by Michael Lyle, Nevada Current
While attending last month’s vigil in Southern Nevada remembering unhoused people who died in 2022, Clark County Human Services Administrator Tim Burch took note of many of the stories circling in the background.
An estimated 240 unhoused people died in Southern Nevada between Nov. 1 2021 and Oct. 31, 2022, which was around the same number of deaths the previous year.
In Washoe County, 96 people experiencing homelessness were reported to have died last year, up from 57 the previous year.
Numbers in both metro areas are still preliminary as deaths continue to be investigated, but data so far indicate drug and alcohol abuse was the number one cause.
“Talking to our nonprofit partners and those with lived experience, I cannot overstate the power of the fentanyl and overdose that is happening,” Burch said. “You hear people talk about their friends they lost and tragic drug use, it really drives home the opioid epidemic we’re having. These were based on stories we were hearing from others. But the trend from people with lived experience is that fentanyl is an absolute curse.”
Each year in December, a vigil organized by the homeless nonprofit Straight from the Streets recognizes those who died in Southern Nevada. The most recent event was also organized by another nonprofit, Caridad.
After climbing to 192 in 2018, the number of unhoused folks who died on the streets dropped to 149 in 2019.
Then in 2021, the number shot up to 245, followed by 240 last year.
Washoe County has seen a steep increase each year since 2016 when, the reported number of those unhoused who died was 19 according to the medical examiner’s office. The number reached 57 in 2021 and preliminary data shows it spiked to 96 in 2022.
In Clark County, Burch said some of the rising death rate may be attributed to changes in investigation techniques at the county coroner’s that may have led to more accurate reporting on those identified as experiencing homelessness.
“Their investigators have been able to make better or more investigative efforts into the person’s residence,” he said.
But the higher number of deaths also coincided with an increase of the overall homeless population in 2022.
Last year’s Point-in-Time Count and Survey in Southern Nevada showed the largest increase in homelessness since 2019 and found 5,645 people experiencing homelessness.
The number was 5,083 in 2021
The report estimated 13,972 people would experience homelessness in Southern Nevada this year compared to 13,076 in 2021 and 2020.
Though cause of death is pending in many cases, drug use was listed as the cause of death in 100 cases in Clark and 44 in Washoe.
“What comes first?” Burch said. “Is it the mental health issue and why people are more prone to abuse a substance or does substance abuse exasperate and trigger a mental health issue or is it an issue of substance abuse disorder as a mental health issue? Anyone of those three variations wreaks havoc on the individual.”
Still, the road to overdose is more nuanced.
Some of the precursors of homelessness, Burch said, include a medical event, incarceration or job loss. People leaving hospitals or correctional institutions who are unable to find suitable housing also end up on the streets.
“Frequently a loss of job is cited,” in the cause of homelessness, he said.
“What we don’t see” in the data “is the depression and anxiety that comes from suddenly not having a job, not being able to pay your bills and facing eviction,” he said. “Those things exacerbate and make people more prone to using substances to deal with the stress.”
When substance abuse contributes to homelessness, Southern Nevada lacks treatment options.
“I know we have programs that we refer to in our community that have wait lists right now for substance abuse treatment,” he said. “The last thing you need to hear is ‘thank you for calling, we’re glad you want help but you’re going to have to wait.’ ”
Environmental factors, such as heat stroke and hypothermia, are also a cause of death among the unhoused, killing 35 people in Southern Nevada last year. Washoe County had four deaths from hypothermia and two heat-related deaths.
Merideth Spriggs, who runs the nonprofit Caridad in Southern Nevada, attributes some of those fatalities to a decrease in access to resources like water fountains.
Some solutions are attainable, like increasing access to water stations within the community.
“That’s what needs to happen, letting them have 24 hour access to water,” she said. “It’s a super easy way and far cleaner than other solutions, and unlike a water fountain they can’t break it off and do whatever with it. They just put the bottle in front of the censor.”
Burch said the number of heat-related deaths underscores the importance of setting up inclement weather and cooling stations as well as putting a higher priority on putting people in noncongregate shelters like hotels while people wait for housing.
“The county has stood up several hundred units of noncongregate shelters where people are in motel/hotel rooms tonight because we know they are more susceptible to environmental issues,” he said. “We would love to get you an apartment, but we know a hotel room that night is the best thing, so if you’re on diabetes medication or insulin you don’t need to be out in 110 degree heat or out in 32 degree rain.”
Despite being in the middle of a pandemic, covid was only listed as a cause of two deaths.
“We don’t know why but our best guess is that because people are outside, it’s staying away from all the sick people.” Spriggs said.
The recent death rates among the unhoused population also underscore the need for the community to build affordable housing, especially for low-income populations. Nevada lacks more than an estimated 105,000 affordable units.
Both the state and the county used money provided by the American Rescue Plan Act, a relief bill signed into law by President Joe Biden in 2022, to begin making investments into affordable housing projects.
Additional housing units would not only help get more people off the streets and into housing, but also help protect people from entering into homelessness in the first place.
“If I have people who are currently in noncongregate shelter or transitional housing and I can move them out into these apartments, that creates space in other programs to move people off the streets into those programs,” Burch said. “A truly healthy system we envision as a community is one that has the available resources to house someone at whatever level they are ready to be housed at the moment they need to be housed. We are working toward that, and you need the big investments we made to make it a reality.”