Re: mental health

That is because mental/psychological healthcare is completely broken in the US.

Im currently dealing with the system for a family member, and I am shocked at just how hard it is to get help. Ignore the financials, most psych hospitals won’t treat you and have zero interest in keeping you longer than absolutely necessary. The one my family member went to twice didn’t even set them up with a treatment plan or doctors/psychiatrists/psychologists when they were released.

I’m homeless and have schizoaffective bipolar disorder. I haven’t been able to see a regular psychiatrist or therapist since Covid started. A lot of my therapist were taken over by people suffering from dealing with the lockdowns. should they have really been the priority?

My homelessness exacerbates my mental illness, not only because of the stress of living out of a van but also the inability to have consistent healthcare being that I have to drive to warmer temperatures or cooler temperatures depending on the season.

And the treatments for psychiatric diseases are still stuck back about 50 years. I’ve had to run my own genetics and do my own research to find out what would help me. I mostly done it no help to any doctor or physician or psychiatrist.

Many people act like homeless people don’t want to get better, but I’m doing everything I can and no one is helping me absolutely no one. Psychiatrist who take Medicare have zero investigative initiative and psychiatric awards are for profit hotels for the mentally ill.

If anyone has a positive view of this country and the goodness of the people of this country, I want to dissuade you of that notion.

I am currently parking at Walmart in Palm Springs, California. The amount of wealth I see driving around me in vehicles alone could end homelessness in this country.

Usually lurk here - I sincerely hope you will get to better places, how you handle your situation sounds admirable

I was homeless for awhile due to mental health issues and this couldn't be more true. The people dealing with the homeless professionally aren't the people you would want dealing with them and the funding isn't there for anything better. A LOT of people end up worse off because of bad experiences when they reach out for help. That's certainly true in my case. I have autism and was a "gifted" student growing up, so it isn't like the system is impossible for me to understand. It really is that bad (in my experience and where I live).

I’m always amazed at some of the responses here whenever the mentally ill are brought up. Suggesting that they should simply be hospitalized for their illness. That would be lovely, but speaking as someone who has been locked in a hospital before, it’s very expensive. When I’m between layoffs, I do have health insurance, but I don’t imagine that’s the case for the chronically ill.

When I bring this up here, I’m told that these people just need to engage with some system and they’ll be well taken care of. I have seen no evidence of this myself; as the article and your experience would suggest, it’s just the opposite.

The best someone can have going for them is a family member with money, but the mentally ill tend to burn their last bridges quite often.

Just want to offer some additional context here: "in the US" isn't really necessary. Mental health care is generally broken everywhere. Over here in the UK, waiting lists for "talking therapy" are long, and access is limited. Same story for most other countries with socialised healthcare. And, often, mental health care is even more stigmatised than it is in the US (where at least there's fairly broad societal acceptance, at least amongst younger generations).

Further, while the US is seeing major shortages of mental health care providers, most European countries are even worse off, in large part because there's no class of master's-degree-holding therapists -- you either get a doctoral-level degree, or you just attend some basic courses and call yourself a therapist with no licensing or regulatory bodies governing your practice.

I'd actually argue that the US's system is better than most other western nations' mental health care systems -- which is not a statement in favour of the US, but an indictment of other nations' approaches.

(Source for my data and opinions here: I'm an American immigrant to the UK, and my wife has a master's degree in clinical mental health counselling - she only practised for about a year before she quit because the system is so broken in the US.)

Some people need a hand to get back on their feet. Some people need a small, safe space just for them and their stuff (voluntary homelessness, broadly speaking; tiny homes or more dense concepts in urban areas work here), some people need to be committed (I know some folks like this both in a clinical setting, as well as a working farm in New England operated just for this need). These statements are the easy part, the hardest part is implementation.

Affordable housing is of course key to broad housing security for those of sound mind and economics who desire to be housed.

Oh, to be clear, I have no idea what a solution is. Some are straightforward (It was great to see when people finally got a job and got off the streets). But I'd say the majority of them are not easy solutions. Give a job to someone who is mentally not capable of ever holding a job, and there won't be any success.

The "give people free money and freedom to do with it whatever THEY think is necessary"-model seems promising.[1] Unfortunately it's also politically sensitive.

[1]: https://www.jrf.org.uk/housing/providing-personalised-suppor...

If only America was the richest country in the world...

Homelessness for San Francisco was a mere PR problem during a state visit. Their is 0 appetite to tackle these social problems. Before implementation comes the actual political will to do something about it.

I just think there is no way to deal with it in a liberal society. I think most people want to help.

