California is re-examining mental health problems ‘solved’ half a century ago as a way of dealing with some aspects of chronic homelessness.
Some chronically homeless people have such severe mental health issues that, from an outsider’s perspective, they are incapable of effectively looking after themselves.
This has been an age-old problem for families blessed or cursed with members who are unable to function within the limits of social norms. Must an individual in question somehow be coerced into adapting to the norms of society? Or does society bend to the needs of the individual?
In the past, those on both sides of the problem might bend. A community might act with care and compassion for a ‘village idiot.’ Other more socially abrasive individuals might face persecution, incarceration, even burning at the stake for witchcraft.
With the evolution of psychiatry and other forms of therapy, compulsory hospitalization allowed for the possibility of ‘cure’ while at the same time keeping troubled, and sometimes troublesome, individuals from upsetting/upending ‘normal’ society.
The means of determining just who is ‘a suitable case for treatment’ was, and very much still is, down to a conservator. Parents are automatically conservators of their children (unless disqualified for some reason). A conservator has the responsibility of monitoring an individual’s behaviour and, if necessary, recommending ‘hospital treatment’ in its most optimistic form, ‘institutionalization’ if the result is more incarceration and less treatment.
In the latter half of the twentieth century, there evolved strong advocacy for allowing adults with mental disorders to have the right to choose freedom if they did not wish for the ‘security’ of mental institutions. Activist, individual, and ‘small government’ economic interests combined to release many people with significant mental impairments of one kind or another to the ‘freedom’ of the streets.
This practice continues. The warehouses for people with mental illness have largely disappeared. For those who might prefer a roof overhead and three meals a day, that option by and large no longer exists. Any return towards an institutional approach to support mental health might well require a new program of public-funded construction1.
Nevertheless, in California, the homelessness crisis is now being evaluated from a mental health care perspective. It is focussed on those who seem severely ill and unable to make decisions for themselves. This requires creating conservator positions for those who would be advocates, supporters, and decision makers on behalf of those who are judged unable to handle their own affairs. Read more in the Times of San Diego: San Diego Councilwomen Propose Conservatorship Unit for Homeless
Conservators are essential to a functioning mental care system that serves incapacitated adults. However, what happens when the conservator recommends supportive housing and treatment, the experts agree, but the individual does not? This situation unavoidably involves coercion, and gives rise to a frequently encountered word that graces the following article. The word is ‘forced.’ Use of it, and all that it implies seems part and parcel of any mental health treatment as a solution to homelessness.
The following article is a discussion of the possible assistance that mental health treatment brings to the homelessness crisis. Read more in VOICE OF OC: Is Forced Mental Health Treatment, Not Housing, the Way to Solve Homelessness in Places like Orange County?
Footnotes
- Permanent supportive housing is a currently popular alternative. Permanent supportive housing assists tenants with the activities of daily living. Project Homekey is adding to the amount of permanent supportive housing in California, but there’s a long waiting list. Try: California’s Rapid Housing Initiative For Homeless People – How’s It Working Out?
