Mentally Ill Street People

[margrace]

A City in California decided to see how much of a liability these people were. They tracked over 20 people for 18 months and found that the average cost to the state in that time was $100.000. each.This included ambulances and hospitals.

I know our system is a little different in Canada but we still have to pay. There is an organization operating in New York City to get these people off the street and into apartments of their own where case workers can look after them.

[jdobbin]

A City in California decided to see how much of a liability these people were. They tracked over 20 people for 18 months and found that the average cost to the state in that time was $100.000. each.This included ambulances and hospitals.

I know our system is a little different in Canada but we still have to pay. There is an organization operating in New York City to get these people off the street and into apartments of their own where case workers can look after them.

Most of them in Canada get their Conservative party membership paid for and have access to the Internet from their mother's basement so I think the costs are more reasonable in this country.

[Drea]

Excellent!

...made me choke on my coffee!

Seriously tho... mentally handicapped people should be taken care of. They should have special housing and people to make sure they are eating right etc.

It's the right thing to do. Seniors too. Nothing saddens me more than to see an old man or woman of 80 living out of a shopping cart.

[jdobbin]

Excellent!

...made me choke on my coffee!

Seriously tho... mentally handicapped people should be taken care of. They should have special housing and people to make sure they are eating right etc.

It's the right thing to do. Seniors too. Nothing saddens me more than to see an old man or woman of 80 living out of a shopping cart.

Mental illness is no different than other illnesses that affect your health. They deserve as much care as any other person suffering an illness.

[jbg]

Mental illness is no different than other illnesses that affect your health. They deserve as much care as any other person suffering an illness.

Absolutely. New York just passed "Timothy's Law" in order to require insurance companies to provide equal coverage for mental illness with physical illness. The government pays the cost difference for companies with less than 50 employees.

[theloniusfleabag]

Sadly, many people with mental illnesses end up on the streets, and become 'homeless'. Schizophrenia is often undiagnosed until it is too late. They simply end up ostracized and on AISH or welfare. I see a few of them every day, but it is somewhat saddening, as they are the ones that truly should get gov't assistance, yet their access to treatment is limited due to limited funds. Of the 'homeless' and welfare/disability cases, I would say that 5-10% are mentally ill, while the other 90% are freeloading, lazy drunks or addicts that suck the system dry.

I am not surprised at the $100,000 figure. One of my customers, a surgeon, told me about the real reason for the ambulance shortage in Calgary. Evidently, the Drop-in center (and the adjacent scum-bag hotel, the Cecil) sees about 50 or more ambulance calls per week. They have an ambulance sent there nearly 10 times a day, for everything from a runny nose to stabbings over crack money. One of the big problems is that the paramedics must stay with the person until they get admitted/treated, thereby keeping that ambulance/paramedic team out of commission for sometimes hours.

An on-site medical specialist (who could decide if an ambulance ride was needed) would be a boon.

[jbg]

Sadly, many people with mental illnesses end up on the streets, and become 'homeless'. Schizophrenia is often undiagnosed until it is too late. They simply end up ostracized and on AISH or welfare.

The real problem that I see is the lack of reseasrch into etiology and if possible cure or treatment. The fact is, even diagnosis in early stages seems to accomplish little.

[Charles Anthony]

Sadly, many people with mental illnesses end up on the streets, and become 'homeless'. Schizophrenia is often undiagnosed until it is too late. They simply end up ostracized and on AISH or welfare.

I believe this is unfortunately inevitable due to the very nature of mental illness.

A person is easily dismissed by his pears as being pleasantly or unpleasantly <--insert expletive here--> bizarre in early stages of a developing mental illness. Until there is violent activity, there is really no impetus for anybody to act.

In our State of affairs, I have a pessimistic out-look on the plight of the mentally ill. I believe their protection is a catch-22 situation. Until an adult commits a "crime" as listed in our books, we do not take it upon ourselves to force that adult into mental treatment. This makes me think of drug addicts.

