I believe people in the future will judge us harshly concerning our current treatment of homeless people with serious mental illness.
Serious mental illness runs in my family. What were called demons hundreds of years ago, have possessed some of my loved ones. Only they are not demons but severe brain disorders. They have wreaked havoc nonetheless: breaking up marriages and families, causing fear for the loved one’s safety and constant worry. In the case of my brother, severe mental illness caused his untimely death.
My family had the resources, knowledge and access to medical care to try to help afflicted family members. Without us would they have ended up homeless or in prison? I don’t know for sure.
In seeking solutions to homelessness today, severe mental illness is one of the most difficult problems local governments and social workers face. One out of 100 Americans is affected by schizophrenia; bipolar disorder affects another one percent, but a much larger proportion–as many as 200,000, or one-third—of this country’s homeless population is seriously mentally ill.
These fellow citizens live under bridges and in our parks – forage in trash cans, pace and rant on street corners, shun others and self-medicate with alcohol or drugs. We cringe. We turn away. We cross the street to avoid them.
In New York State, an involuntary outpatient treatment law for the mentally-ill homeless has produced dramatic results. In just five years, this humane law has reduced the most severe consequences for people who formerly rejected treatment: Almost three-quarters of those treated are no longer homeless. The majority did not require psychiatric hospitalization. Arrest and incarceration are rare. A similar law enacted in 2003 in California has begun to show comparable results. These laws bridge the gap between personal freedom and societal responsibility, and include important safeguards against long-term involuntary commitment.
Because of the roll of genetic dice, life events the rest of us could handle have caused the brains of others to malfunction. Their illnesses are well-understood and medical breakthroughs in the last two decades offer great promise. With regular treatment and medication, many who have become homeless through no fault of their own could return to society. Instead they regularly reject this help; too ill to recognize they need it. Instead they exist every day in a hellish alternate reality.
Mandatory outpatient treatment works, and is less expensive than incarceration or repeated emergency room visits. Treatment could dramatically change the lives of thousands of people living on the streets of America. Solutions exist to help those with severe mental illness out of homelessness. I hear those in the future asking how we could turn our heads and ignore our brothers and sisters.
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