5 ms·

I wonder if better/more accessible health care would eliminate homeless as a side effect. It seems much of the homeless in Boston, anyway is mental health/healt

by tabeth 10y ago

I wonder if better/more accessible health care would eliminate homeless as a side effect. It seems much of the homeless in Boston, anyway is mental health/health related. I doubt anyone will say that what Utah did here is bad, but you have to wonder what's preventing a more comprehensive solution (the answer is politics, but ideally you'd get a more specific answer).

ebiester 10y ago
Some yes, some no. Let's remember that mental health care is not as easy as a magic pill. It can take months to stabilize someone. Someone with schizophrenia may have difficulty staying on a regimen. (The side effects are bad in many cases, and the drugs aren't a magic cure.) Some people would do best in a psychiatric ward more permanently, for example, but that's including housing. Bipolar treatment can stop working and it can take months to get things readjusted. Inversely, homelessness exacerbates mental illness in many ways, and stabilizing the housing situation goes a long way toward stabilizing the mental illness.
- tabeth 10y ago
  I agree with you, but (most) people don't start off homeless in life, so what factor(s) make people homeless? I bet one of the top ones are health reasons.
  - ebiester 10y ago
    Luckily, we don't have to speculate. http://www.nationalhomeless.org/factsheets/why.html http://www.nationalhomeless.org/factsheets/why.html
jrowley 10y ago
The line between safe housing and healthcare really starts to blur when you start talking about people with severe mental health issues. Another side is that debt from expensive medical care can result in homelessness. It all should be considered basic welfare that we should be providing instead of gutting.
xraystyle 10y ago
It seems to me that largely the issue is there's no mechanism to force people into treatment for drug/alcohol addiction and mental illness. Here in Los Angeles the number of homeless who are severely mentally ill is incredibly high. It's quite common to see homeless people standing on street corners, yelling and screaming at non-existent antagonists, behaving bizarrely, urinating and defecating in broad daylight, and creating a general nuisance for everyone around them. The same goes for seeing drug and alcohol use in public, especially in places like downtown LA and Venice Beach. Seems to me that the homelessness isn't the problem, so much as a symptom of the underlying issues of addiction and mental illness, and unless people voluntarily seek treatment for those issues their situation is unlikely to change. Whether the healthcare is available or not, the question is moot if you can't force people to go to rehab and take their meds.
- NewCathargo 10y ago
  Rehab is worthless beyond worthless. I liked Audrey Murphy's strategy, of locking himself in a room for a week, far better. Rehab doesn't address the part where you come back to normal life. And all the old aches and pains start up and nothing seems worthwhile and there's little work... Teaching the homeless to be COMPETENT nomads is a better strategy. Otherwise they're at the mercy of public officials and contractors who only see them as a flesh to money machine.
- vondur 10y ago
  You care completely correct about the obvious need for mental health and addiction care. I'm guessing 90% of the people living on the street are drug addicts and have mental illnesses. It's a hard problem to deal with as just giving someone housing that has these kinds of issues won't fix the underlying problems and they'll end back up on the streets. In California, due to a court order and some newly enacted laws via propositions, a lot of people have been released from jails, which I'm guessing is where many of the mentally ill/drug addicts previously ended up.
- slv77 10y ago
  In the US the Supreme Court ruled in 1978 that unless an individual was a threat to themselves or others they couldn't be institutionalized. This was one step of a much bigger reform of care for those that are disabled or mentally ill called deinstitutionalization. In the past those with mental illness or disability were locked up in facilities with little support for reintegration into society. In many cases being committed was effectively a life sentence. There were also cases of abuse of the system where people were committed for rebelling against parents, homosexuality or political dissidence. Deinstitutionalization was supposed to transition patients to community based care but it was never funded to the level that would have been needed to support the transition. Even in the US today mental health care is typically the bastard child of the US health care system with minimal coverage. A $50,000 dollar a year arthritis medication is covered but only a couple of days to stabilize a patient in a mental health crisis. I'm not sure if community based care would have ever worked even with the right funding and that a lot of the addiction and mental health issues may be related to the lack of environments that support mental health. I'm pretty sure that the alternative from earlier in the century also isn't the right approach.