I am speculating here:

Although I do not believe that drug addicts are worthy of the same treatment as the mentally ill, on the surface, the logistics of helping them unfortunately MIGHT be the same. Both must seek treatment on their own volition. [How they can do that when their faculties are disturbed, I do not know.] If a mentally ill person (like a drug addict) does NOT have super-human caring friends and family, hitting rock bottom may be a necessary shock. Unfortunately, that may mean sink or swim. Like people who are struck with cancer or AIDS or Lou Gehrig's disease or a cluster bomb dropped from an airplane, I do not think a happy ending or a soft landing is always in the cards.

[August1991]

Good thread.

Sadly, many people with mental illnesses end up on the streets, and become 'homeless'. Schizophrenia is often undiagnosed until it is too late.

There was a woman interviewed on local radio in Montreal a while ago who was looking for her schizophrenic son. She worried that he was on the street and she didn't know how to help him.

In the past, such people were taken care of by family members or others in the community. There is innumerable examples of this from literature or even from one's own family history. A good example is in the movie The Last Picture Show.

Nowadays, they wind up on urban streets and too often, the police and ambulance attendants have to deal with them.

I can speak from personal experience that dealing with schizophrenics is particularly trying.

I don't what the solution is. I think where feasible they should stay with family members or if not, they should be in small private homes. Governments should provide financial assistance.

[theloniusfleabag]

Dear Charles Anthony,

Until there is violent activity, there is really no impetus for anybody to act.

In our State of affairs, I have a pessimistic out-look on the plight of the mentally ill. I believe their protection is a catch-22 situation. Until an adult commits a "crime" as listed in our books, we do not take it upon ourselves to force that adult into mental treatment. This makes me think of drug addicts.

I am speculating here:

Although I do not believe that drug addicts are worthy of the same treatment as the mentally ill, on the surface, the logistics of helping them unfortunately MIGHT be the same. Both must seek treatment on their own volition. [How they can do that when their faculties are disturbed, I do not know.]

Excellent swing, a direct blow to the 'brad-noggin'. I have had situations regarding the 'mentally ill', and the police told me that if they are not 'a demonstrable threat to themselves or to others, they cannot be held against their will." However, another police officer told me (off the record) that he believes that some people should be 'institutionalized', where they would be far less likely to harm themselves or others, and would have proper medical treatment. Unfortunately, (or fortunately for some) individual rights supercede the rights of 'society' (read: others).

I feel addictions, especially if a crime is involved, should be treated the same way. Pee in a cup, if drugs are found, then off to the treatment centre. But not for hours, (as it is now...a severly intoxicated/drugged person is taken by the police, if at all, to the drop-in/rehab center for about 4 hours, until they are 'out of danger') but for weeks/months.

[Charles Anthony]

In the past, such people were taken care of by family members or others in the community.

I believe therein lies the solution -- if there is one. [i am going to chicken out intellectually and make the following generalization: I trust a family member to care more for a person than non-family.] There needs to be an incentive for a family to take on the responsibility. Nowadays, relinquishing family (or more accurately, community) responsibilities is too affordable.

Nowadays, they wind up on urban streets and too often, the police and ambulance attendants have to deal with them.

Not only do the police and paramedics have better things to do but they are not the best people for that job. We should be ashamed of ourselves for brushing off our responsibility on those professionals. It is like expecting a school teacher to deal with a discipline problem instead of teaching a class.

I can speak from personal experience that dealing with schizophrenics is particularly trying.

It can be even more trying (if not hopeless) when the mentally ill person does not have a designated power of attorney (as most people do not) and every member of the family has a separate professional opinion on the best course of action.

Excellent swing, a direct blow to the 'brad-noggin'.

I genuinely do not know what you mean. Please explain the slang.

I am not ready to judge drug addicts in general terms. Both drug addicts and the mentally ill pose a health problem first. They are a criminal problem secondarily.

I have had situations regarding the 'mentally ill', and the police told me that if they are not 'a demonstrable threat to themselves or to others, they cannot be held against their will."

