illness and homelessness, she said, “Those numbers are not a coincidence.” She also agreed with the notion that the stigma surrounding psychotic disorders in particular contributed largely to the lack of needs being met for the homeless population. A Review of Deinstitutionalization By Raiden Browning, TSA According to BioMed Central Psychiatry, up to 28% of the American population suffers from a mental illness in any given year, with only one percent of them being diagnosed with a psychotic illness, such as schizophrenia, bipolar, which may involve symptoms such as hallucinations, delusions, or catatonia. Despite this, 92% of the homeless population suffers from a mental illness, 21% of them being psychotic. 60 years ago, those statistics would have been unthinkable. At that time, individuals who suffered from mental illness and who could not provide for themselves, professionally termed the severely and persistently mentally ill (SPMI), weren’t as commonly found on the Page 6 streets as they were in psychiatric wards, then called asylums. These asylums were often horrendous places, being overcrowded, underfunded, and inconducive to the wellbeing of their patients. Beginning in the 1960s, a process known as “deinstitutionalization,” which was intended to move SPMI patients out of these asylums and into spaces where they could care for themselves, was set into motion, and its method was twofold: reducing the size of the patient population in mental hospitals and reforming the psychiatric system to make patients more independent. Deinstitutionalization has failed in its primary endeavor - making patients more self-reliant and liberated - and should be reversed. From the established correlation between homelessness and mental illness, we can draw two conclusions, not necessarily mutually exclusive: one, that mental illness at least contributes to a person’s propensity to become homeless, and two, that the condition of homelessness and its accompanying trauma can cause an individual to develop mental illness or become more mentally ill than they were when housed. According to Carlyn Campbell-Johannes, MA, LPC, LPSC, a licensed therapist and high school counselor working at Toledo School for the Arts, it is likely that both are true. Commenting on the numbers evidencing the correlation between mental Homelessness is not only a difficult condition; it is a condition incompatible with the natural state of man. It is a condition that no decent or prosperous society would allow to exist within its borders; not only this, but it is a condition that is largely preventable through state action. An obvious key to this government intervention in the homelessness crisis is government action regarding mental health. Mental illnesses are diseases just like any other; they require serious medical intervention, which in the United States is normally so expensive that even the middle classes can’t afford it. A solution to the issue which needs to be considered is publicly funded healthcare. State-provided mental health services would not be something completely new to the United States; according to Loren Mosher, MD, a psychiatrist and expert on schizophrenia, the care for SPMI individuals before the 1970s fell largely upon state-run asylums and was only delegated to privately run psychiatric wards afterward as a conservative effort to cut government spending. Again quoting Ms. Campbell-Johannes, “It is possible for the government to provide for those needs, and right now that is obviously not happening.” This does not mean that the solution is returning to the previous system of widespread involuntary committal to dilapidated asylums. It means that once a person has proven themselves incapable of providing for their own basic needs due to psychological disorder, in particular psychotic illness, the state or federal government has a responsibility to make up the difference and end its more than six decades of neglect. While the process of deinstitutionalization was built off of a dream of personal responsibility, it may be wise for us to reconsider just how realistic that dream may have been.
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