Caring for Mentally Ill Homeless

Of the five well-advised recommendations made by the RAND Corp. (Aug. 7) regarding the homeless mentally ill, three recommendations offer substantial possibility.

RAND suggests that since many homeless visit physical health clinics, we should bring these clinics into the process to help link the homeless to needed services. Often overlooked is the fact that up to 39% of those diagnosed with mental illness actually have other physical disorders that can cause or exacerbate their psychiatric condition.

What a waste it is to have someone with a brain tumor or viral encephalitis roaming the streets disoriented and severely depressed for lack of proper medical screening and treatment.

RAND also points to the successes of helping the homeless in applying for benefits such as Supplemental Security Income. What a difference it could make if those applying were not automatically rejected on their first application for these federal funds. There is an urgent need to reduce this time-consuming process.

Finally, RAND reported the excessive caseloads that hamper case managers who are assigned to link those with chronic mental disorders to needed benefits, services and a roof over their heads.

It’s time to detail who should and should not be provided services of a case manager. These vital services should be for the seriously and chronically ill, not for those with transient emotional problems.

Highly trained professionals acting as case managers may not be necessary, given the job description and the limitation of funds available for salaries. The Alliance for the Mentally Ill has an overwhelming number of families providing case management services with on-the-job training to their mentally ill relatives.

Many successful programs in the nation staff their case management services with compassionate, creative, hard-working people (some of whom are recovering from mental illness) who earn minimum wage and have effective supervision and training.

Other recommendations might have included:

Preventive measures such as phone calls or street-side and jail visits by adjusting bureaucratic limitations and the regular business hours kept by traditional mental health clinics.

Such calls and visits can prevent an escalating illness from resulting in homelessness and costly hospitalization.

Speedier review of state applications for case management funds to the state through Medicaid.

Making and implementing plans for stable, permanent low-cost housing to reduce the stresses of living on the streets or in temporary facilities.

The hundreds of thousands with mental illness deserve the commitment of resources, compassion and imagination RAND recommends.

With a greater cross-section of the community participating, including churches and service organizations, many of these ill people will not only find a life in their community but will be enabled to contribute to the community.

WENDY KELLEY

President

Southcoast Alliance for the Mentally Ill

Costa Mesa