When New York City Mayor Eric Adams announced Tuesday a major effort to remove people with severe, untreated mental illness from the streetshe delves into an issue that has driven policy for years — and frustrated policymakers — in cities across the United States and the rest of the world.
Here is a snapshot of a few places where authorities are trying to reframe their support services for the homeless, including those with mental illness.
Mental health care for the homeless has been a difficult legal issue for more than half a century in California, since the nation’s turn to de-institutionalization and a 1967 law – signed by Ronald Reagan, then governor of the state – to protect the civilian population. rights of Californians with mental illness.
The state has spent tens of billions of dollars on homelessness, but efforts have been hampered both by neighborhoods that oppose building shelters and supportive housing as well as by problems with structures, such as holding cities accountable for housing and shelters for the homeless, but putting counties in charge of the public funding needed to provide people with mental illness continue treatment.
A law signed this year by Governor Gavin Newsom aims to force some people with serious mental illnesses into court-ordered treatment and housing, but it will only apply to about 12,000 people with schizophrenia. and other serious mental disorders, not all of them are homeless, and won’t start until next year.
There are nearly 42,000 homeless people in Los Angeles, most of them without shelter, according to recent county data. According to the report, about a quarter of homeless adults are identified as having a serious mental illness. Under one program run by the countyPsychiatrists work on the streets to connect homeless mentally ill people to their care.
More disappointing the city’s homeless crisis boiling point has been reached. Officials have banned public camping at dozens of sites, as well as within 500 feet of schools and daycare centers. City officials are also increasingly willing to use police force to clear makeshift campsites, and the newly elected mayor, Karen Bass, has vowed to end the practice.
In San Francisco, a variety of programs provide people with mental illness and sleeping on the streets respite, shelter, and treatment. But experts say that without enough medical staff or housing, those programs often fail to meet demand.
Margot Kushel, a physician and director of the Benioff Housing and Homelessness Initiative, a research group that advises policymakers and is based at the University of California, San Francisco, “Not enough,” said. “Without housing, it all falls apart.”
In Chicago, homelessness is a widespread problem that has become more apparent since the pandemic, especially as camps have sprung up under viaducts near Lake Michigan and in parks throughout the city. .
But homeless advocates say they’ve never heard of city employees – from the police department or elsewhere – sending homeless people to the hospital against their will in a way that Mr. Adams made Tuesday.
Debbie Pavick, clinical director of Thresholds, a non-profit behavioral health organization that works with homeless people, said: others.
Instead, city employees and nonprofit providers work to connect homeless people with services and housing. Thresholds deploys trucking groups of mobile workers to try to engage the homeless and help them get primary health care, mental health treatment and medication, and services, Pavick said. other service.
In Portland, concerns about homelessness and safety have been at the heart of recent campaigns by both local and state offices, and the city has now launched a controversial plan to ban camping in the streets, hoping to eventually direct the homeless into a series of tent sites run by the city.
The city has also moved to attract more homeless people into mental health care. The region’s capacity for mental health services has long been strained. Two months ago, three hospital systems sued the state, saying that people who commit civil crimes because they are a danger to themselves or others end up in the hospital for months instead of receiving treatment. long-term, such as in a state psychiatric hospital. hospital.
Tina Kotek, a Democrat who recently win the governor’s raceannounced it would pursue policies that build more housing, increase the number of people working with the homeless, and expand services to people in a mental health crisis.
In East Asian cities, homelessness tends to be much less common than in the United States. But the problem persists, and in some places it’s worsened during the pandemic as some working poor can’t afford to buy homes in expensive real estate markets.
Hong Kong, a territory of China with high rate of inequalityis one of several East Asian cities where homeless people have sheltered for years in conspicuous places, including in McDonald’s restaurant 24 hours. The number of people signing up as “street sleepers” in the territory nearly doubled over a seven-year period, to more than 1,500 last year, according to government report – a little more than the number reported in Singaporeanother wealthy banking center in the area.
Data on mental health issues in Hong Kong’s homeless community is scarce. An extensive quote academic survey 2015 of the 97 homeless found that more than half had a mental illness – and most did not receive psychiatric care.
Hong Kong typically offers subsidized dormitories for stays of up to six months, but social workers and other experts have said the time limit should be expanded. They have also asked the government to invest more in public housing and stop clean up homeless camps in parks and other public places.
Despite rising rents and house prices, Australia’s largest city has managed to significantly reduce homelessness over the past five years through programs that combine immediate intervention with public and private services. Non-profit includes long-term follow-up.
Homelessness has been declining in Sydney since the introduction of the Transition and Engagement Assistance Program in 2018, which rapidly resettle homeless people and provide counseling on drugs and alcohol, health care and crisis support. In February 2017, the City of Sydney street count counted 433 “sleepers” on the streets. This year, in a city of 5.3 million people, that number has dropped to 225.
In part, Sydney has built on its pandemic response strength. With the help of the police, who are empowered under a 2002 law to remove people from public places if they harass anyone or frighten others, the government has paid the homeless. housing in affordable hotels and apartments when Covid peaks in 2020. Social service groups connect with the population at the time, helping to build trust with those who are often difficult to get in. family.
Australia as a whole has also benefited from a stockpile of public housing, albeit much smaller than in many European countries, still make up nearly 4 percent of the population, compared with 1 percent in the United States. It’s not enough — waiting lists for so-called social housing in Sydney and New South Wales reach 50,000 people — but with nationalized health care and robust welfare systems, homelessness population has not reached levels that can be found anywhere in New York or San Francisco, and the trend lines are down rather than up.