Moral obligation to homelessness

originally posted by: th3dudeabides
a reply to: KyoZero

I help each month at a local homeless shelter. What I see is epidemic of cyclical mental illness. The homeless I see should all be in treatment of one sort or another. ..

What specific, realistic solutions would you suggest?

a reply to: Tangerine

If i could chime in:

In the US, as SSRI's increased in the mentally ill population, hospitalizations decreased. Patients who had not responded with any meaningful results to the prior medications, many of which were utterly debilitating (Haldol, Resperdol, Thorazine, etc) in their side effects. Side effects which were not reversable.

As med compliance improved, inpatient hospitalizations continued to decrease. To the point where the ability to fund hospitals was not possible without a different set of patients. So community admissions were closed in many cases, and forensic patients were brought in from prisons. Which, to be honest, has an upside. It has been long talked about how many prisoners were mentally ill, and didn't belong in prisons (where they were a danger to themselves and others, as well as targeted for exploitation).

The downside: beds made available for community admissions are much lower. Access to inpatient care for the uninsured is almost nonexistant. The only real route in is through a police department.

So we have 2 problems here:

- there isn't enough bed space for inpatient needs
- SSRIs are very useful, and have a very high level of efficiency. However, when they don't work right....you get Columbine.

How do you solve this? Well, throwing money at it will actually help. Making inpatient care accessible for people who are not brought in wearing shackles would certainly be a good first step. If nothing else, it will help provide the "three hots and a cot" that can keep folks alive during the colder months.

With SSRI's...that is another matter entirely.

After hospitalization....that is a regional thing. In our area we have a very robust community services offering for MHMR. It is important that social services are given a priority. It is hard to integrate into society once you are released.

In any event, we do have a duty to help the mentally ill. It is a benefit of our society, and I absolutely do think we owe it to humanity at large to take care of our mentally ill. Even if we bomb a few less Afghans to be able to afford it.

I would say that the best thing to do with men like that is .......Land in the nearest parking lot with a Huey, while the pilot sits idling have 2 big men with guns get out walk over to the men in question and point their guns at them and tell them to get into the helicopter. As the helicopter takes off it turns and starts ascending away from the city as you toss each of them a backpack as you tell them what's happening. You each have one week of food, you each have a survival knife and some other miscellaneous survival stuff...... You land in a small clearing in the middle of the forest and pat them on the back as they are getting out. When they make it out they will probably be pretty decent people afterward. I imagine that's kind of what happened with the Devil and his angels when they got kicked out of Heaven.

I volunteer in my local area and have a point of view from a church mission. First off their is no connection to government, only private donations that in large part are small in dollar amount(per each person) and food and clothing from churches throughout the county, Around twenty total. During the winter months, an overnight shelter is maintained that includes beds, dinner and breakfast for approx.. 30 people.
What I have observed over the last five years of my involvement has been a trend in the ratio of group that gets involved with this particular mission. Against my better judgment I'll use numbers, although approx.. still get to my point ! ; 10% are mentally ill to some degree and are unable to maintain employment. They are not necessarily in a substance abuse position, but many have prescriptions to help with a condition of some sort. I feel they will most likely be in are care as a society (as long as they stay in our reach) for the rest of their life. However long that may be...........
10% have made a poor percentage of good/bad decisions and have hit bottom, but still climbing as hard as they can. I hope we(and society) can help them in their way up and out of that hole. They learn from mistakes and usually don't come back into the program.
80% are the bell curve in the middle and contain some combination of evil and laziness. They are not usually aggressive or hostile, maybe on occasion it shines through and they are immediately removed from the program. Although the overwhelming majority of time, they are just freeloading. Interesting enough, the age of the person/people in this group seems to be in the 20's. Kinda wore out the welcome from the parents and on a extended party vacation or something like it. Lots of substances and doing things that feel good...... It almost hurts to see a pregnancy within this group as there is little chance of proper prenatal care ! I really feel as is this is where we as a society need the structure to reduce this. These misguided souls will probably never get it together to be self sufficient. I do not have an answer an as for the OP seeing another angle of the same group. Perhaps as they get older and more savy/desperate/manipulative, the hospital becomes a/another resource......Sometimes I wonder if a program such as CCC would be a constructive place for the 80%er's. At least a place to get something back or a mild deterrent to not being at least a little close to self sufficient.

originally posted by: FyreByrd

originally posted by: Meldionne1
You can go ahead and shoot me for saying this.....BUT....I personally don't feel any moral obligation to ANYONE ( homeless or not) who's cheating the system at the tax payers expense.

