Homelessness and Healthcare Are Linked
My wife used to run a nonprofit that helped eligible disabled people to get on Social Security. Some people didn’t understand why this was necessary, since most people just stroll into a Social Security office and apply. But contrary to what the Washington Post wrote about recently, one doesn’t just stroll in, fill out a form, and get approved. Almost all initial applications are denied outright. It’s not as easy as it sounds to prove your case, and many disabled people don’t have the knowledge or understanding of the system to get approved. And in some cases, people are so mentally ill that walking into a Social Security office is impossible (some have been barred). Advocates like my wife can tell if a person is likely to be eligible, and they can help them through the system and refer them to a lawyer who specializes in appeals, if needed.
Most of the people Ahnna helped were homeless. Particularly before the American Healthcare Act (ACA, or Obamacare), it was (and still is) common to find disabled or seriously ill people on the street because they were unable to work, lost their job, and therefore lost their insurance and housing. One of Ahnna’s clients was a woman who was getting cancer treatment, and she had been homeless for two years. “I had a choice,” she said. “I could die and be housed, or I could treat my cancer and live. Now I wish I’d chosen the house.” There are many stories like this. One homeless client had a colostomy bag. Many were in wheelchairs. Some were dying of terminal illnesses. And some were mentally ill.
Here is Jack’s story, in Ahnna’s words:
Every morning, Jack came into the day shelter where my office is to find coffee and use the bathroom. He drank out of an old Gatorade bottle that looked like it had been buried in mud. It was hard to see what he looked like because his dreadlocks were caked with filth and completely obscured his face. He would not make eye contact with anyone. Ever. He was so dirty — he purposely covered himself in excrement — that he would clear whichever side of the room he occupied. He always kept completely to himself.
One day after I had been walking by him for almost two years, he lifted his eyes to me. They were bright blue, and I was shocked at how young he was. He said the only words I had ever heard him speak up until that time: “I’m Jack.” Then he disappeared again behind his hair.
A few days later, another regular client at the shelter led Jack into my office by the elbow and said, “Can you please help this dude?” Then he left the room.
I asked Jack if he wanted help. He said simply, “Yeah.” He lifted his eyes to me for the second time. He said, “I see the mark of the devil on you.”
I replied, “You see something I don’t, Jack.”
“I see a lot of things other people don’t. What do I have to do to get help?”
I had him sign a release so that I could talk to the Social Security Administration on his behalf. The nonprofit that I started, Benefit Advocacy Coalition, existed to help people just like Jack navigate a system that they could never navigate on their own. With help, severely disabled people can become stabilized with the small income that Social Security provides. Without it, they wander the streets as Jack was now doing.
After my first talk with Jack, we had to change the chair because he had purposely soiled it. His mother later told me that he frequently peed on furniture to “sterilize” it. Jack was clearly unable to cooperate with the process of having me take an application for benefits, but someone in the shelter knew his mother. I called her and completed the application over the phone without involving Jack.
Jack was 30 when we applied for benefits on his behalf. He had been on SSI after a psychotic break that occurred shortly before he was 19. Before that happened, he had a 4.0 GPA and early admission to college. He lived at home after his break, but he became so violent that his mother had to lock him out of the house because his rages were directed at her. He was missing for ten years on the street. He lost his benefits because no one could locate him. His mother said she had found him a few times, but never knew how to get him back on benefits because of his lack of ability to cooperate with the process.
I had a psychologist come to the shelter to do the evaluation SSA needed. Jack’s diagnosis of paranoid schizophrenia was confirmed. Jack was allowed benefits within a month of his application for them. Because of this, the housing experts at the shelter we partner with were able to get him into a residential facility specifically for people with schizophrenia. Jack had his own room there, and daily meals. He was finally persuaded to take the antipsychotic medication he needed and was monitored daily by professionals.
One day, as I was coming into work I noticed a young man who was trying to catch my attention. He asked me if I knew who he was. We help so many people that I often have trouble remembering everyone, but he did seem so familiar. His red hair was freshly cut and his clothes were clean. He didn’t smile at me, but he looked at me intensely. I recognized him only because of those bright blue eyes. He had gained weight. There was color in his cheeks. It was Jack.
He said, “I have my own room.”
I said, “I heard.”
“I’m sorry about the devil. My mother says you are an angel. Are you?”
“I just see things other people don’t Jack.”
It was the closest I’ve ever seen to a smile on his face. And then he was gone.
Ahnna doesn’t run her nonprofit anymore. She couldn’t get funding. No one, it seems, wants to help people get on federal benefits. But many people have no other choice. What should they do? Charles Dickens’ Ebenezer Scrooge, when asked if he would contribute to the welfare of the poor, heartlessly said, “If they would rather die, they had better do it, and decrease the surplus population.” Given the state of our healthcare system and the social safety net, too many Americans and Congressional representatives agree.