I am ready to assume that we can all agree that such a criteria is not good enough. We should aspire to helping the mentally ill earlier.

Recommendations for institutionalization must include a discussion of funding. There are jurisdictions in Canada that keep mentally ill people in jail for no other reason than a lack of beds in mental institutions.

[jbg]

Family care is great. However, those people have to earn a living. If they cannot afford a live-in babysitter (who's willing to grapple with a strong adult) going to work can be a problem, given the destruction and/or escape risk.

[newbie]

I feel addictions, especially if a crime is involved, should be treated the same way. Pee in a cup, if drugs are found, then off to the treatment centre. But not for hours, (as it is now...a severly intoxicated/drugged person is taken by the police, if at all, to the drop-in/rehab center for about 4 hours, until they are 'out of danger') but for weeks/months.

The problem there lies with the waiting time to get into treatment. It can take weeks, if not months, to access this resource where I live.

[theloniusfleabag]

Dear Charles Anthony,

QUOTE(theloniusfleabag @ Feb 5 2007, 12:59 PM)

Excellent swing, a direct blow to the 'brad-noggin'.

I genuinely do not know what you mean. Please explain the slang.

Terribly sorry, just trying to be funny. A 'brad' is a sort of nail.

http://www.aircofasteners.com.au/BRADDER.p...ES&cat1=BRADDER

By 'noggin', I mean head. In a roundabout way, I meant 'You hit the nail on the head'.

Recommendations for institutionalization must include a discussion of funding. There are jurisdictions in Canada that keep mentally ill people in jail for no other reason than a lack of beds in mental institutions.

I am not sure that there are 'mental institutions' apart from those for 'the criminally insane' (that is, someone who has met the criteria of being a 'demonstrable threat')

from...

http://www.irmacs.sfu.ca/events/past_abstr...php?pkey=130471

Over the past century, Canada's mental health system has moved away slowly from its former reliance on large mental institutions. In this post-deinstitutionalization era, what form will mental health services assume?

[margrace]

The program on "PBS' followed a man who was part of this program set up by Mr. Bush. People who were addicts and alchoholics etc could not get homes until they had cleaned up their act. Pretty hard to do on the street. This program takes people off the street, puts them in apartments of their own and follows them up closely with help. Evidently it is working very well.

However Mr. Bush also cut programs that help other types of homeless people such as single mothers. So it has its down side. As has been said by some of the authorities on here, homeless people with mental problems make up a small amount of the homeless population. I beg to disagree on that, I believe that it was said of Toronto's homeless that 80% of them have mental problems. Of course that was before the wonderful Mr. Harris forced so many more onto the streets.

[scribblet]

Most of them in Canada get their Conservative party membership paid for and have access to the Internet from their mother's basement so I think the costs are more reasonable in this country.

We in Canada (at least in Ont. not sure about other provinces) cannot force a mentally ill person into treatment or homes, a big part of the problem here.

[Charles Anthony]

Family care is great. However, those people have to earn a living.

If we want to be compassionate to the mentally ill, we need to be compassionate to the budgets of the family and friends (as opposed to civil servants) who want to care for them. Maybe we should consider making it cheaper for people to earn a living.

If they cannot afford a live-in babysitter (who's willing to grapple with a strong adult) going to work can be a problem, given the destruction and/or escape risk.

Prison guards are trained precisely for that.

By 'noggin', I mean head. In a roundabout way, I meant 'You hit the nail on the head'.

I guessed the "noggin" part correctly but "brad" is new to me.

I am not sure that there are 'mental institutions' apart from those for 'the criminally insane' (that is, someone who has met the criteria of being a 'demonstrable threat')

This gives me the following thought: maybe there is nothing morally wrong with treating the mentally ill the same as we treat criminals? I would hope the answer is an emphatic NO but it seems that we let the chips fall in the same place. I am sure aborted fetuses are innocent too but they get the short end of the stick too.

Crack-pipes are more important.

Safe-injection sites are more important.

Artificial joints are more important.

Free dentures are more important.

