My mission as the coordinator for the Faces of Homelessness
Speakers’ Bureau is to educate my community about the multifaceted issues
surrounding homelessness and poverty – while providing support and teaching
self-advocacy to my homeless and formerly homeless brothers and sisters.
Additionally, it is my goal to help the Charlotte County
Homeless Coalition build a self-sustaining program that will act as a platform
for these men, women, and children to finally have a much needed voice within
their community, state, and country.
In addition to my work with AmeriCorps, I am proud to say
that I am also a board member of NAMI-Charlotte County. As a member of NAMI, I
hope to help raise awareness to the complexities of mental illness and
co-occurring disorders as they relate to poverty and homelessness and to
advocate for those who have increasingly become invisible to our society.
It is my opinion that society has forgotten that we are all
in this together and I feel like many of us get caught up in our own lives –
ignoring the fact that some of our fellow brothers and sisters are out here
struggling.
It’s as if we are walking through life with blinders on “If
it isn’t directly affecting me then why should I worry about it?”
The fact of the matter is we are all affected by these
issues whether we choose to realize it or not. We have to change our mindset or
things will only get worse.
I don’t think many people realize that the only difference
between them and someone who is homeless – is their home.
Homelessness has become an enduring presence in American
society. According to reports, more than 630,000 individuals are homeless in
this country on any given night--keep in mind, however, that this number is significantly under-counted.
About a third
of all adults who are homeless in this country have substance use
disorders, and many have co-occurring mental illnesses, as well.
Approximately 45% of homeless individuals suffer from an
untreated Axis I mental disorder such as anxiety disorder, bipolar disorder,
clinical depression, schizophrenia, schizo-affective disorder, and severe
personality disorder.
An estimated 150,000 to 200,000 individuals living in this
county suffer from severe schizophrenia or bipolar disorder.
For homeless individuals, mental illness plays a key role in
keeping them on the streets.
PTSD is also very prevalent among the homeless population –
most notably among our veterans.
Approximately 40% of homeless men are veterans, although
veterans comprise only about 34% of the general adult male population.
Over 45% suffer from mental illness and half have substance
abuse issues.
It is estimated that some 22 million American’s have
substance abuse or dependency problems.
The federal government postulates that these issues cost our
country around 40 billion dollars a year.
Because housing stability is essential for treatment and
recovery from addiction – homeless men and women that suffer from addiction
issues usually have nowhere to go but deeper down into their addictions.
Recent studies indicate that the cost of providing
permanent, supportive housing for people with serious mental illnesses or
substance abuse issues is more than offset by the savings incurred by the
public hospitals, prisons, and shelter systems.
We as human beings have a responsibility to our fellow
brothers and sisters who are suffering from poverty, homelessness, mental
illness and addiction. Yes we know that providing programs and services costs
money – but did you know that the actual dollar costs to our society and
economy is higher if we don’t invest in housing and supportive services?
These essential programs not only get people off the streets, they also bring
Federal dollars into our community where the money can then be recycled 5 or 6
times over within our local economy.
When nothing is done, people with serious mental illnesses
and/or co-occurring substance use disorders who are homeless often cycle
between the streets, jails, and high-cost care, including emergency rooms and
psychiatric hospitals. This is inhumane, ineffective, and costly.
On the brighter side, research indicates that people with
serious mental illnesses and co-occurring substance use disorders who are
homeless, once believed to be unreachable and difficult to serve, can be
engaged into services, and can accept and benefit from mental health services
and substance abuse treatment, and can remain in stable housing with the
appropriate support systems.
We know what works--now we must take what we know and
implement it.
It is important that efforts to end homelessness address the
substance use treatment needs of this particular population. These efforts can
be modeled and supported at the Federal and state levels, but the real work
takes place with us--in the communities where these individuals live.
The human and financial toll of homelessness for people with
serious mental illnesses and or co-occurring disorders in incalculable.
Importantly, strategies to prevent and end homelessness
among people with serious mental illnesses or co-occurring disorders must be
based on a strong foundation of knowledge about who these individuals are, why
they are susceptible to homelessness, and what has been done to learn more
about their characteristics and service needs.
Unfortunately many programs are tailored for this specific
population, instead of with them – which is why some researchers believe that
no matter how many times a person enters treatment, they often fail to recover.
Much of what we know attests to both the extreme
vulnerability and the remarkable resilience of this disadvantaged and
disenfranchised group. Most importantly, however, is the fact that people who
are living with mental illness and co-occurring disorders can and do recover.
Housing First is the most affective avenue for people to
reach and remain in a housed and productive place in society.
Having a safe and stable home is crucial for anyone to
recover from poverty, mental illness, or substance abuse disorders. And while
having a place to call home is a social and financial responsibility, it also
gives us an enormous sense of dignity.
When we begin to live our lives with new found joy, self-respect,
and a sense of self-worth, healthy choices are likely to follow.
Research and practice reveal that communities can reach out
to people with mental illnesses and substance use disorders; engage them in
treatment; and create local partnerships to increase availability and access to
affordable housing, employment, and treatment and supports to help prevent and
end homelessness.
Understanding how to do so, however, begins with knowledge
about why people with mental illness and addictions are vulnerable to becoming
homeless and why they have a difficult time exiting homelessness.
It’s important for us all to remember that people who are
homeless are people first. The fact that they may have mental illness or
co-occurring disorders doesn’t diminish their rights, their responsibilities,
or their dreams.
