I have spent a short time working almost exclusively with the homeless mentally ill. It is a population that can be extremely polarizing, even among those who choose to provide care for them. Often, there is debate about the precipitants and perpetuating factors for homelessness, but there are always stark reminders that these are people. These are people that hurt, and cry and bleed like everyone else. These are people who are attempting to survive…many dealing with psychological and physical traumas so devastating it would likely crush others. That is not to say that many aren’t “crushed”, although they walk around everyday…existing.
There is a stark difference between living and existing. Biologically, we are designed to exist…we breath, the heart pumps, blood flows, electrical impulses travel along neurons. Existing is mostly out of our control. Living takes hope. The belief in something bigger than you. The belief that even when things are darkest you can still see the ethereal light of the moon and stars. Many of these folks we call “homeless” have lost hope.
I do what I can for the homeless, specifically those that are mentally ill….many times it feels woefully insufficient. There are thousands of people suffering…and almost daily I feel helpless…often unable to do more than acknowledge their existence and try to provide a basic need. That feeling of helplessness is something that I have to monitor. I was trained in medicine….trained to heal…but I watch as medicine increasingly becomes content with placing bandages. I stand helplessly trapped in a system in which those involved appear content with the disjointed “care” that is given to those we deem “mentally ill”. I acknowledge there are not enough inpatient beds for those that need them. I am aware that there is not enough affordable housing for those in need of a place to live. I know all too well the difficulties that mental illness can place on maintaining a stable living situation. I also see the devastating effects that homelessness has on mental illness. It is easy to become swept up in a wave of moral outrage….loudly proclaiming that this is not right. But its also just as easy to attempt to ignore or blame or to feel disgust.
The issues of homelessness and mental illness are complex….and need complex interventions and solutions. There has to be an expansion of clinical services for those that suffer from severe mental illness…if not, we perpetuate the problem, we aid its persistence, we hinder the ability to recover. There has to be innovation and creativity…if not, we become stifled and complacent. We have to think outside the box, but we have to ensure that the solutions are based in compassion. Additionally, there has to be an expansion of residential services for the severely ill and affordable housing opportunities not for just the mentally ill, but for those we have relegated to the American caste of “Untouchables”