Thursday, September 10, 2009

Solving the Problem of Mental Illness & Homelessness is Simple: Meet their Needs

It's a particular pet peeve of mine when people start whinging about how "difficult" or "complex" the homeless problem is. How there are "no easy solutions" and other sorts of nonsense. Actually, it dead simple, not hard at all.

The mentally ill and homeless require housing. Now. First. Before anything else. Every human being in this world needs a space to be inside, to have a place to keep their belongings, to have belongings that mean something to them. A place to have some dignity. How would most of us handle not having anywhere to do our business in private, to shower, or bath? Don't we all want to have a place to keep the world out, or to have people visit? Seems pretty basic to me.

And food. Nutritious food. With enough of it. Not from dumpsters. Not thrown out from restaurants. Not past their best buy dates. A place to cook, to have stores of food.

From there, the mentally ill need treatment. They need to be able to get in the front door of their local mental health clinic. Into the hospital when they need it. The research is clear, short-term stays aka "tune ups" do not work for those with chronic and serious psychiatric illness.

We have to stop moralizing about drug use and we need to treat addicts and those who become mentally because of drug use like the sick people they are. Sometimes they need to be hospitalized, they have a right to care for their complex health issues. Addictions are a health issue and part of the DSM-IV and as such fall within the domain of hospitals to treat. We don't get all moral at people with MS, with cancer, with diabetes. We give them health care. And when they need to, they stay in hospital.

Another beef I have with how we frame the issue of the "mentally ill" is to presume that there is some sort of homogenous group of "the mentally ill." Each and every one of us walk by people every day who are diagnosed with some sort of "disorder" and perhaps are on medication.

There is a continuum of mental health on which each and every one of us shows up on at some point along a line. And we can go back and forth depending on many factors.

What being labelled mentally ill does is creates an arbitrary, socially constructed category of people and then exposes them to socioeconomic and cultural vulnerabilities and risk factors that often lead to their marginalization and social exclusion from the privileges and benefits many of us take for granted as citizens who happen to appear at one side of a continuum at a particular point in time in our life.

How is it fair that our governments construct this sort of frivolous and socially sanctioned discrimination against a group that any one of us could slide into given a bad enough set of circumstances? Those with mental illness don't ask to have it. They don't set their sights on living on the sidelines, slaves to something that is often completely beyond their control. But even if it is in their control, why would we still not help and support those who need it. It serves our own self-interest to do so as a society. Public disorder flourishes with lack of access to care for mental illness and addictions and the health impacts. That harms all of us.

Fix the broken mental health system. That is a solution too. If you can't get into a mental health clinic to get an assessment and you can't get into a mental health clinic without an Axis I diagnosis, how does anyone get anywhere? When mental health centres can stop taking patients for a while, where do those people go? How many end up in jail like the good ol' American style of care for their mentally ill?

Fix the Broken Child Welfare System. Think about this, each year the BC Liberals are in power in BC, we are adding to the next generation of mentally ill, homeless and criminal populations. There is no debate, no spin, no BS. A generation of children have grown up with profound systemic and governmental negligence. Some have died because of it. Many have been hurt, raped, abused, neglected. School districts are being forced to cut hot lunch programs for kids for god's sake? BC has led Canada in child poverty for six years in a row because our government does not care whether our next generations of children live in poverty, have enough to eat, or anywhere to live. Whether they have people abusing, or hurting them. Because if they did, they would do something to improve the future viability of our kids. Our children simply do not matter to the BC government and it's high-priced incompetent bureaucracy. While they are creating "Appreciation Champions" they might consider creating Champions for Childrens' Safety & Protection.

How many kids, before they are even adults, actually get mental health services?
If a government will cut funding to children who have been sexually abused, they have crossed into a place of no return. A place of true evil. A place where the next generation of mentally ill and addicted citizens get their start, at the hands of their own government, who then throw them out like garbage dumped down at Main & Hastings.

There are many things we could do to help those who have mental illness, to offer them dignity, care and support. But our governments are not doing that. Because they quite simply do not care.


Dignity for All:
The Campaign for a Poverty-free Canada

I believe that freedom from poverty is a human right.
I believe in equality among all people.
I believe we are all entitled to social and economic security.
I believe in dignity for all.
NOW is the time to end poverty in Canada.


Mentally Ill and Homeless

The Victoria Times Colonist - The Gazette, Montreal

September 10, 2009

In the almost 50 years since Canada first began discharging mentally ill patients from psychiatric institutions to live in the community, homelessness has become an intractable problem for many Canadian towns and cities.

Grandly declaring that mentally ill patients had the right to decide for themselves whether to get treated, governments across the country shut down psychiatric asylums. The fact that the state thereby saved millions of dollars didn't escape the attention of the patients' families, friends and doctors. They complained, but to little avail.

Today, desperately ill psychiatric patients are seen in every major Canadian city: Some ramble incoherently; others can be seen digging through garbage bins.

No one doubts that the mentally ill form the bulk of the homeless population. Research from Ontario shows that they make up 66 per cent of those without homes.

The Ontario research found that in the year before they lost their home, six per cent of homeless people had been in a psychiatric facility, 20 per cent had been treated for substance-abuse problems, 25 per cent had received psychiatric outpatient services and 30 per cent had spent time in police stations or jails.

In a move that has been a disgracefully long time coming, the Canadian Mental Health Commission is launching a $150-million program to see how best to help the homeless. Five cities have been chosen to participate in the four-year-long project: Montreal, Toronto, Moncton, Winnipeg and Vancouver.

The homeless chosen to take part in the project will be divided into two groups. Those in the control group will carry on as usual in their chaotic existence, bouncing from shelter to jail cell to hospital. The other group, numbering about 300 homeless, will be housed and followed by as many experts as are needed. The idea is to find out whether a home and services adapted to the individual will allow that person to lead a more stable life.

British Columbia has already tried this "experiment." Compared with the $694 million a year that homeless people cost in police, hospital and homeless shelters, B.C. found that using a combination of subsidized housing and social services would cost $32 million less.

It isn't necessary, surely, to take another four years to prove the same thing.

© Copyright (c) The Victoria Times Colonist

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