Free flu shots are more important.

etc. etc.

Everything is more important because the mentally ill are a burden: they are not productive (now or in the future) and they can be easily sequestered away. I will boldly make the leap of drawing a parallel with the elderly.

Like incarcerating the mentally ill and drug addicts, many old-folks homes are filled with people who do not get much care -- let alone not much attention. Anybody who has an old loved one institutionalized should find out how often the inmates get bathed.

As has been said by some of the authorities on here, homeless people with mental problems make up a small amount of the homeless population. I beg to disagree on that, I believe that it was said of Toronto's homeless that 80% of them have mental problems.

I agree with you even though I am not a statistician.

As an anecdotician, most homeless people above the age of 25 years that are visible on the streets of my city (just under 1 million people) are clearly not mentally sound.

Even if they are mentally sound when they become homeless, I believe we should consider the possibility that living on the street might lead a normal person to go crazy. Just a thought.

[Charles Anthony]

Maybe the highly constructive "Conservative party membership" comment tainted my attention but I wish I had caught this earlier.

Mental illness is no different than other illnesses that affect your health. They deserve as much care as any other person suffering an illness.

Mental illness is particularly different from other aspects of health because it confounds the concept of responsibility and informed consent for treatment.

For example, a mentally ill person is told that he has cancer and needs treatment. Following this, he agrees to accepting a proposed treatment but forgets the conversation one minute later. Effectively, the oncologist has said nothing. How should the oncologist spend his time?

[sideshow]

Maybe the highly constructive "Conservative party membership" comment tainted my attention but I wish I had caught this earlier.

Mental illness is no different than other illnesses that affect your health. They deserve as much care as any other person suffering an illness.

Mental illness is particularly different from other aspects of health because it confounds the concept of responsibility and informed consent for treatment.

For example, a mentally ill person is told that he has cancer and needs treatment. Following this, he agrees to accepting a proposed treatment but forgets the conversation one minute later. Effectively, the oncologist has said nothing. How should the oncologist spend his time?

I have to agree with your assessment CA.

The very sad truth is that a very large percentage of mentally ill people end up on the street, are physically and sexually abused, and ALSO have substance abuse problems.

They make up a very large proportion of the calls that FIRE, AMBULANCE, and POLICE respond to in core regions. They cost huge amounts in regards to resources used from the above, as well as hospitals, and "contribute" in a large way to the problematic waiting times at inner city hospitals.

These people are unable to help themselves. They are a burden to themselves, others, and society.

My personal belief is that there should be some sort of mandatory law, policy or whatever that emergency service people can avail themselves of to have these people placed in proper care.

I don't know what exactly, but they need to be in some sort of "home, facility, or institution" with 24 hour supervision to ensure they don't hurt themselves or others, stay off intoxicating substances, and that they are taking the required medications for their illnesses. As well, most of them can't even take care of their basic health and cleanliness needs.

It is nice to see a thread where there is some compassion and empathy from posters from all ends of the political spectrum.

[Mad_Michael]

Great thread with some very interesting posts!

On a related, but slightly different point, the angle that interests me most here is the political-legal side of this issue. This issue has not always been this way - traditionally, the mentally ill have been sequestered in asylums - religious, charity or state sponsored.

Against that, our constitutional laws hold that we cannot hold people against their will - or force their treatment. And that is why all these mentally ill people are out there wandering our streets costing society a small collective fortune in various incidential expenses.

So how can we resolve this problem? Without resolution to this legal issue, our courts will just strike down most attempts to herd the mentally ill into public treatment and/or shelter. And do we want to do that?

[Charles Anthony]

Against that, our constitutional laws hold that we cannot hold people against their will - or force their treatment. And that is why all these mentally ill people are out there wandering our streets costing society a small collective fortune in various incidential expenses.

Part of me thinks the cause is simpler.

It is too easy for people to participate in society without being fully responsible for themselves or their family or their friends or their neighbors. Part of our culture involves delegating responsibility to things or people with whom we have no contact -- if they exist at all.

So how can we resolve this problem?

