by Bhaani Singh and Kenneth Hahn
Berkeley is a city that boasts the reputation of free speech, liberal thought, and environmentally conscious behavior; a land that prides itself on diversity and social progress; a place that many of us find simultaneously chaotic and serene. Like the tie-dye shirts seen on Telegraph Avenue, Berkeley’s rich culture is a swirl of various ethnicities, academic backgrounds, and political thought.
The homeless population, too, is weaved into the fabric of our history. Yet, despite its familiar presence, we are left with many dangling threads of housing and mental health, which must carefully be sewn back into this fabric to ensure community strength and solidarity.
According to the U.S. Department of Housing and Urban Development (HUD), more than 610,000 people experience homelessness every night, including about 140,000 children. These numbers are far lower than the actual figure — closer to 3 million people in many estimates — because HUD only counts once a year and the number of homeless persons changes as people move in and out of being homeless.
It is often observed that about one in five of these individuals suffer from severe mental health issues, and have been diagnosed with schizophrenia, substance use disorder, bipolar disorder, and depression. These mental disorders may affect an individual’s ability to carry out essential activities for survival and maintain stable relationships with family or friends.
The social selection hypothesis states that as a result of schizophrenia impairing earning power and income, schizophrenic persons are often forced to move into poorer neighborhoods. On the other hand, the social causation hypothesis states that people with low socioeconomic status develop mental disorders as a result of the stresses and adversities they face.
Thus, mental disorders and poverty are often thought to be of a cyclical nature. Furthermore, unmet mental health needs affect one’s physical health. Compared to the general population, homeless people have poorer health outcomes, including higher rates of tuberculosis, asthma, diabetes, and HIV. Nearly half of mentally ill individuals also suffer from substance use disorders, as a way to self-medicate or to cope with the stresses they face.
As a result of poor mental and physical health, as well as social stigma and inadequate income, these individuals face barriers to housing, employment, and a healthy livelihood. Many of the mental health issues faced by the homeless population can be treated with therapy or counseling. Medication has been effective for some individuals, but many have reported adverse and severely incapacitating reactions to antipsychotic medications.
However, when these conditions are neglected, they end up not only costing our healthcare system millions of dollars in hospitalization, but also prolonging human suffering. In Alameda County, nearly one in five adults reported that they needed professional help for emotional health or alcohol use in 2007.
Unfortunately, a systemic discrimination against the mentally disabled is prevalent in our political and economic systems, where funding is allocated towards direct physical ailments but mental health problems are neglected and given a lower funding priority. Medicare and Medicaid have far more stringent restrictions on mental health care provision than physical health care. Mental health facilities are underfunded and slowly emptying, while emergency rooms and prisons are overcrowded.
In 2006, the Justice Department reported that nationally about 1 million people in custody suffered from a mental health problem. If funding is appropriately designated to mental health resources, the saved costs can not only help people avoid hospitalization and prison, but also can be spent towards other important areas of our society, such as education.
As a society, we are willing to look for cures for cancer or diabetes, but we find it challenging to focus on risk factors that contribute to mental disorders. It is time to give equal importance to preventative care, mental health resources and medical treatments.
One step towards alleviating mental disorders, especially in the homeless population, is to acknowledge that the issue exists. Many people who suffer from a mental disorder wish to be treated; they just don’t have the resources to receive the necessary care towards a healthier lifestyle. Homeless individuals often come from backgrounds of social disadvantage and economic instability, which can trigger or exacerbate the development of mental health problems over time.
Over the past few years, we have had the privilege of working with the Suitcase Clinic, a group of dedicated students and professionals who attempt to slowly bridge the gap between the privileged and the underprivileged populations in Berkeley through free social and health services to the underserved.
Through our conversations with many clients, we have come to realize that most people do not just want the services we have. Rather, they want to be acknowledged as people and to be treated with respect and dignity, something which they do not experience very often.
When society ignores people over and over again, for days and years at a time, people are forced to wonder why they are being ignored. They are provoked into questioning their existence.
As a result, it is important to acknowledge that issues in our community exist and by doing so, we can begin to foster dialogue and target interventions to help individuals break away from the cycle of mental disorder, hospitals, streets, and poverty.
Another important step is to create permanent supportive housing. Permanent supportive housing is a mixture of affordable housing and a package of supportive services to help people attain education and employment opportunities, housing stability, and improved health and social outcomes.
These housing programs often work with community workers to reach out to mentally ill homeless persons and help them find support groups, learn daily living skills, and access treatment.
Many research studies, including those from the National Mental Health Association, reveal that in addition to helping most people break free from homelessness, this housing approach lowers public costs for prison stays and hospital treatment, and is effective for people with mental health issues.
Even in 2015, many current proposals in Berkeley, such as preventing bedding on sidewalks and sitting near tree wells, are seemingly targeted against the homeless population. Spending money towards initiatives like these will not solve homelessness. It targets a very important group in our society and attempts to remove them from view, an experience that can easily be construed as dehumanizing.
Rather than increased citations and arrests, city officials should invest in affordable supportive housing and increase the number of outreach workers who can help homeless persons find physical and mental stability off the streets.
The government should consider increasing funding towards these supportive programs and mental health services so that even when economic times change, services will be still be stable and provide help for homeless individuals, particularly those with mental health problems — a group that composed an estimated 40 percent of the homeless population in Berkeley in 2009.
The homeless population is part of our community. They are part of the Berkeley we all love and are proud of. It is time to stop labeling homelessness and mental disorders as controlled or personal choices, and to socially integrate individuals suffering from these situations into society.
For a peaceful world and a stronger Berkeley, we must invest ourselves in compassion and empathy. The dangling threads of our community need to be sewn, for we cannot ignore those whose humanity is intertwined with our own.
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The Suitcase Clinic
The Suitcase Clinic is a humanitarian student-run organization and volunteer community group offering free health and social services to underserved populations since 1989. We operate three multi-service drop-in centers in Berkeley, and are open on Monday and Tuesday nights to anyone in need, regardless of income, residence, gender, ethnicity, age, etc. For more information, please visit our website at www.suitcaseclinic.org.
We do not offer professional mental health services, but are able to lend a listening ear and direct referrals to appropriate professionals in the community. If you, a loved one, or community member is in crisis, please call the 24-hour, 7-day-per-week Crisis Support Hotline for phone-based counseling and referrals. Their telephone numbers are 1-800-309-2131 (Alameda County Hotline) and 1-800-273-TALK (Nationwide Hotline).
For residents of Berkeley and Albany, the Berkeley Mental Health Mobile Crisis Team delivers crisis intervention services, consultation on mental health issues, and disaster and trauma-related mental health services. Their telephone number is 510-981-5254. More information can be found at the Alameda County Behavioral Health Care Services website, www.acbhcs.org.