Sadly, we like to demonize all homeless into one big “druggie”, trash making, useless annoyance. The truth is some we can help, easily. For others it is a much more complex problem. The chronic, mentally unstable, drugged out is only a fraction of the total, but the most obvious, and the most vexing.
For those tormented souls, there is no hope. The safety net that we had for years — the “asylums” are long gone. Before the 1970’s we protected our communities by placing these people — who could not work in society — apart from it.
It was accepted. You go nuts, don’t follow the rules, you get put into a facility.
My own grandfather ended up traumatized (what we’d now call PTSD as he witnessed horrors in his homeland) lost track of reality and threatened his family at midnight with a knife and overwhelming fear (that my then 2-year-old mother remembered vividly). He ended up involuntarily committed to the Agnew Insane Asylum (aka Agnew State Hospital) never to rejoin the family, again. Sad, sure, but he lost his grip on reality, and it was better than wandering the streets, or injuring someone.
The shift in opinion on forced institutionalization began with the Community Mental Health Act of 1963. It was the first of the clear policy shifts, promoted by John F. Kennedy, to move away from state run centers, to federal funding for community-based mental health centers (as in non-profit, and private). It pleased the states to get federal funding, especially for the “feel good” idea of community centers instead of the asylums that were scattered and remote, far from an urban center.
The momentum built with magazine articles about bad experiences in the asylums. We were infatuated with these books and movies like Ken Kesey’s One Few Over the Cuckoo’s Nest (1962) The Bell Jar by Sylvia Plath (1963) Janet Frame’s Faces in the Water, (1961). There were numerous magazine articles, and documentaries (plus, the newly minted 60-Minutes news magazine show) all did terrifying exposés.
Misinformation, at its best.
The refrain was that it was cruel, forced incarceration, that new miracle psychiatric drugs could FIX them, and these people could be just like you, or I. It was swept up in the civil rights, civil liberties, where patient rights were human rights.
“Do your own thing” was the battle cry, in the name of freedom. It was tossing out the baby with the bathwater. There was no half-way measure. No one asked what would happen when a legion of lunatics were set loose.
Three California legislators drove the fix to end mental asylums, appease the critics of the existing mental health programs, and virtue signal for civil liberties. Frank D. Lanterman(R), pushed de-institutionalization, mostly for budget cutting reasons; Nicholas C. Petris(D) believed that involuntary hospitalization was a violation of civil liberties; and Alan Short(D) cited widespread abuse (heavily influenced by the loudest critics and the media slant).
The LPS Act happily signed by California Governor Ronald Regan, because it had “good optics” and really improved the state budget. The money didn’t result in lower taxes, and the savings were never reinvested in community mental health programs. The money was used elsewhere, mostly to build more prisons (until Jerry Brown, emptied them).
Of course the government was thrilled to eliminate the facilities. “Yippeee we can get rid of a big item on our budget” and divert the money to their pork barrel du jour pet projects. (You know, all those “feel good programs” that just waste money.) Lip service was paid to diverting the money to non-profits, but it was a trickle down the pant leg.
The passage of the poorly thought-out and badly executed Lanterman, Petris, Short Act in California was ‘feel good’ legislation. It was copied everywhere, because <ca-ching> money saving, and “those new pharma drugs will fix ‘em.”
Every state copied California and closed state-run mental hospitals, wholesale. Those people least able to actually function within a community were booted onto the streets. The very worst committed crimes that put them in the OTHER forced incarceration program: prisons, although there were other consequences that we still deal with, today. Clearly, now we can see that the LPS Act was a major failure.
Of course, the bad idea was reinforced by an errant Supreme Court opinion O’Connor v. Donaldson, 422 U.S. 563 (1975).
You can see echos linger with civil libertarian lawyers, clear slanted propaganda continues to flood the media, and then, there is the entire homeless industry that has popped up and supported by the frequent, chronic visitors. Who does it really help?
Cause-and-effect?
