Recently, President Donald Trump signed an Executive Order to remove the American homeless from the streets. It is my understanding that the order is supposed to facilitate access to individual support, which could significantly improve the lives of people who have been neglected for far too long.
When hearing that this administration was interested in solving some of the crisis of the unhoused, I realized my voice could be helpful because of my lived experience, with not only homelessness but also severe untreated mental illness.
Having been homeless for four years of my life, from 2003 to 2007, including 13 months living outside, I find myself believing this could be a step in the right direction.
Here are a few reasons why, and a few things that must happen for this Executive Order to be successful.
Each person has distinctly individual reasons for being homeless
To understand the homeless population, we must first define what it means to actually be “homeless.” When I was homeless, I had a severe form of schizophrenia that led me to reject all help. I had a number of families that would have welcomed me to live with them, even for free. This included a Chinese-American family that offered me a free bedroom suite in their home and free food, with no strings attached. My parents would have done anything to help. Dealing with psychosis, I soon left both the Chinese-American family’s home and rejected my parents’ offer for housing, preferring my homeless life in Los Angeles.
There is a great discrepancy between the severely mentally ill and/or drug addicted homeless population that rejects all help, preferring to sleep outside under bridges and on benches, versus healthy persons who have had bad luck, medical bills, loss of jobs, etc. I was very different from a person accepting a place in a homeless shelter, seeking a job, and actively working on rebuilding their life.
The great need for change involves helping people like I used to be—those who refuse aid. Again, in my schizophrenia, normal life was impossible.
Today, in my work as president of a nonprofit foundation, I am shocked at how many people I encounter who have loving families or friends willing to do anything to help them out, and they refuse all help.
In addition to severe psychosis, most of the chronically homeless living outside struggle with substance abuse. In this way, I personally was an exception to the rule. I never used drugs.
The mentally ill and drug-addicted homeless population deserves compassion and treatment
Unfortunately, society has largely become complacent to people subsisting outside in deplorable conditions.
I do not agree with this.
I remember talking with a Cincinnati-area social worker a few years ago. This social worker often saw a homeless woman wearing rags, living outside for a long period of time. Years later, after having no contact, he ran into her again. She was well-dressed, confident, and appeared healthy. When he asked what had happened to her, she responded, “Why? Why didn’t you help me when I was severely mentally ill, homeless, and living outside?”
I feel the same way. In 2006, I thought I wanted to be homeless, and it was my right and my choice. I did not realize that I was choosing to live in hell. I suffered every day, looking for garbage, staring into the distance in public parks, and getting soaked when it rained. Only after I had begun an antipsychotic did I realize how terrible my life had been, and how dangerous.
I wish someone had picked me up and taken me for evaluation in a psychiatric facility back in 2006 when I began living outside. Perhaps I would have been in a detention center for a brief period of time. But this would have been better than being raped outside, or even killed. Looking back, I was extremely lucky to have not been a victim of crime.
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What it takes: discharge planning
To address the needs of people with serious mental illnesses and debilitating and chronic substance abuse issues, I recommend that we make sure there is a plan in place for each person who is discharged from a psychiatric hospital or a drug rehab facility. When I was discharged after my first hospitalization, my loving parents stepped in. With a mind much clearer from antipsychotic medication, I accepted their help.
Had I not had a family available to help me rebuild my life, I would have needed a group home, halfway house, or other facility where I could recover.
Shortly after my discharge from the Los Angeles hospital, I was granted Social Security income for a period of several years. Our government has programs in place for people like me who are ill and need financial support to get back on their feet.
What it takes: more beds
Perhaps the biggest problem that we will encounter when offering aid to this population is a lack of beds. In the 1980s, there was a wave of mass closure of psychiatric hospitals throughout the United States. This was the time when the homeless, as we see them today, showed up in the first place. In the 1950s, there were half a million hospital beds. Today, with a population that has more than doubled, we have 40,000 throughout our country.1
Conclusion
A movement to remove the homeless from the streets makes sense to me. For those with friends or family who refuse their help, treatment can bring a mentally ill or addicted individual into a supportive living environment that they would otherwise refuse. For those who do not have family or close friends, the government must step up to the challenge and provide services, discharge planning, and housing while they get on their feet again. For this Executive Order to work as it is supposed to, we need both more psychiatric beds and greater use of long-acting injectable antipsychotics to prevent relapse.
Should Americans be left behind to suffer in homelessness, searching for garbage to eat, and spending their days staring into space, much too sick to work any job? In my opinion, the answer is no. In my opinion, treatment is a human right, not chronic homelessness.