Cheating the system - in what ways might you cheat the system, everybody does it. Do you somehow cheat on your taxes, do you drive over the speed limit? However, you may justify it, everybody tries to game the system.[/quote)

No I don't speed and no I don't cheat on my taxs...also,got audited on my taxs twice and had all the receipts to prove my write offs...I am legit, and don't like when people "play " suicidal just because....

originally posted by: swanne
In my opinion, food and shelter should be not be privileges. They should be rights.

So being a right do you pick where you live under these conditions or are you offered a choice to take only one thing or stay on the streets? What do you do with those who by choice choose the streets. To take someone off the streets means funds, so who pays for that?

originally posted by: theabsolutetruth
Housing should be a right.

It has never been a "right" in the past, our founding fathers didn't see it as a right, so should we make it a right? Is this a Government thing or a charity thing?

wow...I posted my reply and it is now gone...so I am at work and fortunately saved it at home so will reply again this morning when I return home

originally posted by: buster2010
Yes everyone does deserve a place to live. Right now we have enough empty houses in America that we can get rid of the homeless overnight.

Before the homeless get to pick can I get a free upgrade on the house I been paying for?

It may be like a cancer but the true cancer is unregulated capitalism and it has destroyed this nation. It is because of this that we have so many homeless now. Many people lost their jobs and were unable to find another one because of the jobs moving out of the country.

40% of homeless are 6 months or less, 25% are crazy, so that leaves 35% long term but not crazy. Out of that 35% what do you think is caused by your evil unregulated capitalism? I would suggest that Capitalism and Water always take the path of least resistant. People on the other hand have a choice, and many will pick a substandard lifestyle because it is the path of least resistance, while others choose a more resistance path that leads to a better lifestyle.

Capitalism is not really a conscious entity. If the best returns are on sending jobs overseas based on Government regulations then so be it, the jobs go overseas. If more profit is to keep those jobs here at home then the jobs come home, very simple.

It is like grabbing the bull by its nose ring, it will go where you pull it.

The vast majority of people will select a substandard living if it means they do not need to work. The most subsidized ethnic groups of Indians and blacks are also still the poorest no matter what we do. Subsidization is a life term prison for those who choose it.

The long term non-crazy 35% who live on the streets are all a part of the path of least resistance, it is just that is the path they choose.

a reply to: bigfatfurrytexan

Thank you for the information. I'm sorry but I don't know what SSRI's and MHMR are.

The question remains whether we (ie. society) has the right to remove people from the street against their will for being mentally ill/alcoholics/drug addicts.

originally posted by: bigfatfurrytexan
Caring about it should always happen. But one issue we do have is that, from an aid perspective, there is no way to distinguish between those who choose to be homeless vs those who are victims of it.

Surely, you can determine whether the individuals are seriously mentally ill, drug addicted or alcoholics and whether they've been run through the system multiple times, right?

a reply to: Tangerine

A quick google will clear up SSRI's better than me typing several paragraphs. MHMR = Mental Health Mental Retardation

Society has a right to remove people from the streets that pose a risk to themselves or others. Being insane...nothing wrong with that. Acting a little crazy? Nothing wrong with that, either. Putting yourself/others at risk? That is where the line is crossed, and we must act compassionately to help them.

I have seen quite a few times where someone behaved, while seriously decompensated and psychotic, in a manner that was shocking and embarassing to them once they regained some sanity. That creates another issue they have to deal with.

The other option is, you have a mentally ill guy with a spoon that get shot by a cop who thinks its a knife.

originally posted by: Tangerine

originally posted by: bigfatfurrytexan
Caring about it should always happen. But one issue we do have is that, from an aid perspective, there is no way to distinguish between those who choose to be homeless vs those who are victims of it.

Surely, you can determine whether the individuals are seriously mentally ill, drug addicted or alcoholics and whether they've been run through the system multiple times, right?

You would like to think you can....

....but you can't. Determine if someone is a drug addict is easy. They detox. Most folks, when triaged, will tell you their indiscretions.

I worked in acute care admissions for 5 years at a state mental hospital. What did me in was a guy who had a drug induced psychosis. I had to literally fight with him for a week. I was the biggest guy on the unit, and he was a 6'7" giant. Once we got a few pounds on him, and got him cleared, he straightened out (and was actually a pretty good guy). We released him to a halfway house. He lost some weight, his psychosis returned. I got to fight with him for another week.