Is it any wonder that in the 1970’s when there was a proliferation of notable serial murderers? The term serial-killer didn’t exist before then. It wasn’t even considered prior to the closing of the state mental hospitals. Why? Because before we let them “be free” murderous lunatics were locked up.
You know their names, the sensational names given to them by the media: Ted Bundy, Son of Sam (David Berkowitz), Deal Corll (Houston Mass Murder), Hillside Strangler (Kenneth Bianchi and Angelo Buono), Zodiac Killer, BTK (Dennis Rader), Green River Killer (Gary Ridgway), Manson Family, John Wayne Gacy, People’s Temple Church massacre (Jim Jones), Joseph Naso, The Night Stalker (Richard Ramirez), Golden State Killer (Joseph James DeAngelo), Gypsy Hill Killer, Santa Rosa Hitchhiker Murders, The Scorecard Killer (Randy Steven Kraft), The Doodler, Freeway Killer, and so many more.
Pandora’s Box was opened.
The Obviousness of The Chronic Homeless Problem
For those with serious drug-aggravated mental illness — intensive long-term treatment is the best hope for improvement. We ended the practice of indefinite, involuntary psychiatric commitment and instead moved to short-term involuntary holds and conservators based on a crazy measuring stick: “danger to oneself or other, or gravely disabled”. (Both of which are very difficult to prove and harder to make work).
The LPS Act destroyed hope for forced long-term care or the ability to force anyone into rehab. Even if you could find a place for those drug afflicted family members, even if you could snag them under “Ricky’s Law” (WA State’s “Involuntary Treatment Act”) where can they go?
The reality: It is very difficult to get treatment for mental illness, for serious drug abuse, for the mentally disabled — high cost of care, lack of insurance coverage, a fragmented healthcare system, and a scattered patchwork of “non-profits”.
Lets Consider Where We Are NOT
In 1955, daily mental health census (nationwide) was of 559,000 patients were treated daily. This means about 1 in 300 people were getting treatment (or .33% of the adult population) based on our population at the time (166 million).
In 2022, the National Institute of Mental Health estimated that there are 15.4Million U.S. adults with a “serious mental illness” which is about 6% of the adult population. This could be expressed as 6 in 100 (18 in 300) need treatment.
Serious mental illness means that it substantially interferes with major life activities.
This doesn’t count the 13% of US Adults taking SSRI’s, or the 17% with mental illness classified as “not serious”. It is estimated that there are 48.5million people with “drug abuse disorders”.
Today, mental hospital ‘beds’ totals is estimated to be only 40,000 nationwide (current population 341 million) or about 0.011% of the population.
Look at those numbers. If we had the same percentage of treatment as in 1955 (1 in 300 people needing these services) there would be AT LEAST 1,136,667 available treatment beds. Which is 97% MORE treatment beds than we have today.
Sure, it still wouldn’t be enough for everyone, but it would take care of the most severely afflicted, the most dangerous, and those most unable to function in society. Or simply put, we might have homeless but we wouldn’t have the real nutty ones loose.
Housing Rules Complicate Everything
Sure, housing can help some people, and look at my categories of homeless at the end of this article. The other issue that no one seems to want to talk about is the HUD “Fair Housing Act” that prohibits discrimination based on race, color, national origin, sex, religion, and disability — which includes mental illness.
The Fair Housing Compliance for Non Profit Housing Programs and Housing Shelters means equal access, and requires that programs prioritize those who have been homeless the longest (meaning the chronically homeless).
The American’s with Disabilities Act (section 504 of the Rehabilitation Act) mandates non-discrimination for individuals with disabilities. (Mental illness, according to the Social Security Administration, includes schizophrenia, and bipolar disorder to be considered a disability.) These rules don’t allow sorting the homeless into groups — prioritizing those who have been homeless the shortest, and most able to regain their footing in society. It mixes the really disturbed with those just needing a hand-up.
