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The Homeless Are Just Ordinary People Down on Their Luck, Except When They Aren’t
Article in the LA Times on Homelessness:
There are also misconceptions about homeless people — that the vast majority are hopelessly mentally ill or drug-addicted.
Later in the same article:
Supportive housing in particular — which offers not just a place to live but also access to job counseling and mental health and substance abuse treatment, among other things — is the best long-term solution for the chronically homeless
So … it’s a “misconception” that the homeless are primarily mentally ill or have substance abuse problems. But the solution to homelessness has to include mental health and substance abuse treatment.
Maybe one of the reasons certain social problems seem so intractable is an inability to admit that the politically correct characterization of these problems is at odds with their true nature.
I also dispute the article’s contention that Los Angeles’s homeless problem is a “national problem.” It is not. It is a local disgrace and a product of political choices made by the city of Los Angeles and the state of California.
Published in Culture
Working in California years ago as an ER doc, had a young adult patient brought in by her parents who was clearly psychotic and she was living on the streets and eating out of garbage cans. Her parents were frantic to get her help. We called the local police who were the only ones who could put her on an involuntary psych hold. Cop came in and refused to put her on papers. I argued with him that she was a threat to herself living on the street and eating garbage with wildly psychotic disordered thinking. He responded ” that eating garbage is not that unusual”. I told him ” it is in people who come from the middle class”. He flat out refused, I had run into a “street lawyer”, and he wasn’t going to infringe on her “rights”. I had never before or since run into such an unreasonable officer. As he left I loudly announced to him ” well I wasted all that time in Medical School, I should have gone to the Police Academy to learn to diagnose mental illness”.
Eventually, I told the parents what they needed to do was load the kid in their car and drive directly to the local psych hospital, where they would evaluate her. She was in fact admitted there. She was also saved because her parents still cared.
I took care of a paranoid schizophrenic friend for thirty-five years. I was involved with three involuntary commitments.
It is my opinion that a third of the problem of what to do with mentally ill people lies in the medical profession–all of it, from the psychiatrists at the top of the organization chart to the allied health professionals at the bottom. I encountered so much ignorance about schizophrenia that I was constantly shocked.
Let us begin our understanding of extreme mental illness with the knowledge that we are talking about fear more than anything else.
I had a funny encounter with a top cardiologist at one point–a brilliant doctor, truly. He was watching my friend on a treadmill test, and he was making a concerned face and mumbling things as the test progressed. In a moment of frustration, I grabbed his lab coat and pulled him out of the room. I said, “I don’t care how much knowledge and equipment you have. If you scare her, you will never get to use it!” “I’m sorry, ” he said. “You’re right.” Years later I ran into him late one night in the grocery store, and he burst out laughing when he saw me.
And in the same week as the treadmill test, I was with my friend while another cardiologist was describing the angioplasty procedure. He started his talk the way he always did, “One in 10,000 patients have died.” I glared at him across the bed, and he shut up right away. What is it about having a guardian standing there that doctors don’t understand? You don’t talk to the patient. You talk to the guardian, and he or she talks to the patient.
Those are just two incidents that come to mind because they are still funny to me and the story had a happy ending.
We as a country have enjoyed enough success at this point in helping mentally ill people live somewhat normal lives that it is a matter of will and finding the money, not knowledge. I wish the churches of the country would take the lead because mentally ill people truly are the least of us. We need to look for the success stories–they are out there now in abundance–learn from those stories, and roll up our sleeves and get to work.
It has been over a decade since I went off my meds, but I used to do it all the time. Other than a little bit of weight gain-and I was very thin to begin with-I experienced no bad side effects. It was purely a matter of trying to prove that I didn’t need them. If you haven’t been there, it’s hard to describe how devastating a diagnosis of mental illness is, and how inclined people are to deny it. Most mentally ill people don’t actually become mentally ill until they are young adults; most of them, including me, were accustomed to being “normal”, and lived their whole lives with the assumption that they would have normal lives. That might be why so many go off their meds: they think they can go back to place where mental illness just isn’t an issue. Unfortunately, most can’t.
There’s an app for that:
https://thecrimereport.org/2018/03/06/how-ipads-are-changing-one-police-forces-response-to-the-mentally-ill/
Yeah I’ve worked places that do tele psych evals and it is a valuable resource for us in the ER. If beat cops can get access to it that would be pretty interesting.
I think part of it is that we treat mental illness different from other illnesses. Schizophrenia is based on chemical imbalances in the brain. It’s fundamentally a neurological problem, like a brain tumor, epilepsy, or Parkinson’s. No one is going to blame you if you get a brain tumor or develop Parkinson’s. Someone diagnosed with schizophrenia has a neurological condition that can be corrected with medication, not an extension of being eccentric. The same with clinical depression – it is a chemical imbalance, not just being sad.
True. For statistics, “homeless” includes people staying with relatives or friends but having no place of their own. Not always a useful definition, as the term evokes images of people sleeping in boxes.
I went thesaurusing for ‘homeless’ and found; destitute, displaced, dispossessed, derelict, down-and-out, itinerant, outcast, refugee, vagabond, vagrant, wandering, abandoned, banished, deported, desolate, disinherited, estranged, exiled, forlorn, forsaken, friendless, houseless, uncared-for, unhoused, unsettled, unwelcome, and without a roof (but not ‘hobo’).
One of the sad things in this world is the idea that a list of synonyms is the same as a group of interchangeable words. There are many different reasons a person might not have a home and many different ideas about what ‘not have a home’ means.
If you can’t define a problem, you’re never going to find a solution.
Well, to be a bit cynical about it… I think when it comes to definitions that “meet the requirements for a government program,” our bureaucrats prefer to use the most vague terms possible. That way, they can conveniently define and redefine the problem as it suits their aims. In my experience, the problem must be massive to justify the response; then, we get as many people dependent on “solutions” as we possibly can.
Ah yes, this reminds me of the history of U.S. military pensions and how they were expanded and altered over time to include so much more than was originally intended.
https://www.usnews.com/news/articles/2016-08-08/civil-war-vets-pension-still-remains-on-governments-payroll-151-years-after-last-shot-fired
Well, as we’ve been advised, substance abuse is a disease, so it’s not their fault.
Although I really have a hard time finding leukemia stores.