I had never had a patient actually do that. I could not physically control him to a degree that I could provide for my own safety.

Drug users can be every bit as mentally ill. Matter of fact, often times mentally ill folks will use drugs to self medicate.

originally posted by: bigfatfurrytexan
a reply to: Tangerine

A quick google will clear up SSRI's better than me typing several paragraphs. MHMR = Mental Health Mental Retardation

Society has a right to remove people from the streets that pose a risk to themselves or others. Being insane...nothing wrong with that. Acting a little crazy? Nothing wrong with that, either. Putting yourself/others at risk? That is where the line is crossed, and we must act compassionately to help them.

I have seen quite a few times where someone behaved, while seriously decompensated and psychotic, in a manner that was shocking and embarassing to them once they regained some sanity. That creates another issue they have to deal with.

The other option is, you have a mentally ill guy with a spoon that get shot by a cop who thinks its a knife.

I live in a community where the homeless are treated quite well compared to many other places. In fact, every year right before the shelter opens there's an influx of homeless coming here from other areas. Almost all of them are regulars who are obviously drug addicts, alcoholics, mentally ill or some combination of the above. I make a clear distinction between this group and people living in the area who are down on their luck and find themselves homeless. The latter group takes advantage of services made available to them and they attempt to get back on their feet. The former group takes advantage of services made available to them and raises havoc with the lives of everyone who comes in contact with them. Thefts in stores increase. Encounters with them are unpleasant (and I'm not talking about having to look at them. I'm talking about harassment, pick-pocketing, and crimes).

Yes, I'm sure it's not pleasant to be a drug addict, alcoholic or mentally ill but at what point do the rights of those who aren't and who abide by laws and common decency get priority over those who don't abide by laws and common decency? Should falling into one of those categories get someone a free pass?

a reply to: KyoZero

YES! There is, indeed, a time to tell them to take a hike, no more help, etc. Absolutely!! I don't sau this lightly, either.

I have a LOT of sympathy for people down on their luck, who have no place to live. Lost jobs, trough no fault of their own, mental issues, etc, can lead to such problems. There are many such people that want to work, and want to take care of themselves, but simply can't. I feel for them. Those aren't the ones you mean. The type you mean, I know well. I am related to one.

This person is a CLOSE relative, who gas basically chosen to be homeless, out of some warped idea that he's owed a free ride, and that rules don't apply to him, and oh yea, he thinks he knows better than literally everyone else. No, not exaggerating at all. I'll try to list relevant points.

1. Lived at home with parents till after the father died, then continued to live with disabled mother till she moved in with a sibling. After that, lived off f her money, and bragged to friends (tol me he did this himself!!) that he didn't have to work, and was partying off her money.

2. When his mother died, he complained about not being handed every bit of the meager inheritance, claiming he "could not get a place to live without it", and actually stopped speaking to one sibling for YEARS, because said sibling didn't agree with his proposal.

3. Worked at low paying jobs for years, barely getting by, but earning enough to pay the rent on a trailer he DID manage to purchase (lot rental), and ended up losing that because he simply didn't turn in a rent check. Had the money, didn't pay the bill.

4. Lost his job or quit (no one sure), and if lost, because of a truly vulgar attitude that would warrant a sexual harassment suit. That, and assuming bosses know less about their business than he does.

5. Lived with a sibling till told he had to move, because of breaking things, stealing, complaints about the kids, and other bad behavior.

6. Lived with the other sibling for a far shorter time. Refused to look seriously for work, stole money and alcohol, and 'broke things on purpose. Yelled at the kids for no reason at all. Refused to even clean up after himself. Refused to BATHE regularly, or brush his teeth.

6. Moved in with a friend, who helped him get a job, then lost that and went to a homeless shelter, after stealing from the friend as well.

7. Complained constantly about rules at the shelter, claimed he wasn't treated fairly, and ended up leaving there (maybe), and living who knows where.

8. Currently selling plasma for cash, too irresponsible to even make appointments to obtain and keep food stamps (had them and lost them because of refusing to go in for appointments), complaining that family won't "help" him (read, "support like an overgrown toddler"), calling the ONE friend left names because he won't do more than he has, which is a LOT, and yet, while supposedly homeless, able to bathe, and always seems well-fed, and isn't losing weight.

I'd guess the ones you encounter are like him. Feel no guilt You cannot help someone who wants babied. He isn't disabled, and could work; he simply WON'T.

