I’d like to start by saying how much I’ve appreciated Nick Welsh’s articles concerning mental illnesses. They are thoughtful and kind, which isn’t always easy in the face of distress. That pain is certainly a hallmark quality of mental illnesses. I also appreciate his professional stature in expanding an audience willing to listen to such an important topic. However, I am responding to a few points I see generally missing and, in particular, the most recent article about Richard Berti betting $450,000 to purchase property against funds matched for treating homeless adults with mental illnesses. I don’t believe Mr. Berti’s idea is an effective solution as presented without inserting a few extra considerations.
First, I think identifying homeless people as the problem, is a problem. Doing so is misleading. People become homeless as a result of internal and external — i.e., societal — problems. Homelessness comes later down the line. Portraying people who are already feeling badly as pieces of a profoundly broken collective will only make them feel worse and unlikely to trust.
In the second place, the one commonality most shared by people with serious mental illnesses or homelessness is trauma. With trauma, a person has experienced extreme fear but been powerless to act in self-defense. That trauma has a way of getting stuck in people’s emotional systems in various ways, sometimes even unconsciously. Any assertion of power thereafter, even if it’s just hierarchical helpfulness, can be re-traumatizing because again, the person is forced to accept what is done to him or her without volition or recourse.
Perhaps what bothers me at a fundamental level about this subject is that there is a body of research building currently that helps make a case for what works in housing people who have serious mental illnesses. There are also workers in the field and people who have lived with mental illnesses, who have success stories. Yet there doesn’t seem much room for including these people in discussions about broad-reaching and publicized solutions or even in considering the research around those interesting concepts such as trauma-informed care, harm reduction, and peer engagement.
I sometimes feel that we in the community prefer to stick to the same type of backbone thinking about power and its effective use — which contributed to the damage in the first place — rather than take the time and effort to personalize services and introduce them as they can be accepted. We are all individuals, and if we want to solve other people’s problems, we need to include them as experts about themselves. Nobody else can be.
On the other hand, the malaise may go even deeper than an inability to buck prevailing conventions. We don’t come up with effective solutions to helping people who are seriously ill and homeless because we haven’t actually committed ourselves fully to hope in its concrete form. We may want to be effective, but we don’t have a strong vision for substantially bettering hurt lives. Even while some of us have benefited in our society, maybe even substantially rewarded, we can see how it has also failed others. However, I don’t think we need to lose faith completely in our structures. Tweaking them might be enough. For instance, mental health education for young people to set them up for the long run as adults would bring positive results by itself if it is done with appropriate sensitivity. It wouldn’t erode the prevalent cultural codes.
No one approach will achieve 100-percent success. However, a human issue may present a case where thoughtful collaboration is needed as much if not more than spending a lot of money to hammer home a generalized solution. And yes, this is just my opinion but maybe it’s my turn to be heard during this go-round.