The Mental Illness, Poverty, and Homeless Link

Mental illness does not discriminate based on race, age, or economical status although some types may be prevalent in one more than the other may. For example, confusion and disorientation are more prevalent in the older person. Schizophrenia tends to occur most in young adults in their 20s. Posttraumatic stress disorder is commonly seen in military personnel.

The links between mental illness and poverty is the availability of money to afford proper treatment. Many are thrown in the streets and treated like rubbish by families who do not understand important facets of mental illness. The ill may not have the wherewithal to apply for benefits, be in denial of mental health, and/or not aware where to seek assistance. A collaborate approach and support system is required in managing treatment for those with debilitating mental illnesses.

Clients at the lower economic level may be seen in clinics only for medication, there is a significant lack of individual counseling. This is especially true with homeless people who do not have transportation or access to mental illness facilities and/or psychiatrists.

Many people are walking around with uncontrolled mental illnesses due to either noncompliance, under-treatment, inability to afford their medication, or lacking adequate monitoring. It is astounding how our system will release mentally ill patients to communities without adequate follow up, housing evaluation and availability of a caregiver to assist in the correct administration of medications.

Several news stories exists about people released from mental institutions unsupervised and/or too early only to assault or even kill someone. For example, the recently released client who pushed an innocent woman in front of a train, she died instantly.

Some mental illness clients do not have the cognitive factors required for self-care and monitoring. They may not understand instructions on how to take their medications nor when to notify their counselor. Relatives and friends of certain ethical backgrounds do not believe in mental illness (unless very overt) or a need for close supervision.

Some impoverished cultures view mental illness as a weakness and an act of malingering to avoid employment. I have heard of people who blame the mentally ill person of feigning his illness to obtain disability benefits. This thinking only isolates the client farther and may lead to homelessness because of unexplainable behaviors exhibited while in the home or public.

I was approached by a mentally ill person who apparently was not compliant with his medication regime. He stood on the sidewalk talking to him when he asked me to call the police because he felt like hurting himself or someone else. What was different with this person is he actually had a caregiver (his sister) but she was more concerned about his monthly benefits check than whether he took his medication properly. The police and mental institution were very familiar with this person as this happens every month at check time.

Mental illness clinic are notorious for releasing a person, who has been "baker acted", before the 3-day legal hold after the person talks of harming self and/or others. Many institutions cite a lack of beds, space, or staff. At least that is what occurs in my town, which has only one indigent mental illness facility in the county and a large number of homeless people. All the person has to do is appear lucid while denying intentions to harm to be released, many times the same day.

We are seeing more and more mentally ill persons, homeless on our streets, who are mistakenly labeled as alcoholics or drug addicts. Not all homeless people suffer from these demons. Maybe the psychiatric community will devise a system to monitor and assure mentally ill people take their medication, such as a mobile unit.