Mental Illness

There are so many inaccurate preconceptions about "mental illness" when it comes to people experiencing homelessness that appropriate interventions may be being prevented from implementation.

There are no instant, simple answers. I'm involved with a case now wherein medical experts have been attempting to determine the biological and/ or psychological bases for a long time homeless individual's symptoms and behavior.

This individual experiences vivid hallucinations but determining whether these stem from a psychiatric disorder, neurological damage suffered from repeated head trauma, long ago substance use or abuse, a lesion or tumor on the brain, a history of strokes, a combination of factors, whatever, is critical to successful Intervention and treatment.

We don't yet have an answer. It takes a lot of time to get all the necessary appointments and testing completed. We are all working as quickly as possible. In the meantime, sadly, symptoms are getting more frequent and more intense. Why is that?? We are trying to figure this out.

I mention this today because we have long had a system in place wherein untrained and unqualified social services personnel are making pretty much instant determinations about who is an addict, who has "mental illness" and who doesn't and implementing life altering decisions, plans, requirements and sanctions based upon these determinations.

In my opinion, this is one of the most significant factors involved in turning the experience of homelessness into long term, chronic homelessness. Consequences include people simply refusing to accept the "help" available and /or being denied services. In this respect, this unscientific practice contributes to the high death rate for the chronically homeless population.

First we need an accurate determination about what is going on with an individual.These determinations cannot be made by intake personnel who are not professionally trained medical and/ or psychological experts.

This practice contributes to the seemingly endless recycling of chronically homeless people. If a determination isn't made correctly in the first place, it is not realistic to expect subsequent housing or treatment recommendations to be successful. It is also not realistic to expect the homeless client to want to return for additional assistance.

Moreover, evictions and sanctions are inappropriate under these conditions and may be being issued far too prematurely for "noncompliance."

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