I think there’s also a gradient to “not having a home” here that isn’t discussed. Does “homeless” describe somebody who is illegally squatting? Somebody who has lost their home and is crashing on friends couches? Youth who have a home but do not want to return to it? Somebody who stays in a shelter every night? The group I work with uses “underhoused” as the term, which I think better describes the situation.

IIRC, the terms in the UK are "homeless" if you have no fixed abode and "sleeping rough" if you have no access to permanent shelter. If you're limited to couch surfing, that's the first but not the second.

Homelessness is well-defined by HUD and the definition has been the same for decades. The report discussed here almost certainly missed numerous homeless people because it is based on the point-in-time count, where local agencies go out in the field for one day and try to find homeless people, which overlooks some classes of homeless.

You have to be careful, because what you said is also the standard argument against action. You get people implying that if you can't help everyone you shouldn't help anyone, that more study is needed before doing anything, et cetera. No solution is perfect, but they are all better than nothing.

And all homeless have something in common: they are homeless. Yes, most of them have other problems in addition, but once they have housing they have one less problem and the other problem is likely to be easier to treat or handle once they have their housing situation sorted out.

I’ve never met someone who wanted to be homeless, I met people who didn’t want to live in substandard housing because homelessness was better, but I never met someone who wanted to be homeless. Give anyone of these homeless people $1 million house and I guarantee you they willwant to live in it.

Yeah. The homeless in popular imagination that actually prefer living without a home are called #vanlife’rs.

The one sees in cities are not those at all. Where they have access to shelters or even housing and they prefer to live as homeless instead is overwhelmingly because the housing and shelters are substandard, moldy, they’re exposed to risks of abuse including sexual abuse, they may not be allowed to bring their pets in, they may have addictions that they will be asked to wean off cold turkey (both understandable from the housing/shelter point of view, but it’s also obvious why someone addicted to a substance would not be able to do this), etc.

In my interactions I was genuinely surprised by the really large percentage of homeless who preferred to live on the streets (even in the winter) over decent shelters without many of these risks, because of pets not being allowed. For many the companionship with the pets are quite literally keeping them sane, and there’s no way they’d give them up, and yet the vast majority of shelters have a no pet policy (again, understandable, but it still is a contributing problem).

Now, there are definitely a few homeless who have mental health issues. And unfortunately, for obvious reasons those are the ones most people are likely to encounter (the sane homeless people prefer to stay out of the way and would prefer avoiding people altogether because of the shame and the judgment they’d encounter to begin with). So most people’s (including mine until I started volunteering with organizations that worked directly with homeless people) estimation of homeless people is based on this tiny minority at one extreme. Which is unfortunate because it makes passing actual useful policy that will help the homeless and reduce homelessness and all the issues that come with it, very difficult to bring into force.

> In my interactions I was genuinely surprised by the really large percentage of homeless who preferred to live on the streets (even in the winter) over decent shelters without many of these risks, because of pets not being allowed. For many the companionship with the pets are quite literally keeping them sane, and there’s no way they’d give them up, and yet the vast majority of shelters have a no pet policy (again, understandable, but it still is a contributing problem).

The few shelters I've looked into have a huge list of rules that are strictly enforced which quickly turned me away. And they were in old, run down, dirty buildings. It almost seemed like they didn't want anybody to use the shelters, and very few appeared to be using them.

I'll try to clarify. I met a large number of people who had all the tools, facilities, ability, and help they needed to not be homeless and still chose to be homeless.

Just as an example, one young man I spent a lot of time with had a family that wanted him to come home, but who wouldn't let him smoke weed in the house. I wouldn't have called him an addict by any stretch, but it was something he was unwilling to give up. He was a strong, able bodied guy that could have gotten a job. Despite all of this, he decided he'd rather live on the streets and do what he wants. (Could he have had severe mental problems and be making all of this up? Sure, but I don't believe that he did).

It's actually the biggest reason I stopped volunteering. Over the years that I volunteered, I noticed a steady shift from people who really need and/or want help to a large number of people like the young man I described. When helping out the homeless people you can't pick or choose or make judgements, so you treat everyone equally. But it became very hard to hand out things like sleeping bags to folks like that young man and then see people who really did have nothing unable to get one.

But, yes, in your example if you offer anyone a free million dollar house they will take it over living on the streets, but I don't think that's a very realistic comparison.

Also, to be clear, I'm just some dude. I don't have any realistic answers to fix the problem.

Can’t upvote this enough. There are so many categories of homeless. It’s such a a board bucket that any policy that helps some may have a negative effect on others or is at least ineffective. To lump them all together makes the problem unsolvable