The Federal Healthcare Bill Could Actually End Homelessness
by Tony Chavira
While Tea Party types rant about the government taking over something-or-other and while millions of people do whatever they can to pay their healthcare expenses out of pocket this Christmas, the Obama administration has put a huge effort into something that I think has been a long time coming: a reinvestment of resources and manpower into the Substance Abuse and Mental Health Services Administration’s (SAMHSA) Homelessness Resource Center. To draw a straight line, if the Federal Healthcare Bill allocates proper funding toward SAMHSA’s programs, we may be well on our way to a homeless-free society.
Time for a little backstory though: founded in 1992, SAMHSA’s always been an underfunded agency that does the best with the money it has to assist and provide a network for those dealing with mental illnesses, for their loved ones, and to help maintain a network for clinics and mental healthcare professionals. In 2002, then-President George Bush established under SAMHSA the New Freedom Commission on Mental Health, which completed a pretty comprehensive report and eventually came up with nineteen formal recommendations for adjusting the mental healthcare system to make it more efficient, practical and useful. At first, everyone was elated that the commission actually seemed to do its job, and most were totally for whatever the commission recommended. However, as actual healthcare expenses revealed themselves and the commission members’ motives became more transparent, it became really clear that the major beneficiary of this report would be the pharmaceutical industry. In retrospect, are you really that surprised? Especially since the Secretary of Health at the time, Former Wisconsin governor Tommy Thompson, mostly promoted healthcare changes that benefited companies in which he had a personal investment. Of course, wanting to impose mandatory mental healthcare screenings for children wasn’t something you called fascist in those days.
All past political dealings aside, the fate of consistent homelessness right now is literally in the hands of the U.S. Government, and steps they take today can make or break our approach to homelessness from this point forward.
Have you ever thought about what the world would be like if everyone who wanted to live in a home had one? Would this end to homelessness be glorious, free, and perfect for everyone? No. And why not? Because it wouldn’t actually be the end to homelessness. It certainly would be fantastic to give everyone who wanted a home a place of their own, and that’s absolutely the goal of affordable housing advocates worldwide. However, there’s a certain population out there that may not be socially adjusted enough to afford or maintain consistent living conditions. These people are on the streets for a completely different reason than your neighbors who recently lost their homes: they are mentally ill. They cannot or have not lived normal lives in nice homes, lofts or apartments. They are actually sick, and they need help right now.
When these poor, sick people go out (or are thrown out) onto the streets to live, eat garbage, and scream obscenities in the middle of our city streets, we as a society have the terrible tendency to look at them in disgust—or worse, disdain. But they may, in many cases, prefer the anonymity of the streets. They may not be able to live in one place, use their real names, or even remember anything about their past. They may have severe, crippling disorders which make them a threat to the people around them. Or to themselves. But put all that aside for a moment and remember that they’re still homeless. They have nowhere to go, so they go nowhere. What’s worse is that their families may be looking for them, hoping that they’re somehow able to get along on their own despite their mental condition. It’s not unheard of for people suffering from mental illness (sometimes completely out of their control) to literally get up and run away from those who love them. And what are their loved ones left with other than the sad, longing hope that they’re not dead in some cold city alley.
However, any legislation that provides the homeless and mentally ill with healthcare facilities should have five core criteria:
- Absolutely Free—Healthcare should be so free that there’s not even a question in the minds of the clinicians about whether or not they’ll take care of anyone who steps in for help, homeless or not. Naturally, there is always the threat of violence from mentally ill patients, so some type of security should be required, but generally speaking the clinic and mental health facilities should always be free, all the time.
- Ability for Anonymity—This can be a huge deterrent for some mentally ill homeless individuals, especially those who have been victims of abuse and would not go into a hospital out of the fear that their abuser will somehow find them. Aside from this, it can give peace of mind to caring families who just want to know that these services are available in the first place, rather than constantly live in uncertainty of how their mentally ill family member is faring.
- Heavy-Duty Focus on Training—Let’s be clear: most homeless people with mental illnesses are suffering from very severe cases. They’re the people who see screaming on the buses, talking to themselves on the sidewalk, or crying openly in public areas. Since this is their world they’re dealing with, we’d need our free mental health clinicians to be appropriately trained to deal with severe mental illnesses. Just as importantly, these clinicians should have strong backgrounds in drug abuse, as more than half of all homeless people with severe mental illnesses are self-medicating with addictive drugs.
- A Surge of Money to the Healthcare Referral Network—No more dealing with HMOs and no more dealing with bureaucracy when needing to change doctors. If you’re a clinician dealing with a homeless veteran suffering from an advanced case of schizophrenia (which is not uncommon, by the way), you should be able to get to an expert right away. Otherwise, that poor veteran will end up right back on the street. Already SAMHSA’s Homelessness Resource Center has been working to put this type of network together, but the bureaucratic walls need to start coming down.
- On-Site Housing—Remember, these people are mentally ill. They’re not criminals, they’re not disgusting, and they’re not someone you should ever look down on. They are sick. So you cannot provide them with mental healthcare during the day, and force them back onto the streets at night. You just can’t, and this issue will make or break how effective any free program will be. They need to be monitored, constantly. They need to know they can stay in a place that’s warm and safe. They need to be around people who can help them. They need to be treated like people.
Free mental health facilities should be a national priority worthy of massive federal bucks. Homelessness will never end until mental healthcare facilities are free, inviting, and accessible to the mentally ill homeless community. Mentally ill homeless people not being able to afford to check themselves into a facility doesn’t mean they should be completely discarded by society. At the very least, we need to try to help them. We owe them the basic human dignity of some kind of respect, or else we don’t deserve that respect ourselves.
For more information on SAMHSA’s Homelessness Resource Center services, visit their site at homelessness.samhsa.gov.
www.racaia.com | tony@fourstory.org
Comments
as a mother whose son died as a result of mental illness, i thank you from the bottom of my heart.
2009-12-27 by florence