If they're talking to themselves, they need more than that. They probably need to be cared for in a mental institution. Unfortunately the overall national trend has been funding cuts, with the irony being that it doesn't save money overall; since the costs are just shifted over to hospitals and other emergency services.
This isn't a new subject. For those without severe mental issues, the end result is the same when we provide housing: it costs less
https://www.vox.com/2014/5/30/5764096/its-three-times-cheape...
The statement that they should probably need to be cared for in a mental institution isn't true. That some or several may need to be cared for is true, yes, but the probability of that need is less well know. Schizophrenia and other schizophrenia-related disorders can often 'mellow out' on their own over time. [1] It is important to give someone a stable and loving and validating environment for them to be able to recover. There are several kinds of people who, while they talk to themselves, really just have their symptoms exacerbated by stress (e.g. schizotypal personality disorder can have quasi-psychotic symptoms triggered by stress).
1. https://www.nationalelfservice.net/mental-health/schizophren... (I will also note that this has been anecdotally determined, though I understand anecdotes are not data.)
> It is important to give someone a stable and loving and validating environment for them to be able to recover. There are several kinds of people who, while they talk to themselves, really just have their symptoms exacerbated by stress
Yes, which is why a mental institution is a good starting point for a homeless person with mental issues. Let's not confuse these institutions with the mental asylums of the past. Are there better alternatives for the mentally ill homeless that I'm not aware of? I don't feel that most if not all homeless shelters are equiped to fully deal with individuals suffering from schizophrenia.
A short-term stay in a mental hospital might be necessary while getting the patient adjusted to their medication. But once someone is stable, there is no need for such things. Even though the institutions have changed, they are still pretty horrible places to stay in, with all sorts of lifestyle restrictions that aren't generally needed.
A small apartment is appropriate for most folks once they are stable, along with access to someone to call. Some communities have social workers that visit once or twice a week and help with grocery shopping, bill paying, and general "how are you" sorts of things. Group homes are another option if someone chooses it: Private space with shared kitchen and whatnot, staffed with someone to help with cooking and cleaning. My ex, diagnosed with schizophrenia, would have been a candidate for such a thing. I was his primary caregiver, fair or not, and his doctor didn't want him living alone for his own protection.
Give support for family members as well - this is something seriously lacking in the US system. He had help, I didn't.
A small amount of folks might need some help for substance abuse, but many short-term mental health facilities are equipped to do this. A fair amount of folks would be helped by police that are capable of helping mentally ill folks with training and a marker on their ID so the cops know what to change in their approach.
I would like to see more options here for medicine and research. Truly, recovery can be a long process for many and it takes time for the brain and body to heal from trauma. Some of that may be emotional trauma as well. I would love to see more options for preventive mental health services in the United States.
What is available for drug users, I'm not sure. It seems one of the major problems in the states is that substance abuse help is difficult. Some charities help folks by donating things like hygiene items and things like that. As you said, some folks nearly forget how to take care of themselves, having fallen out of the habit for such a long time. The same can happen with some mentally ill folks.
Most importantly, though, these programs need funding. Some of these things nearly need laws to happen (like police training). Having worker protection laws that allow folks to take care of themselves would help. One of the better ways to do this is by contacting your state and local government.
if the mental illness is as serious as schizophrenia, a home isn't enough. The issue isn't just about the mentally ill person's welfare, but also if that person poses a danger to others who live nearby. There is a strong correlation between schizophrenia and violent crime. Without treatment in a controlled environment like a mental hospital, it's hard to see a mentally ill homeless person being able to safely integrate with society when they also lack a family and friends support network.
> I was his primary caregiver, fair or not, and his doctor didn't want him living alone for his own protection.
This is the issue. The homeless will not have the luxury of having a caregiver to be able to live independently at least initially. I'm sure why it's so hard for people to accept that the homeless people, who also have mental issues, just don't have access to the same resources that a non-homeless person with mental issues has access to.
I’m not saying “you are wrong and I have the answers”, merely that thmakes perception that anyone who talks to themselves needs inpatient and medication may not be necessarily true. They could just need some time in a safe place, while inpatient treatment can actually not be safe and incredibly traumatic.
Bullshit. There are many people capable of losing touch with reality who live normal lives thanks to medication.
This may be a free country, but we shouldn't use that to neglect our duty to our neighbors.
> And unless they’re a danger to themselves or others (and
> not just in the sense of making bad life decisions), they
> can’t be held against their will.
We just choose not to. AFAIU, the Supreme Court decisions in the 1970s that, arguably, precipitated the dismantling of the archaic mental health institutions never even came close to suggesting that such people couldn't be forced off the street. For example, in the famous case of O'Connor v. Donaldson the patient, Donaldson, had actually been living in an apartment of his own in Philadelphia. He traveled to Florida to visit his parents, and it was his parents who had him committed after he shared paranoid delusions about his neighbors in Philadelphia. I've seen people use that case to argue against forcing people off the streets as-if we had no legal choice, but it's just plain wrong. Donaldson wasn't living on the streets; his ramblings notwithstanding he was clearly capable of taking care of himself, and in any event the case was never about his initial confinement but his continued confinement 15 years later.
We choose to let people live on the streets because we've somehow internalized the perverse logic that to do otherwise would result in a tyrannic state oppressing the mentally ill. (Myths about SCOTUS opinions come into being to bolster the logic.) That such an approach happens to require little or no budget outlays while simultaneously absolving us from moral blame is, I'm sure, merely coincidental....
Ouch, that's kind of an uncalled for jab at religion.
Why don't atheists band together and form communities to show the religious how it's done...?
This seems unjustified. Your statement assumes (a) Support systems in the community are run only by religious people. This implies (b) Non-religious people do not run any community programs.
Assuming (b) is true (which it may very well not be), the question that needs to be asked is, why do non-religious people and institutions not run more community programs. Not rail against the religious people who do.
Disclaimer: I am not American.
This explains it. You probably live somewhere with a reasonable social safety net. Our government safety net is full of holes, and religious people build webs to catch people who fall through.
Not all of them are bad. Some of them will just help people and not make it conditional on joining their religion. In my experience and from accounts by other LGBTQ+ people, these are the outliers.
When I see people screaming and walking down the streets talking to themselves, I see people that need love. I see people that need to be taken in, not just for a night, but for a year or longer... so they can stop stressing about where they'll get their next meal, or if they'll have someplace warm and safe to sleep at night.
It is so easy for people to judge them.. say that it is their fault for being down on their luck. When you're homeless, you just get used to people assuming the worse... heck you even start to assume the worse about yourself. You say, why is it that no one cares to see that I'm hurting inside. People judge them for not taking whatever work is available for the day, because they assume... hey, one day helps, right... well when you're homeless, the help of one person is kind and does help for a bit, but what what people need in America are communities helping them.
Unfortunately, you will likely have to go to religious services and pretend to care about religion enough to get the help you need, because that is who America has designated as their community support system.