3 ms·

I spent some time working on a psych ward for a very low SES hospital. I can’t tell you how often we established a place of residence and continuity of care for

I spent some time working on a psych ward for a very low SES hospital. I can’t tell you how often we established a place of residence and continuity of care for patients before discharging them, only to have them more or less openly tell us they’d bail and go homeless as soon as they got out because they don’t like the rules (eg, no drugs) or resources (roommate or community dwelling situations, rather than private apartments). Just throwing more money at the problem would have helped, but certainly wouldn’t have solved the problem.

mrec 7y ago
"SES" in this context is socio-economic status? I hadn't seen it used to classify hospitals before. I worked at an emergency homeless shelter for a while, long ago, and saw the same kind of thing you talk about. I'm not sure it was quite as deliberate, but you can absolutely set someone up in a perfectly nice free apartment and they'll still somehow find themselves back on the street in short order. Now, that's not everyone! Not by a long shot. You're absolutely right that throwing money by itself is not going to eliminate homelessness, but throwing some money would probably take a good-sized chunk out of it.
- prostheticvamp 7y ago
  > “SES" in this context is socio-economic status? I hadn't seen it used to classify hospitals before. Yeah, we were a safety-net hospital across the street from a prison. We got a lot of inmates, had a locked wing on most floors for prisoner patients, many many uninsured illegal immigrants, etc. We had quite a few patients that should have gone home, but we couldn’t safely discharge them, so we were just their free hotel while they hung in social support limbo - we were owned by the county, so taxes paid for their stay, and they were in no rush to leave. It was very much a case of seeing how most failed social policy ultimately ends up in the hospitals. Working in wealthier hospitals is way more fun. Treating disease is much more satisfying than “treating” poverty.
  - csharptwdec19 7y ago
    Question. Or maybe a statement Given how expensive medical care can be, doesn't this indicate that perhaps our current system is more expensive to society as a whole? (I mean, there are other factors, but given that the cost of health care is something that even more 'well off' people care about, perhaps it is a better angle to push for discussion and reform?)
snarf21 7y ago
Well, I agree that if we take an approach of "you have to get off drugs and have 3 roommates", it will continue to be a dismal failure. It does take a different approach (private rooms, no conditions, safe haven, etc.) and this will tend to cost more. People need stability and autonomy first and that will allow some to get back to normal society. Yes, there are some that just want to drink but having a home base in a building with food and other resources is the only way they even have a chance. I think this is key as they need to start to feel human again and having people there every day honestly trying to help (not "fix" or "correct") is empowering.

mrec 7y ago

"SES" in this context is socio-economic status? I hadn't seen it used to classify hospitals before. I worked at an emergency homeless shelter for a while, long ago, and saw the same kind of thing you talk about. I'm not sure it was quite as deliberate, but you can absolutely set someone up in a perfectly nice free apartment and they'll still somehow find themselves back on the street in short order. Now, that's not everyone! Not by a long shot. You're absolutely right that throwing money by itself is not going to eliminate homelessness, but throwing some money would probably take a good-sized chunk out of it.

prostheticvamp 7y ago
> “SES" in this context is socio-economic status? I hadn't seen it used to classify hospitals before. Yeah, we were a safety-net hospital across the street from a prison. We got a lot of inmates, had a locked wing on most floors for prisoner patients, many many uninsured illegal immigrants, etc. We had quite a few patients that should have gone home, but we couldn’t safely discharge them, so we were just their free hotel while they hung in social support limbo - we were owned by the county, so taxes paid for their stay, and they were in no rush to leave. It was very much a case of seeing how most failed social policy ultimately ends up in the hospitals. Working in wealthier hospitals is way more fun. Treating disease is much more satisfying than “treating” poverty.
- csharptwdec19 7y ago
  Question. Or maybe a statement Given how expensive medical care can be, doesn't this indicate that perhaps our current system is more expensive to society as a whole? (I mean, there are other factors, but given that the cost of health care is something that even more 'well off' people care about, perhaps it is a better angle to push for discussion and reform?)

snarf21 7y ago

Well, I agree that if we take an approach of "you have to get off drugs and have 3 roommates", it will continue to be a dismal failure. It does take a different approach (private rooms, no conditions, safe haven, etc.) and this will tend to cost more. People need stability and autonomy first and that will allow some to get back to normal society. Yes, there are some that just want to drink but having a home base in a building with food and other resources is the only way they even have a chance. I think this is key as they need to start to feel human again and having people there every day honestly trying to help (not "fix" or "correct") is empowering.