of Mental Health becomes the de facto provider of the entire collective. Now, I understand that, and I actually am honored to have that role. And what I see there is really a big-time air traffic control function where we're all over the place, we're engaging people, and then we're triaging them to get treatment. Now, the problem becomes uh significant when it's an enduring disaster. I mean, it believe me, it's a challenge when it's not an enduring disaster. Because it draws a lot of our resources. And by that I mean people and our contractors, our community providers, and our time, but also our money. Um and then the and then people will say, oh, well, FEMA will pay, will give you extra money for doing disaster work. Well, kinda, except it's not enough, and you have to spend as much time filling out the paperwork to get the money as you do doing the work. So we and many other uh you know departments in LA County and other places, you know, um, choose not to take the money. It's not worth it, it's exhausting. Now, I'm not saying FEMA does that on purpose, uh, but that's the those are the kind of bureaucratic challenges that uh that we face. And the reason why it's so important in the homeless arena is that there's been a massive appropriate effort to help people on the street, particularly who are vulnerable, to keep them safe from COVID. And what that does to departments, including my department, is it takes me, who may have 200 people doing outreach and engagement on the streets on any given day, and it gets it it shifts them from what I consider, you know, my people, the core most severely ill, away from them towards larger numbers of the general public. I have a problem with that. People don't understand that, that don't dig into the policy and the funding mechanisms. And actually, very soon when I get off this call, I'm gonna speak to the LA County delegation in Sacramento, all the legislators, about many, many things, including this, uh, because I don't think people understand it. And I don't think it was set up in a way that was meant to be nonsensical and challenging. But on a day-to-day basis, when you run a department like this, it's a big problem. We're in the process right now of developing a very, very powerful partnership with LA Care. LA Care is the biggest managed care plan in Los Angeles, run by a great man, John Bacchus, and a wonderful team of people who, a lot of whom used to work in the county, to figure out how to bring together, you know, mild, moderate, and serious mental illness resources through one system so that we're more flexible about how the funding is deployed.

Jessica Richards 31:58

Thank you so much for uh helping to walk through that because I think that there's a lot going on there that most folks are not privy to, and it it makes much more sense hearing it from you.

Jonathan Sharon 32:10

Yeah, you bet.

Kirsten Moore-Sheeley 32:12

Yeah, it sounds like there are um a lot of obstacles, kind of extreme obstacles that you're facing at this time, but it's it's also nice to hear about the silver linings that you mentioned. Um, and so thank you for mentioning those as well. Um I have uh one final topic of conversation I want to get to, um uh certainly a national, but uh definitely a county issue as well, and that's racial equity. So racial equity is at the forefront of local and national conversations. And as our report highlights, uh, African Americans are disproportionately represented among people experiencing homelessness and often face barriers to accessing quality uh health care. Um and so uh what role can mental health policy play in addressing um racial health disparities Well, I think we have to play a primary one.

Jonathan Sharon 33:13

Um when you look at institutional inequity, structural racism, and you look at the populations that are most that suffer the most, including the African-American population, I would say top of the list. Um you have to recognize that that means living in a state of ongoing stress and trauma because the structures that surround you are always selecting against you and excluding you. Um any population that suffers ongoing stress is uh gonna be like less likely to thrive or survive, and and and we see that. Um I did mention to you that we're mapping that uh out very carefully, and then we're creating programs such as the Community Ambassador Network uh that will help um in our own ways respond. But I do think it's critical that we understand um and help set policy uh policy, and I would even say at a public health level, based on our knowledge, that structural racism is actually, yes, it's a health care issue, it's a big time mental health care issue because people and uh because of their most sensitive organ uh in in general known as the brain, um, suffer. And it impacts the ability to get education, it impacts the ability uh um to get work, uh it impacts uh you know the prevalence of poverty, uh, it impacts the types of jobs that people get so that they're more exposed to things such as COVID, the living conditions where people are living in confined quarters in a um you know in a more collaborative setting as opposed to having more space. I mean the list goes on and on, but the reason why mental health is so central is that trauma drives uh organ damage. And that's and the brain is no exception. In fact, the brain probably because of its sensitivity is as impacted or more impacted due to ongoing inequity than any other organ. And that impact that affects your psyche, your your your your uh you know, your stability and your your ability to function. Um, and and frankly, at some level, stay connected.

Kirsten Moore-Sheeley 35:45

Yeah, and I know you have to go um pretty soon here, but I just wanted to thank you so much for speaking with us. Thank you so much for your incredible work, um, incredible ongoing work in the face of, again, numerous obstacles, not least of which is the COVID-19 pandemic. Um, it was a real pleasure speaking with you, Dr. Sharon.

Jonathan Sharon 36:09

Thank you. It was a pleasure to speak to you all as well. I hope you have a great day, and maybe sometime down the road we can reconnect and have another uh podcast.

Jessica Richards 36:19

That would be great. Then and Now is a production of the UCLA Luskin Center for History and Policy with support from the UCLA History Department. Ven and Now can be found wherever you listen to your podcasts. Thank you to executive producer Maya Ferdman and to our guest today, Dr. Jonathan Sharon, for joining us. Let us know your thoughts on this or other episodes of Ven and Now by emailing us at LuskinCenter at history.ucla.edu. You will be able to read our new report on the history of homelessness in LA County by visiting our website at luskincenter.history.ucla.edu. See you next time.

Narrator 37:01

Thank you for joining us this week on Then and Now. Then Now is brought to you by the UCLA Luskin Center for History and Policy, where we study change to make change. For more on our work, follow us on Twitter and Facebook at our handle at Leskin History. Our show is produced by Maia Ferdman and David Myers, with original music by Daniel Reichman. Special thanks to the UCLA History Department for its support, and thanks to you for listening.