MYTHS AND CLICHÉS: THE UNDERPINNINGS OF HOMELESSNESS
Besides being a society plagued by a destructive polarization, we are fast becoming a culture dominated by the use of simplistic clichés to explain away our most troubling problems. All this has done is perpetuate our damage, insure its chronicity, and give us a false and self-righteous sense of caring and helping others.
The most blatant example of this is our current focus on the plight of the homeless. We are deluged with analyses and diagnoses by pseudo experts telling us that the vast majority of the homeless population is, in fact, suffering from various forms of addiction, or mental illness; and that the solution to their afflictions is a dramatic increase in rehabilitation centers and mental health facilities. We are also told that these afflictions are exacerbated by the shortage of affordable housing in all of our major urban centers.
I am always surprised that no one ever mentions the fact that hundreds of thousands of people continually arrive in our urban centers, from within the country and abroad, and find places to live. In addition, the history of subsidized “public” housing, has an abysmal record of providing decent, humane habitiations.
But the aspect of homelessness most mystified and fraught with misinformation, concerns those addicted to drugs and alcohol, and those suffering from “mental illness.” I put mental illness in quotation marks, because it is an essentially meaningless term. The mental health industry in America would have us believe that there is an organic disease entity, like the flu bug, that infects people and makes them act strange and “abnormal.” No such entity has ever been identified, and no scientifically valid research has ever consistently proved that brain abnormalities or biochemical imbalances cause strange behavior (remember, correlation does not equal causation). But we continue to do things to people – hospitalization, medication, therapy – based on the premise that there is something wrong with them, and we need to make it right. Dr. Thomas Szasz, the founder of radical psychiatry, coined a phrase that sums up our current approach. He made the point that – “We treat people who are disturbing; not people who are disturbed.”
There is no such thing as involuntary, or forced treatment for “mental illness” or addiction. It is nothing less than incarceration without the constitutional protections of due process. In my over forty years of working with people with a wide variety of psychiatric and addictive diagnoses, I have never seen anyone significantly change, who was mandated and forced to get treatment. (If you’re thinking of “interventions,” they ultimately require a willing, albeit resisting, participant.) As any recovering addict will tell you, no one seeks help unless “they’re at the bottom of the toilet, looking up.” I’m not aware of any city in the country that’s deluged with addicts and the mentally ill, breaking down the doors of clinics and rehab centers. There is, in fact, no shortage of treatment facilities – there is only a shortage of people voluntarily seeking help.
Addiction and mental illness are symptoms, not causes. Both involve self-anesthetizing of deep, soulwrenching pain. People abuse substances and act crazy, to dull the agony of an incessant, throbbing wound – a feeling that they will never ever find relief. People diagnosed with severe mental illness and/or addictive personalities, have had shattering (and very often, early) life experiences that have produced self-loathing, selfpunishment, and self-denial. Can you imagine how repulsive you’d need to find yourself, to live on a sidewalk, within feet of your own (and others) feces and urine? Does this make the homeless irretrievably bad or worthless – unworthy of our caring or concern? Absolutely not. What it does mean, is that nothing will change for them, until their underlying pain is identified and grieved. And this only occurs when the pain of doing nothing exceeds the pain of self-abuse.
Homelessness is fundamentally a public health crisis. (I’m amazed that I’ve only seen one person in the mainstream media – Dr. Drew Pinsky – point this out.) We are allowing debilitating and potentially fatal diseases, to incubate on the streets of our most populous cities. Our chronic neglect and denial is tantamount to taking vials of deadly flu viruses, and dumping them into schools, businesses, government centers and our water supply.
There is only one solution to the homelessness crisis – a concerted, focused and comprehensive program, led by the public health apparatus and the healthcare community, to quarantine those currently in homeless encampments. This means the identification of geographical locations that are non-contiguous to population centers, and are exclusion zones in terms of entry and egress. The only people allowed in would be appropriately protected professionals, providing services intended to inhibit and ameliorate the pathologic conditions. The only alternative to this, is to wait for a full blown pandemic to begin to severely sicken and kill large numbers of people.
If this sounds harsh, ask yourself how you’d feel if homeless encampments sprang up in front of your children’s schools, your local healthcare facilities, or your home. You may consider this proposal extreme, but I have no doubt that we are closer to a public health catastrophe than we think. Our propensity for denial has always caused us immense harm – economically, ecologically, politically, and culturally. I would hope that this time, we see through it before the cost becomes astronomical.
Morrie Shechtman