by tabeth 10y ago

ebiester 10y ago

Some yes, some no. Let's remember that mental health care is not as easy as a magic pill. It can take months to stabilize someone. Someone with schizophrenia may have difficulty staying on a regimen. (The side effects are bad in many cases, and the drugs aren't a magic cure.) Some people would do best in a psychiatric ward more permanently, for example, but that's including housing. Bipolar treatment can stop working and it can take months to get things readjusted. Inversely, homelessness exacerbates mental illness in many ways, and stabilizing the housing situation goes a long way toward stabilizing the mental illness.

tabeth 10y ago
I agree with you, but (most) people don't start off homeless in life, so what factor(s) make people homeless? I bet one of the top ones are health reasons.
- ebiester 10y ago
  Luckily, we don't have to speculate. http://www.nationalhomeless.org/factsheets/why.html http://www.nationalhomeless.org/factsheets/why.html

jrowley 10y ago

The line between safe housing and healthcare really starts to blur when you start talking about people with severe mental health issues. Another side is that debt from expensive medical care can result in homelessness. It all should be considered basic welfare that we should be providing instead of gutting.

xraystyle 10y ago

It seems to me that largely the issue is there's no mechanism to force people into treatment for drug/alcohol addiction and mental illness. Here in Los Angeles the number of homeless who are severely mentally ill is incredibly high. It's quite common to see homeless people standing on street corners, yelling and screaming at non-existent antagonists, behaving bizarrely, urinating and defecating in broad daylight, and creating a general nuisance for everyone around them. The same goes for seeing drug and alcohol use in public, especially in places like downtown LA and Venice Beach. Seems to me that the homelessness isn't the problem, so much as a symptom of the underlying issues of addiction and mental illness, and unless people voluntarily seek treatment for those issues their situation is unlikely to change. Whether the healthcare is available or not, the question is moot if you can't force people to go to rehab and take their meds.

NewCathargo 10y ago
Rehab is worthless beyond worthless. I liked Audrey Murphy's strategy, of locking himself in a room for a week, far better. Rehab doesn't address the part where you come back to normal life. And all the old aches and pains start up and nothing seems worthwhile and there's little work... Teaching the homeless to be COMPETENT nomads is a better strategy. Otherwise they're at the mercy of public officials and contractors who only see them as a flesh to money machine.
vondur 10y ago
You care completely correct about the obvious need for mental health and addiction care. I'm guessing 90% of the people living on the street are drug addicts and have mental illnesses. It's a hard problem to deal with as just giving someone housing that has these kinds of issues won't fix the underlying problems and they'll end back up on the streets. In California, due to a court order and some newly enacted laws via propositions, a lot of people have been released from jails, which I'm guessing is where many of the mentally ill/drug addicts previously ended up.
slv77 10y ago
In the US the Supreme Court ruled in 1978 that unless an individual was a threat to themselves or others they couldn't be institutionalized. This was one step of a much bigger reform of care for those that are disabled or mentally ill called deinstitutionalization. In the past those with mental illness or disability were locked up in facilities with little support for reintegration into society. In many cases being committed was effectively a life sentence. There were also cases of abuse of the system where people were committed for rebelling against parents, homosexuality or political dissidence. Deinstitutionalization was supposed to transition patients to community based care but it was never funded to the level that would have been needed to support the transition. Even in the US today mental health care is typically the bastard child of the US health care system with minimal coverage. A $50,000 dollar a year arthritis medication is covered but only a couple of days to stabilize a patient in a mental health crisis. I'm not sure if community based care would have ever worked even with the right funding and that a lot of the addiction and mental health issues may be related to the lack of environments that support mental health. I'm pretty sure that the alternative from earlier in the century also isn't the right approach.