In an absolute sense, I do not think we can resolve it in a fair manner. The mentally ill genuinely need compassion but at the risk of being callously partisan, I must object to compelling people to be compassionate. I think the best we can do is make the plight of the mentally ill better in the future.

We have to encourage people to assign themselves a power of attorney. It should become part of our culture. We should say:

- learn to walk

- toilet training

- brush and floss your teeth

- look both ways before you cross the road

- wear a seat belt

- stop smoking

- exercise regularly

- go to school (if you believe that sort of thing)

- buy a house

- get life insurance

- write a will

- assign yourself a power of attorney

Understandably, not everybody has responsible family or friends, but we can at least start somewhere.

Imagine a world where all minor children are de facto assigned their parents to be their power of attorney. When they reach the age of majority, it is a cultural habit to write a will and re-new their assignment of power of attorney. If ever mental illness strikes, there might at least be a little more hope.

[Moonlight Graham]

Excellent!

...made me choke on my coffee!

Seriously tho... mentally handicapped people should be taken care of. They should have special housing and people to make sure they are eating right etc.

there's a difference between being mentally handicapped & mentally ill.

[jbg]

Excellent!

...made me choke on my coffee!

Seriously tho... mentally handicapped people should be taken care of. They should have special housing and people to make sure they are eating right etc.

there's a difference between being mentally handicapped & mentally ill.

Ah, that great PC lingo.

[theloniusfleabag]

Dear jbg,

there's a difference between being mentally handicapped & mentally ill.

Ah, that great PC lingo.

I don't know if that is actually 'PC lingo', because there actually is a difference, though they might be able to be lumped together under 'mentally deficient'. Down's Syndrome is not really the same as schizophrenia, for example. 'Mental retardation' is making a comeback as a valid term, I hear.

Charles Anthony makes a good point here...

It is too easy for people to participate in society without being fully responsible for themselves or their family or their friends or their neighbors. Part of our culture involves delegating responsibility to things or people with whom we have no contact

My biggest beef with society today is that life (for many) has become a big game of 'dodge the responsibility', and it is being taken to ridiculous levels.

A prior thread was started about one man's action (Robert Latimer) in dealing with an extremely ill person...his daughter. He smothered her to 'save her from her constant torture', that being severe and painful disability(ies). The girl was over the age of 18, so he could have, theoretically, wheeled her to the end of the driveway (kicking her out of the nest, so to speak) where nature would have run it's course, and she would have starved to death (or been eaten, depending on where they lived).

At what point should the 'burden' of caring for the severely handicapped be foisted on others (if ever)? Should someone be 'forced' to take care of those that cannot care for themselves, even in the most rudimentary fashion?

[sideshow]

Dear jbg,

there's a difference between being mentally handicapped & mentally ill.

Ah, that great PC lingo.

I don't know if that is actually 'PC lingo', because there actually is a difference, though they might be able to be lumped together under 'mentally deficient'. Down's Syndrome is not really the same as schizophrenia, for example. 'Mental retardation' is making a comeback as a valid term, I hear.

Charles Anthony makes a good point here...

It is too easy for people to participate in society without being fully responsible for themselves or their family or their friends or their neighbors. Part of our culture involves delegating responsibility to things or people with whom we have no contact

My biggest beef with society today is that life (for many) has become a big game of 'dodge the responsibility', and it is being taken to ridiculous levels.

A prior thread was started about one man's action (Robert Latimer) in dealing with an extremely ill person...his daughter. He smothered her to 'save her from her constant torture', that being severe and painful disability(ies). The girl was over the age of 18, so he could have, theoretically, wheeled her to the end of the driveway (kicking her out of the nest, so to speak) where nature would have run it's course, and she would have starved to death (or been eaten, depending on where they lived).

At what point should the 'burden' of caring for the severely handicapped be foisted on others (if ever)? Should someone be 'forced' to take care of those that cannot care for themselves, even in the most rudimentary fashion?

I thought Latimers daughter was 12, but I may be wrong.