The homeless have been a defining presence on the sidewalks of our cities and the covers of our newsmagazines for more than a decade.
So it's odd that when we see the familiar unwashed man huddled in blankets on the street or the mother and child seeking refuge at a shelter, we still need to ask: Who are they?
Now, answering that question, a pair of activists are here to tell us that the homeless are not who we thought they were.
The vast majority of homeless Americans, say Alice S. Baum and Donald W. Burnes, are not people just like you and me who, for lack of a job and an affordable place to live, have fallen through the nation's fraying safety net and found themselves on the street.
Instead, the authors write in the forthcoming book, "A Nation in Denial: The Truth About Homelessness," between 65 and 85 percent of the homeless are afflicted by alcoholism, drug addiction, mental illness or a combination of those maladies.
Most homeless people have no place to stay because they have burned bridges to family and friends, and stand alone. Even when housing or jobs are available, most of the homeless are too disabled by addictions or other illness to take advantage of them, the authors say.
By questioning the efficacy of all the nation has done so far to help the homeless, the book seems likely to spur debate about future policies at a time when, the authors say, Americans have grown "weary, angry, and in some cases, bored with the problem."
"America is in deep denial about homelessness," write Ms. Baum and Dr. Burnes. "There is compelling evidence that the primary issue is not the lack of homes for the homeless; the homeless need access to treatment and medical help for the conditions that prevent them from being able to maintain themselves independently in jobs and housing."
Why denial? It is partly due, the authors argue, to homeless advocates' fear that by appearing to blame the homeless for their own problems, they would undermine whatever public support they have mustered for providing shelters and other services.
In a "can do, feel good" response to homelessness, Americans have "developed a vast system of shelters, soup kitchens, clothes closets, grate patrols, transitional services, and most recently, homelessness prevention programs," the authors write.
But the authors contend that the U.S. shelter network treats only the symptoms of homelessness, not its root causes. Workers at shelters and the voting public at large are more at ease feeding lTC the hungry and housing the "deserving poor" than finding long-term treatment for winos, crack addicts and schizophrenics.
In 1980, the late advocate Mitch Snyder asked a congressional committee to envision "an infinitely long line of people, stretching -- five, 10, 20 abreast -- as far as the eye can see. There are literally millions of them -- men, women and children."
These, he said, were the "homeless." The very word defined the problem: lack of low-cost housing. Mr. Snyder's suggested solution was "the creation of adequate, accessible space, offered in an atmosphere of reasonable dignity, for every man, woman and child who needs and wants to get off the street."
That shelter-oriented view of homelessness prevailed throughout the 1980s and still does. "Homelessness is a housing problem," the American Public Welfare Association has stated. "The principal causes of homelessness must be addressed: poverty and the lack of safe, affordable, decent housing."
About the time the Reagan administration was slashing social programs, the homeless became visible en masse in American cities. Many advocates assumed a cause-effect relationship.
Ms. Baum and Dr. Burnes, who describe themselves as "old poverty warriors," say they took the same view when they began a three-year stint with a Washington ministry to the poor in 1986. But they quickly discovered that the problems of the homeless went much deeper.
The authors based their arguments about alcohol and drug abuse and mental illness among the homeless on considerable research they found tucked away in "obscure, technical journals that nobody reads," Dr. Burnes said. "None of our stuff is new, but nobody knows about it."
The authors concede Reagan era cuts were devastating for many poor Americans. But they say the effect on the homeless was greatly overstated, partly because "only one-third of the homeless make use of public benefits to which they are entitled."
So how to account for the explosion of American street people in the early 1980s?
Ms. Baum and Dr. Burnes point to the "baby boom."
The same extraordinary bulge in the population born between 1946 and 1964 that first inflated the nation's school enrollments and later created a huge demand for housing as the "boomers" matured also contributed to a boom in homelessness, the authors contend.
In 1970, there were 73 million Americans aged 18 to 44, the period when people are most at risk for addictions and mental illness. By 1980, that age group numbered 94 million and by 1990, 108 million, or a 48 percent increase in two decades.
Meanwhile, there were few places for homeless "boomers" to go. The policy of deinstitutionalization had reduced the number of beds in the nation's state mental hospitals by 80 percent; urban renewal had razed skid row hotels; and government budget cuts were erasing publicly funded drug and alcohol treatment slots.
As a result, the authors say, the homeless were more numerous -- and visible -- than ever.
Despite media reports about the "new homeless," Ms. Baum and Dr. Burnes say the largest group of homeless (at least 40 percent) are male alcoholics, much like the maligned skid row "bums" of the past. Another 10 to 25 percent are drug addicts, including some mothers hooked on crack. At least one-third are mentally ill, they say. Some have multiple afflictions.
Diana Smith, director of residential services for the Baltimore YWCA, said she wouldn't quibble with those percentages based on her experiences running shelters.
"There are still people who need affordable housing," she said. "But there are large numbers for whom substance abuse and mental illness are at the core of why they're homeless. Most people here weren't living at Cross Keys. They were evicted from housing projects or Section 8" federally subsidized units.
"The fear, of course, is that the general public will see these people with substance abuse problems and mental illness as people you throw away," Ms. Smith said.
Norma Pinette, executive director of Action for the Homeless, contends that lack of affordable housing is the "fundamental reason" many people are homeless.
But she acknowledges that the homeless do have "major substance abuse problems" which are not addressed by the existing network of emergency shelters.
"Advocates basically have focused on what's achieveable," she said. "What has been politically possible has been to get dollars, public and private, for shelters. But shelters alone are nowhere near enough."
"The public is starting to feel, 'Gosh, we've been doing shelters for a long time, and there's more homeless people and more shelters, and where is it going?' " Ms. Pinette said.
Ms. Baum and Dr. Burnes want to turn the current network of emergency shelters into "intake centers" to funnel the homeless into long-term treatment for addictions and mental illness. They suggest recycling abandoned military bases as treatment centers.
Coupled with aggressive recruitment and "sober hotels" where the homeless can live after treatment, the authors say such a program offers the best hope of reducing homelessness at a cost that, in the long run, may be less than today's revolving-door shelters.
The rapid growth of private treatment centers for alcoholics, drug addicts and the mentally ill in recent years suggests that "people are overcoming their denial when these diseases appear among the middle class," the authors write.
"It is time to put aside class prejudices," they say, "and recognize that those who stay on the streets and live in shelters deserve the same kind of help and treatment."
James Bock is a reporter for The Baltimore Sun.