It was supposed to be a one-year assignment, but treating Boston’s homeless population turned into Dr. James J. O’Connell’s career and passion that has lasted 33 years.
O’Connell has served thousands of patients and is president of the Boston Health Care for the Homeless Program (BHCHP), a Boston clinic. In 2015, he compiled career anecdotes and published a book, “Stories from the Shadows: Reflections of a Street Doctor.”
O’Connell came into his work in the 80s, a decade which saw a greater number of mental and physical disabilities in America’s homeless.
According to Homelessness in the City of Boston, a 2008 study conducted by Boston.gov, 14.5 percent of homeless people suffered from mental disorders, 35.5 percent reported a disabling condition or physical disability and 28 percent reported substance abuse. The 2017-2018 Boston census recorded 2,341 homeless single adults and 1,123 homeless families.
O’Connell explained that many homeless individuals fail to seek treatment in traditional hospitals where the fast-paced environment causes some to feel uncomfortable, neglected and untrusting. The BHCHP focuses on forming emotional connections with their patients so they feel welcomed.
“Imagine standing on a corner drinking coffee, and these people walk past you and you hear one of them say, ‘Ain’t that pitiful?’” said Larry Adams who became homeless in the 80s. “You forget one important thing and most people do: they’re human beings too. Homeless people are people too. You might be where they are at anytime, it can happen to anyone.”
Adams first came to the BHCHP as a patient. He chose to spend many nights on the streets rather than in a rule-heavy shelter. After battling cocaine addiction and alcoholism, he became sober through the support of BHCHP and has lived in an apartment for the past six years.
O’Connell described how the minority of homeless people who stay on the streets do so, not because they want to stay there, but because they refuse to stay in shelters for reasons ranging from wanting to stay with a spouse, to mental illness symptoms.
“There is this one guy who lived under a bridge on the Charles River,” O’Connell said. “He explained to me that when he goes into the shelter, he can’t tell which voices he is listening to are his. When he’s alone under the bridge, he knows when he hears voices – they’re his own.”
To prevent generational poverty that creates new homeless people each year, education and other government programs must be reinvigorated to ensure that no person becomes homeless as a result of failed systems, O’Connell explained.
As for people who were homeless and fully recover, O’Connell says those cases are extremely rare.
“Most homeless people that I see don’t get out of it, and the success is that they can stay sober for three months or maybe still struggle but get into housing,” O’Connell said. “I get nervous that we do a disservice to homeless people when we start to celebrate the big successes.”