Our Failure to Address Mental Illness and Addiction
Using the term "Homelessness" weakens our resolve.
I don't’ like the use of the term “homelessness”. It implies a condition that is a health problem that the “victim” is subjected to; that no choice was available. The actual condition, as I have observed, is addiction, including alcohol addiction, and/or mental health problems. A review of the data terms and reporting suggest that somewhere between 35% to 60% of homeless people are addicted and/or mentally ill. I find it very hard to believe that 40% of this population is people without either addiction or mental illness. If you have typical human capacity, why would you sleep on the street?
Let me briefly describe my bonafides. I have a masters of science degree in psychology and over 40 years experience in government programs including criminal justice, substance abuse treatment and prevention, public health/epidemiology and public education. I served as senior analyst to the Governors Mental Health Transformation Project (2005-08) and, sadly, raised a son that struggled with mental health issues and addiction. My wife is a budget director at a state mental health hospital. These are not topics that we have little interaction with.
In the 1960’s, a national effort referred to as “deinstitutionalization” was a key policy issue and led to downsizing of mental health institutions and efforts to shore up community service programs to support the population. I’ll not suggesting that these efforts were NOT attempting to alleviate the challenges of treating the mentally ill, but now, after almost 50 years, the most telling result of those deinstitutionalization efforts is what we call “homeless” people exhibiting both addiction and mental illness. We now see tent cities in most urban centers, with associated crime and abuse among the “residents”.
With the pandemic, homelessness (hate the word) is a disease ridden group of individuals that I doubt respond to the recommended precautions for covid: hygiene, masks, vaccinations. The greatest of the bouts of plague in history are often attributed to those poor, sick and without shelter. In fact, covid deaths among the homeless is more than 50% of the rates in other populations. This creates a vulnerability to all of society: lockdowns in a tent city? Right.
While working with “consumers”, a term preferred by individuals in recovery from mental illness, I was rather shocked to hear many of them talk about the safety and care received in MH hospitals, and many told of individuals deteriorating after they left the hospital. Some in recovery asked to be reinstated to the hospital if they were fearing a relapse. The overall mental health hospital system needs significant reform, but it remains a better system than the community services that are underfunded, often short term, and is focused on rehabilitation and a return to . . . tent cities?
And what about those whether in recovery or not that commit crimes to survive. Current democratic views of crime try to excuse, even suggesting that criminals are victims (and there’s much to say about this issue including the racial implications). Numerous studies as far back as the 1970’s show significantly (40 times!) greater criminal rates among the homeless. Our system for protecting the mentally ill, addicts AND their victims is dysfunctional. You won’t hear the terms “law and order” much in the reviews I've read, and I didn’t see much in my experiences with these systems and the politicians charged with finding solutions.