Erased, Disgraced, Displaced, Misplaced: The Homeless Mentally Ill
Any discussion of treatment for the mentally ill begins with location. Where can they live? Is the environment habitable? Friendly? Supportive? Therapeutic? Are services nearby? What kind of services are needed? Why, then, is the treatment for the mentally ill homeless population so horrendously dreadful, counter-productive of healing, and unable to provide this vulnerable population physical and mental restoration?
I describe the lack of treatment and understanding as being erased disgraced, displaced, and misplaced: four distinct steps that severely undercut the well-being of this vulnerable group of people.
A homeless person faces erasure — not quite human, unworthy, and despicable. Disgraced — no place at any inn to take them in. The housed ignore them, their chapped hands out for money standing on street corners. The authorities round them up, pushing them to another place, still one more place. Forever maligned and displaced. Some end up in prison. In fact, 40% of American prisons and jails are filled with the mentally ill, while thousands more are simply left homeless, wandering from place to place, riding buses or finding public library seats to keep warm, pushed along by police from one homeless camp to another.
Christian missions and private charities have opened their doors to these labeled misfits — those who are homeless and mentally ill — but such facilities lack the resources to intervene in any meaningful way. Where are the psychiatrists, the medications, the secure lodging on a 24-hour basis, the meals, the daily care plan? Such facilities have none of these, despite their doing the best with limited funds.
My son, Michael, suffering from bipolar disease and panic attacks, confronted this four-tiered stigma when he was home invaded and forced out of his apartment by thugs. Although he was never arrested, he endured each of these. He was effectively erased from the human race, and allowed to sink into the depths of homelessness for over a year. His identity as a responsible renter evaporated as landlords and even mental health staff treated him as incompetent, discredited and humiliated.
As Michael wandered the streets seeking assistance — food, medicine, rest, a friendly face — he was constantly rebuffed. No room in the overcrowded mission, no food in the pantries, no medical care on the premises. Empty. The missions tried but accommodating Michael with his dual diagnosis of drug dependency and severe bipolar condition, made worse by cold, hunger, and loneliness, added to his sense of being totally misplaced.
When Michael experienced a mental health crisis, and increasingly a number of physical health crises — pneumonia, kidney failure, or other medical catastrophe — he was often in for only an overnight and shunted out the next morning with prescription in hand, but no transportation to get to the pharmacy to have the prescription filled. Hospital visits became one more misplaced accommodation.
Still, my homeless son persisted, seeking help, being cooperative, and even sharing his limited food or cigarettes with others, Mike humbled himself to find an opening in the mental health system to squeeze into. And that help opened up in a two-fold process. The first facility offered a regular bed and meals program; primarily a place to recoup mentally and physically. Mike needed to be resocialized, take directions, and learn to live in a congregate setting.
Succeeding in this facility meant he could graduate to a full intensive recovery program available with a separate, shared bedroom, work program, therapists, classes, and a reward system. After the candidate had completed the program, he could apply for independent living. Mike had reached the pinnacle: Securing an apartment to live drug free and with mental health assistance.
I suspect my son’s two-year journey through the stigma maze is a miracle. Many of our society’s mentally ill face a lifetime of rejection and stigma. In the wealthiest country of the world, how is it possible that our mentally ill population continues to grow; a festering wound at the heart of every American city and town.
