No Housing, No Recovery

I have no idea why this study caught my attention, but it did. It has to be one of the most-aptly titled journal articles I have seen in ages: "Surviving the Tornado of Mental Illness." Because that's what it all boils down in the end, isn't it? When going through hell, how do you keep going?

As usual, I can only access the abstract, but the core ideas are there in this Canadian study of what the authors call 90 "psychiatric survivors" (a controversial term within mental health advocacy) struggling to maintain housing while battling debilitating illnesses in a world where if you ain't working, for whatever reason, then you are fucked. The study concludes:

"Individual and team analyses of the transcripts [of interviews with patients] revealed that psychiatric survivors experienced three levels of upheaval, loss, and destruction, similar to the effects of a tornado: losing ground, struggling to survive, and gaining stability. Within each of these levels, five major themes were identified: living in fear, losing control of basic human rights, attempting to hold onto and create relationships, identifying supports and seeking services, and obtaining personal space and place. A caring community response, including adequate housing, income support, and community care, can help people rebuild their lives."

The study is obviously working from a population of people with severe and chronic mental illnesses--the sickest of the sick, who too often end up on the streets of major urban centers. Whatever you make of the call for income support--Canadians are a bit more comfortable with socialism than are Americans--it's been clear to me, like, forever that the prospect of losing one's housing and shelter is enough to make a strong man crazy and people who are in dicey shape slide right out to the streets. I'm not speculating there, of course. Maslow's hierarchy of needs scoped the situation out long ago.

There aren't enough good meds in the pharmacopeia nor enough caring hands in the community to help a patient who has no housing. And without shelter and basic food, there is no way for a patient to recover. So if we expect people to do what society expects in order to combat mental illness, then there simply has to be a level of housing available to those that many Americans--and Canadians, too, no doubt--despise as losers for the life.

Currently, the Bush Administration is doing what it can to claim it wants to solve the riddle of mental illness in American society and also says it wants to end homelessness. So why the hell are they cutting federal Medicaid funding--about 50 percent of which, by some estimates, funds mental health care for profoundly ill people--by billions of dollars and cutting hundreds of millions from public housing dollars that have been depleted for decades? How can we go in both directions at once? We cannot, of course. Not that there isn't already plenty of other hypocrisy to point to in the current administration. Just add this one to the list.