Back in the 1960s, the courts made it very difficult to put a person in a mental care facility, which in most cases were run as state hospitals. Most of those who were interned were released, and if they had no family they became the first of the homeless who lived on the streets. Many of these people were sane enough to live within our society but were not able to take care of themselves. We saw the first evidence of homelessness in the larger cities, and it soon became a problem that has been growing ever since.
Our city has a "free clinic" that was started to address those who had no medical insurance due to cost. Anyone who was below two times the poverty level in income could be seen at the clinic for examinations, and treatment when possible. We treated high blood pressure, some cardiac conditions, diabetes and many more. A local banker helped raise funds while the local pharmaceutical manufacturer provided free drug products, and the dean of the Medical School provided a list of volunteer physicians, nurses and pharmacists. When these were put together, the free clinic was in business. Since that time and after the Affordable Care Act, the funding from state grants has been reduced and the clinic was forced to take Medicaid patients but still offer free medical care to those who have no insurance, which usually is the result of cost. Many of those receiving care are members of the homeless community. This group is very different than the homeless groups in the sixties and seventies. There is still the mentally ill segment, which has been a constant for many years, but others have joined them in the homeless population. Giving to this clinic was the first time that I saw my gift grow. For every dollar given, there was thirty dollars of free medical care provided.
Most of the major cities in this country are dealing with growing homeless populations and have not found a solution to deal with it. Our city has proposed that we move our clinic outside the city to a rural location to draw the homeless out of the city. In other words let us hide the problem and pretend that it does not exist. Most would not follow us to a rural area since they have no transportation. Some of the city’s attractions to the homeless are the food kitchens, such as the Salvation Army. It serves about 120 meals every day to the needy, which includes the homeless. The free clinic provides a place to shower and receive medical and mental treatment. The problem is that more than one solution is needed.
Our homeless population is made up of those who are mentally ill, military veterans who have PTSD and cannot get the help they need from the VA, those addicted to alcohol and drugs, and some who with minimum-wage paying jobs cannot afford the cost of rent in the city. There are others who have lost their jobs or for some reason lost a home to return to. It is a different story for each person being in the position of homelessness. There is no single solution to the problem, but there are many solutions waiting to be put into place. A big problem could be solved if the politicians who spent the money that used to be allocated to treat mental patients was restored and new mental institutions were built for those who are unable to function without help in society. The VA could expand its ability to help veterans who have not been able to adjust to civilian life after service. Treatment centers for those addicted need to be built with mandatory attendance by anyone who has been deemed a habitual drug or alcohol addict. Some low cost housing should be built and made available for temporary use to those with low incomes or loss-of-housing emergencies. I mean “built” because the local federal housing is provided by local rental agencies, which many times are substandard and in bad neighborhoods. Counseling needs to be provided for job procurement and for housing and budget problems. All of these solutions will start to give the homeless population the real help they need to get off of the streets and out from under bridges.
Most cities want to use their tax dollars to get the politicians reelected instead of doing those things that can really affect their citizens, which includes the homeless. States have diverted the tax dollars that used to be used for mental illness care and the hospitals that were available. One of the mental hospitals that I lived near has now become a prison, while others were just shuttered and left to be torn down. The tax dollars that used to run them have been diverted to pet projects and have left a complete population without care. Moving them out of the cities is a cruel way to handle a problem that we caused in the first place. It is time to address the issue head on and stop trying to just remove the problem. It is like the old way to handle the elderly: send them out on the ice to die. Out of sight and out of mind may be the way to go for some, but it is not the moral and ethical way to fix the problem. We are the problem, and homelessness is the result of our problems. A recent trip to San Francisco revealed that most of the lower paid workers in the city were traveling 50 or more miles to work because they could not afford housing any closer. A restaurant owner in our city told me that half of their line cooks lived in a homeless shelter because they could not afford to rent within the city, and they did not have transportation to travel out of the city. These are the working homeless and we have put high rents and profits above their ability to find affordable housing. Because of their plight, they have resorted to drugs and alcohol instead of trying to better their income status.
One of the most serious problems is the way we try to educate our young. Everyone is put into the same basket and told that college is their goal, while many would rather learn a trade. Upgrading the education system to include trade schools, and the old home ec and agriculture, would keep many in school to graduate before being let loose in society with no skills other than a minimum-wage job.
The homeless problem will never go away by itself, and we as a society need to recognize that we have to find as many solutions as there are different types of homelessness. We need to get started.
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