What helps is continued outreach and trust-building. Homeless people can experience traumatic conditions in shelters that can cause them to avoid social programs.
You can thank the Sacklers and the judges that dispossessed them of all blame for the addictions they've peddled before you come for my people. You can thank the NIMBYs for refusing to build housing in their neighborhoods forcing people to concentrate here.
Not sure what that has to do with anything. Dying in public from drug addiction suicide on the streets of the tenderloin is about as bad as it gets. People aren’t choosing it through rational analysis of alternatives and shelter trauma. They choose it because it lets them fulfill their 8 hour dopamine cycle.