Full disclosure, I am sitting outside of my office watching a man walk down the street and scream obsenities into the air…
I don’t have a Public Health degree and I can’t read the article because I don’t have an LA Times Subscription. My Facebook feed is frenzied by this article. Never the less – I have some thoughts:
- Important to note that it includes ALL health conditions, SUD, MH, Developmental and Physical.
- It doesn’t seem to explore the hidden homeless population of what I call “gentrified homeless folks” staying with friends and family long term (according to comments I have read)
- I think there is a definite tie between stress and illness. This has been proven in otherwise healthy adult populations. It is not surprising that those without any form of shelter are more likely to have – or be able to self-identify with an illness of some sort.
- People with resilience still can use a launch pad – having even one of these problems puts you at risk, we see people with combination issues.
- I think TTC does a good job of seeing the whole person and trying to connect them to services.
- Ending homelessness is a long process that involves a lot of after care and follow up.
- Homelessness is tied to the severity of symptoms of their illness(es)
- What I’ve seen: The stigma of having a MH condition is still worse than that of having a SUD – there is some feeling in the population that someone with SUD has made that choice and isn’t innately broken. This stigma also prevents people from seeking diagnosis and treatment. You and I know they are health conditions, the public doesn’t. And the public often judges and then ignores them.
- There is some overlap between people having MH and SUD – and to the outsider they both look equally unappealing and scary. This is the basis of NIMBYism. Even our very religious and self-identifying “good person” who is the president of the OSO HOA lost sleep when she first heard about our patients being 5 doors down from her.
- Shelters are not equipped to help everyone – and there are not enough beds.
- Won’t always take service dogs ( if there is an allergy, animal has fleas, etc – some places literally make up reasons)
- Can’t take emotional support animals
- No parking for motorhomes and cars
- Rely on private donations for clothes, food, etc.
- Are in geographically undesirable areas – either on the edge of town or in skid row (land price is better there)
What I have learned this year is that there is a missing middle level of support that is a cross between Board and Care and Homeless Shelter for the Chronically Homeless (that segment of the homeless population who won’t ever have enough money to live on their own and won’t have the mental ability for budgeting, working, and self-care). You find make shift versions of this in places like The People Concern where “guests” have lived in a shelter bed for 10 years. That is their new normal and where they feel dignity. I would not want to live there, but it works for the severely mentally ill. They are free to come and go but have food and medicine assistance with no expectation they will change their level of housing.
Supportive Employment: Our people who want to work are not always work ready. Part time jobs with incomes low enough to keep social security payments would be a great resource.
Also support groups for those workers, otherwise they often get hired and as quickly lose their jobs because they don’t have the skills to keep them. Chrysalis is great – but really hard for patients to get to. All of my staff have learned to teach resume writing and job searching.
A lot of the patients we have helped to find housing, including those we have diverted from our services, still had vaguely healthy relationships to their families of origin. Supporting those families, and listening to them has opened them to the possibility of taking their loved one into their homes. The most frequent conversation I have with the family is acknowledging their struggle and how scary it can be to be open to this person again. I don’t know that there is a program just for this.