Homeless struggle with mental illness

Editor’s Note: This is the third part in a five-part series on homelessness and panhandling…. Editor’s Note: This is the third part in a five-part series on homelessness and panhandling. Read The Pitt News all this week for installments.

Ten minutes before closing time at the Subway restaurant on Forbes Avenue Wednesday, a panhandler walked in. He muttered curse words to the employees and was swaying back and forth.

He took cups from the drink dispenser and filled them with water. Turned in a way so that no one could witness his nightly routine, the man drank from one cup, gargled and spat the water into another.

After pouring the water from cup to cup, he attempted to steal some soda. An employee asked him to leave. The man gathered his cups, flailed his arms and knocked into a chair.

Then with a string of curses and slurred words, he left for the night.

Any of the other customers might have assumed that he’s got some sort of mental illness.

Christina Newhill, an associate professor who has experience working with homeless mentally ill individuals, said that there’s a significant chance that they would be right.

“Most commonly, homeless mentally ill persons have severe mental illnesses such as schizophrenia, mood disorders (such as depression or bipolar disorder) and certain severe personality disorders,” Newhill wrote in an e-mail.

According to the National Health Care for the Homeless Council, 39 percent of homeless people who have received some form of healthcare have a mental health problem and 25 percent meet criteria for serious mental illness.

In the 1960s, Pittsburgh began a policy of de-institutionalization. The goal was to get mentally ill patients out of the institutions.

Newhill said that the program lacked a solid transition for homeless people.

“We have discharged the vast majority of individuals from the state hospitals, but did not simultaneously develop adequate community mental health services to meet their needs,” Newhill said.

She said that mental health centers offer homeless people things like inpatient and outpatient care, partial hospitalization, emergency services and some housing. But she also pointed out that there are some centers that do not have an inpatient sector.

Because of their symptoms, many of the mentally ill are unable to care for themselves. It often becomes impossible for them to maintain housing or employment.

Local institutions offer a variety of services, but their resources are limited.

“We do not have a ‘system’ of mental health services,” Newhill said. “What we have is a hodgepodge of poorly coordinated and inadequate services staffed by mental health workers who are underpaid and overworked.”

Newhill said the mentally ill are in particular at risk of being the targets of robbery and assault.

The National Health Care for the Homeless Council reported that the Institute of Medicine determined that those without a regular place to stay are far more likely to suffer from most categories of chronic health problems than the general population.

Data from the Health Care for the Homeless Program indicated that more than 70 percent of people who are homeless have no health insurance.

And even if a mentally ill person is hospitalized in an emergency, he or she must eventually return to the unstable environment and harsh conditions that induced the illness in the first place.

“The policy of de-institutionalization – begun in the 1960s under the best of intentions – has been a failure,” Newhill said.

Tomorrow’s paper: State of the Streets, Part 4: Students and panhandlers.