In many cases, these individuals become homeless because
they are poor, and because mainstream health, mental health, housing,
vocational, and social service programs are unable or unwilling to serve them.
Furthermore, they also become subject to ongoing discrimination, stigma, and
even violence.
By law in America, the rights of individuals without housing
are equal to the rights of those with housing – However, as we have seen; many
cities establish laws and practices that violate the basic human rights of
these individuals.
Studies indicate that a person with a mental illness has a
64% greater chance of being arrested for committing the same offense as a
person who does not have a mental illness.
Shockingly, out of the top ten meanest cities in our country
for the criminalization of the homeless--4 are in Florida.
Another problem is the “not in my backyard” syndrome that
many communities have adopted. This can come in many forms such as vocal
community opposition to group living situations, or they can be less obvious,
such as steering public funds away from housing initiatives that serve
controversial populations.
When these individuals have no-where to live, they can and
usually do, end up living in the woods, jails, and other institutions.
Probably no condition is as closely connected with
homelessness as chronic alcohol dependence.
Conceivably, the homeless could have been stereotyped as
unemployed men who needed jobs or job training, as elderly people who needed
our concern and care, or as individuals who were physically and mentally
disabled. Because, instead, they were stereotyped as alcoholics, the societal
answer to their problems often relate to some form of institutionalization,
whether jail or detoxification program.
I think want many people don’t realize is that addiction is
a psychological disorder that affects behavior. Drug addiction has
well-recognized cognitive, behavioral, and physiological characteristics that
contribute to the continued use of drugs despite the harmful consequences.
I have met numerous addicts in my lifetime and never once
has anyone ever told me that they want to or enjoy being addicted to drugs or
alcohol. In fact, many want desperately to stop but are, in many cases,
unsuccessful despite countless attempts at treatment and sobriety.
A contributing factor to this failure is the lack of support
systems available for these individuals once they exit treatment. Often times,
family and friends turn their backs on these individuals because they are fed
up with the cycle or they themselves don’t have the support and knowledge
needed to cope with this often traumatic rollercoaster ride.
Without the ongoing care and persistent advocacy that family
members provide, many people with serious mental illnesses or substance abuse
issues are at greater risk of becoming homeless.
Another reason why so many of the chronically homeless fail
to recover or refuse treatment is due to negative experiences. Research
indicates that this population is difficult to re-engage in services once they
have had a negative experience with an unresponsive treatment system.
Therefore, when working with these individuals, it is essential to their
recovery that they feel safe and can trust those who are advocating for them.
Much like those with mental illness, people with substance
use disorders can and do recover. Studies show that 55% of individuals who
remain in AA for more than 90 days will be sober after one year, and 50% will
be sober after 5 years.
The very fact that people who have serious mental illnesses
and substance abuse disorders have learned to survive on the streets speaks to
their strength, their resiliency, and their perseverance, all of which are
protective factors that can be harnessed to aid in their recovery process.
Street life for these homeless men and women can be
confusing, dangerous, and frustrating. Individuals shuffle unsteadily between
detoxification centers, shelters, bus stations, day programs, jail, abandoned
buildings, and soup kitchens. It is a painful life complicated by, but also
made more bearable because of, the use and abuse of drugs and alcohol.
Although only about 5% of people with serious mental
illnesses are homeless at any given time, as many as two-thirds of all people
with mental illness have experienced homelessness or have been at risk of
becoming homeless at some point in their lifetime.
Once homeless, people with co-occurring disorders have more
problems, need more help or are unable to benefit from services, and are more
likely to remain homeless than any other group of people.
Unfortunately homeless men and women who suffer from
addiction related issues are less likely than those with mental illness or
co-occurring disorders to qualify for Federal disability benefits – in large
part because individuals with substance use disorders, no matter how serve, are
not considered disabled under Social Security Administration guidelines – even
though many researchers would argue that substance use disorders are a very
disabling condition.
Making matters worse, people with serious mental illnesses
and or co-occurring substance use disorders that are homeless require a broad
range of housing, health and mental health care, substance abuse treatment, and
social services, all of which typically are provided by separate agencies with
separate funding streams. The burden of coordination falls on the individual,
but people with serious mental illness or co-occurring disorders, especially
those who are homeless, are ill-prepared to negotiate a fragmented service
system unaided.
A lack of coordination between the hospitals and
community-based providers to ensure appropriate housing, treatment, income, and
supports means that these individuals fall through the cracks in the system and
may – as a result – become homeless.
Recovery from homelessness, much like recovery from mental
illness and or substance use disorders, is a process. Researchers define
recovery from homelessness as being sober, employed, and housed; identifying
six themes that support this process: spirituality, self-insight, security,
self-awareness, support, and suppression of poor self-concepts and negative
attitudes.
Lack of support or connection to others may be the single
most important factor as to why people become and stay homeless.
For many homeless individuals, outreach workers are the
first to break through the isolation and begin to move people toward a life of
greater health and personal stability. This requires compassion that can be
translated into concrete action.
It is about regarding all human beings as intrinsically
valuable. Person-centered values are at the heart of a system that empowers
people with mental illnesses and substance use disorders to recover.
These individuals deserve to have a choice in housing,
treatment, and support services. They deserve to have a voice – to have a say
in the programs, policies, and services that are designed to serve them.
They deserve to feel empowered by being educated and allowed
to make choices in matters affecting their lives.
They deserve to have dignity and to be treated with the same
respect that others demand for themselves, and they deserve the opportunity to
be hopeful -- because we all know that hopelessness only breeds helplessness
and despair.