By shoving “all homeless” into one “homeless box” with a one-size-fits-all approach it doesn’t really fix what vexes a community. It traumatizes all homeless.
The chronic homeless cause problems for the other homeless, for the community, and for everyone around them. Some have severe mental illness (as many as 1/3 of the group) such as schizophrenia, bipolar disorder, major depression, while others are autistic, “low IQ” or severely brain damaged.
Can It Be Fixed?
Sure, it would be a staggering cost to address mental health, if we could, if we would. But, given the costs of crime, murder, mischief, disease vector, trash accumulation, removing homeless “camps”, towing derelict RVs, homeless programs, non-profits, and all of the other money that flows to the consequences because we just dump these people on the street — wouldn’t it be worth it? Would it save money in the long run?
I believe the LPS Act is the main cause of chronic homelessness. We let them go “do their own thang”. We give them handouts, allow some to be a real menace to society, maybe a series of short jail stints (3-hots-and-a-cot), and, eventually, die on the streets.
ARE we our brother’s keeper?
I find it abhorrent that the cause is to protect “civil liberties” at all costs, even if it causes suffering. What should we do if someone is unable to care for themselves? The answer is NOT free apartments, not “housing first”. It isn’t free drug supplies. It isn’t simply moving them to another community. Its putting them where they can do no harm, to themselves or others.
We used to be responsible in our society to care for the mentally ill (even if they and their delusions didn’t think so).
Civil Liberties are laws established for the good of the community with regard to freedom of action and speech. Crime and violence undermine public trust. Forcing treatment is humane, for them, for us. We need to protect these people. We need to protect our communities. We need to protect our society.
It’s Occam’s razor (the simplest choice is the best): If you cannot be part of society then you need to not be part of it.
With madmen running amok — none of us are free.
Flavors of Homeless
Hidden
These are people who find strategies to survive without permanent housing. Couch-surfing, staying with friends and family in overcrowded conditions, in garages and sheds, and other unconventional, and inappropriate spaces. These are the people who are most likely to own RVs and live in cars. Because they are not using traditional “homeless services” they are not apparent.
This is the group that is most likely to retain jobs, and work regularly, go to school, etc. It is the easiest group to help. Support services.
Transitional
The most common group follows significant life event: job loss, eviction, relationship breakdown, domestic violence, death in family, trauma. Usually these are the people who have exhausted couch-surfing and family assistance.
Interventions like financial assistance, job training, and counseling, Housing may include interim steps (RVs, tent housing, roommates, or family counseling). Job support and financial counseling. The goal is stability.
Episodic
These people cycle in-and-out of homelessness, often repeatedly. This is because of a chronic health issues, mental illness, or substance use. Usually caused by seasonal work, lack of resources, learning disabilities, and an unable to manage finances adequately.
Interventions are more difficult. Education is possible, treatment is possible. The reality is this the group most affected by lack of inexpensive housing, and most preyed upon by vulture credit programs, and defeated by state systems to “collect” back child support, etc.
Chronic
Long term, repeated homelessness, often disabled by chronic conditions and/or uncontrolled drug use. This is the older group, underemployed, and often with missing limbs, cancer, chronic heart conditions, or crippling mental deficits and/or severe mental illness.
Intensive support is needed. This is a group that really is unable to sustain a stable existence without serious care and oversight. This is the group that end up in the prison system, usually repeatedly, but, prison isn’t treatment.
Accurate analysis in my opinion. As a little boy in the early 60’s my father used to take me to fish Chambers Creek near Steilacoom in Pierce County. We would drive past Western State Hospital. They had farmland, raised animals and had a for profit dairy. You could see the non-violent patients taking care of the grounds. I was told in later years that the Hospital was somewhat self sufficient. At some point in time it was considered exploitation for patients to perform work. The dairy closed, the farms went idle. The patients no longer had opportunities to be productive. I believe the last 50 years has been a failed experience. Time to go back to basics. Certainly with new technologies and the amount of money we've thrown at these issues we could do better. Less studies. More common sense.