[NYAPRS Enews] STLT: The Close Connection Between Housing And Health

[Matt Canuteson]

NYAPRS Note: This piece underscores the findings of investigators and
reporters looking into the 4 recent episodes of violence involving NYC
residents with psychiatric disabilities over the past 6 months: housing
instability was a major factor for the two who were fatally shot by
police and the two who committed acts of violence. No wonder that
housing continues to be a top priority for NYAPRS members and most
statewide and national mental health advocacy groups.

 

The Close Connection Between Housing And Health 

By Francie Broderick   STL Today    August 4, 2008 

 

A police car pulled up at our offices, and a very pretty but distraught
young woman wearing pajamas and slippers and carrying plastic bags of
clothing got of the car. The sympathetic police officer had found her on
the street and brought her to a place he thought could help. Her newly
diagnosed mental illness already had started to cause her life to
unravel: She dropped out of college; she started fighting with her
mother; she ended up on the street.

 

Not long after, another new face appeared on our parking lot, that of a
heavily bearded young man wearing a long skirt and a bra who told me he
had been homeless for years. "You can't help me," he said. "No one can
help me."

 

These stories are repeated over and over every day. I work in a mental
health agency, not a housing agency, but it has become increasingly
clear that housing and health care are linked inextricably.

 

It is a dynamic that works both ways: Poor health puts one at risk of
losing housing, and homelessness increases the risk of poor health.

 

John Lozier of the National Health Care for the Homeless Council, a
non-profit advocacy group, quotes data showing that people who are
homeless "suffer all illnesses at three to six times the rate
experienced by others, have higher death rates and have dramatically
lower life expectancy."

 

Homeless people are subject to infection, the elements, poor nutrition
and hygiene and the ongoing threat of violence. The situation becomes
even more complicated when they also have a serious psychiatric
disorder.

 

People with untreated mental illness who are homeless often are
frightened, distrustful and unable to understand their need for help or
to maneuver their way through our fragmented mental health system. The
result is that the sickest and most disabled people often are among the
most chronically homeless.

 

In addition, homelessness and inappropriate housing situations among
people with serious mental illness also are linked to higher use of
expensive 

emergency room visits or hospitalization. 

 

Working with a group of health care advocates and providers in the
eastern region of Missouri, we have been identifying and analyzing "high
users," people with the greatest number of emergency room visits or
hospital days. A recurring theme is that these often are people who lack
stable housing. They may be homeless and unable to participate
consistently in their treatment. Or their living situation may include
frequent interpersonal conflict or domestic violence, situations leading
to police taking the person to the hospital. 

 

After four decades of deinstitutionalization, we know that most people
with serious mental illness can live successfully in the community if
they have the right combination of safe, affordable housing and
appropriate treatment. One without the other is insufficient.

 

We also know that one size does not fit all. Given the proper support,
most people can live independently in homes or apartments of their own.
Others may be able to manage in an apartment only if support is
available on site. We should be able to provide the full array of
necessary housing options.

 

The good news is that we have gotten very good at understanding how to
get people into services and treatment. State government has provided
funds for new assertive community treatment teams. The Mental Health
Board of St. Louis helps provide homeless outreach and housing
stabilization services.

 

The bad news is, we still have a crisis getting people housed. 

 

It is time for a broad-based community effort to address this problem:

 

Foundations, legislators and providers need to understand the link
between housing and health care. Banks and developers need to work with
service 

providers to create the various combinations of housing and service
options that will help people live decently, safely and productively.
Housing trust 

funds need to reserve funding specifically for people with special
needs. Neighborhood associations and community groups need to welcome
housing for people with disabilities in to their neighborhoods. These
are not strangers; they are our sons and daughters; our sisters,
brothers, mothers and fathers.

 

On July 30, President George W. Bush signed into law a bill creating a
national Housing Trust Fund, a permanent program with a dedicated source
of funding to create housing. This legislation has long been sought, and
it offers us a wonderful opportunity.

 

As the provisions of this legislation start taking effect, we must
ensure that the housing needs of the seriously mentally ill - the most
vulnerable and often the most voiceless among us - are not forgotten.

 

Francie Broderick of University City is a frequent contributor to the
Commentary page. She is the director of Places for People, a nonprofit
mental 

health center based in St. Louis.

 

http://www.stltoday.com/stltoday/news/stories.nsf/news/editorialcommenta
ry/story/15aa5e4890f0d06f86257498007c39ef?OpenDocument 

 

 

 

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