Homeless and Mentally Ill–The New American Epidemic

As a transit bus operator for the past almost 20 years, I have had the opportunity to observe human beings in all manner of settings. One of the things I have found to be alarming is the apparently increasing number of homeless mentally ill persons I see on a daily basis in the city where I work and live. As far as I am concerned it is beginning to reach epidemic proportions and I began to wonder why these people, who are so obviously ill, are not being cared for somewhere that their physical, emotional, and psychological needs are being met.

So I decided to do some research on the subject. I remember years ago when I was still a child the controversy surrounding then-Govenor Reagan’s push to deinstituionalize California. In 1967, the Lanterman-Petris-Short Act (LPS Act) was passed. It called for many reforms in what was seen as a very flawed mental health care system.

“The bipartisan law came about because of concerns about the involuntary civil commitment to mental health institutions in California. At the time, the act was thought by many to be a progressive blueprint for modern mental health commitment procedures, not only in California, but in the United States.

Its main purposes were:

1) To end the inappropriate, indefinite, and involuntary commitment of mentally disordered persons, people with developmental disabilities, and persons impaired by chronic alcoholism, and to eliminate legal disabilities;

2) To provide prompt evaluation and treatment of persons with serious mental disorders or impaired by chronic alcoholism;

3) To guarantee and protect public safety;

4) To safeguard individual rights through judicial review;

5) To provide individualized treatment, supervision, and placement services by a conservatorship program for gravely disabled persons;

6) To encourage the full use of all existing agencies, professional personnel and public funds to accomplish these objectives and to prevent duplication of services and unnecessary expenditures;

7) To protect mentally disordered persons and developmentally disabled persons from criminal acts.”   (http://www.ukiahdailyjournal.com “Another Voice-Mental Health Myths” by Jim Shields).

Sounds like a great plan right?  Unfortunately that was as far as it got. Great ideas are usually only that–implementing them becomes virtually impossible when you have political parties and powers fighting with each other constantly. Oh yeah–that’s called the US Government and every President and Governor that ever takes office finds out that what they want to do requires immense amounts of lobbying and begging and politicking to even get it in motion, let alone begin functioning in the way it is supposed to work.

In the past 49 years the mental health care system has never recovered from the blow it received when the LPS was passed. I can speak as a resident of California when I say that the homeless population has grown substantially since that law was passed. And the mentally ill population that lives on the street has also grown. Every day I see men standing on the sidewalk near the transit station arguing with an invisible adversary. I see women who are empty-eyed, dirty and disheveled, sitting in the dirt while they chain-smoke. When I leave out on my first bus in the morning at 6 am the sidewalks near the Salvation Army downtown are lined with sleeping transients. There are shelters in town but most require those that reside in them to be sober and drug-free. Many of these people drink and use drugs to self-medicate to escape the demons living in their heads, which prevents them from getting the help they so desperately need.

I just don’t understand how it is ok to let humans who cannot care for themselves to exist the way these people live. We cry over baby seals being slaughtered and whales being hunted and dogs and cats being kept in inhumane conditions, but when we start talking about the homeless and/or mentally ill all I ever hear is “not in my neighborhood! ” or “well they choose to be that way let them be”…. Really? They CHOOSE to be mentally ill?!

I think it is time to re-examine the benefits of state and/or federally funded institutions for the mentally ill. Many are being imprisoned with actual criminals because there is no other solution for keeping them off the streets where they often are violent because of their illness. When you hear about a crime where multiple people are injured and/or killed 9 times out of 10 the person turns out to be mentally ill. And often the family of the person has reported them to the authorities as a possible danger to themselves and others and have been ignored because there is nowhere for the authorities to send them. A 72 hour hold is often not enough time to evaluate, treat, and maintain a person with a severe mental disorder. Its like trying to put a Band-Aid on a femoral artery bleed. It might slow the flow but unless it’s treated the patient is going to bleed out and die.

I realize there is no easy answer to this problem. but its time that it is recognized as a serious issue in today’s society and solutions need to be found before it gets any worse. Obviously closing the mental institutions was a bad idea. Reestablishing them with better controls and more overviews for patient care and treatment would be a start. Jobs would be created and safe living environments would be preferable to the conditions these people are suffering in now. I cannot imagine that it is more cost-effective to allow these mentally ill people to live on the streets and work the social and health care systems than it would be to provide them care in appropriate facilities.  Those with violent tendencies due to their mental illness would have the opportunity to receive appropriate treatment and medications to enable them to function in society rather than be a danger to themselves and others or incarcerating them with actual criminals.

I am only one small voice in this debate. Only one opinion. But sometimes it is that one lone voice in the wilderness that must speak up and be heard before anything gets done. We are on the cusp of a new administration in Washington DC. When the new POTUS takes office it will have been 50 years since the LPS Act was signed into law. Maybe its time to re-examine the intent of the act and provide the care that is needed so desperately by those the least able to speak for themselves. Write your Congressman. Write your assembly person. Look for ways you can help within your own community. Together we can make a difference.