I KNOW all homeless people aren't like that. He's the sort that makes a lot of people think they are, though.

originally posted by: bigfatfurrytexan

originally posted by: Tangerine

originally posted by: bigfatfurrytexan
Caring about it should always happen. But one issue we do have is that, from an aid perspective, there is no way to distinguish between those who choose to be homeless vs those who are victims of it.

Surely, you can determine whether the individuals are seriously mentally ill, drug addicted or alcoholics and whether they've been run through the system multiple times, right?

You would like to think you can....

....but you can't. Determine if someone is a drug addict is easy. They detox. Most folks, when triaged, will tell you their indiscretions.

I worked in acute care admissions for 5 years at a state mental hospital. What did me in was a guy who had a drug induced psychosis. I had to literally fight with him for a week. I was the biggest guy on the unit, and he was a 6'7" giant. Once we got a few pounds on him, and got him cleared, he straightened out (and was actually a pretty good guy). We released him to a halfway house. He lost some weight, his psychosis returned. I got to fight with him for another week.

I had never had a patient actually do that. I could not physically control him to a degree that I could provide for my own safety.

Drug users can be every bit as mentally ill. Matter of fact, often times mentally ill folks will use drugs to self medicate.

You said that determining whether someone is a drug addict is easy. I submit that determining whether someone is an alcoholic is easy. Whenever you see them, they're drunk. I'm not talking about closet alcoholics. I'm talking about alcoholics who can't function without being tanked and can't function even then. I would bet that either of us could observe the same person on multiple occasions and probably determine whether that person is seriously mentally ill. I'm talking about people who are barking mad not people who have a lesser form of mental illness. I'm talking about people who are visibly impaired or exhibiting aberrant behavior. The homeless population that I've observed is heavily populated with these people which is not to say that all homeless people fall into these categories.

a reply to: KyoZero

to the moraless there is no obligation. to the rest of us we would be smart if thought 'there by the gace of (insert your gods name) goes I

If Americian socierty, or any other for that matter, measures the importance of a human life by how much money a person has then they have failed to learn that the more we devalue the lives of others the more we devalue our own life. The more we value the lives of the others the more we value we place on our own.

The US in particular has always been a carzy socieity

a reply to: TrueBrit

There it is right there....the point where I seem to always tip right back to the thought that while ((certain individual)) comes in every night ad it irritates me BUT I find myself on rare moments sitting and having a thought. And this is it

I have never been without home. Oh I've been raised without much but never so much as to have to sleep in a car. So it leads me to think about something rather important that I can never seem to shake. And it is this very thought that keeps careening me back to what I think is reality...

Being without a place to stay for a night must suck. Being without a place to stay, eat, sleep, bathe or look for employment must be sickening. But combine all of this with the fact that it is 10 degrees outside, even if you have a big parka, must be even worse. So I wrote this yesterday and a good 7 or so people answered and I responded. Then after I switched off to go to sleep this morning I thought...

Wouldn't I do whatever it takes to be warm and/or safe?

Bear in mind, irritated, frustrated and tired as I am, this isn't really a judgment issue. I have no clue what really happened to bring these or any other people to the situations they are in. Really it comes down to treatment. I have met and assessed a massive range or fine folk from those who suffer true MDD, bipolar, shcizophrenia, schizoaffective, PTSD and beyond. I have, do and will continue ((at least for four more days)) help in anyway I can including finding someone emergency treatment. It just got to me that I may have to fill an inpatient bed with someone looking for a place to stay instead of ay, someone undergoing a psychotic break.

Fortunately, here in my county, if someone is have a psychotic break or suicidal or manic, there is no waiting for an ER bed...they are brought back in front on anyone EXCEPT someone in the absolute most dire medical need ((not breathing, pulmonary embolism and such))

So yeah...Wouldn't I try damn near anything to be warm? -shrug- I guess I would

Brit, I think at this point, and even well before this, I can say I have a deep appreciation for your manner of thinking. Also, know that my decision to leave crisis is much much more motivated by the fact that I was trained, and desire, to do one on one therapy...that and I have worked a night shift for 15 of the last 17 years...I'm tired. Which that probably also factors in too my bit of a compassion loss...temporary though it may be.

Thank you a TON

LesMisanthrope

I'm really not going to say much but...agreed...Apologies is what I wrote came across as a lack of humanity...it is more so a lack of direction. I’d love to change the title but I don’t mind leaving it as a reminder to myself to think straight and positive wherever possible

Dabrazzo

That is some pretty wicked cool stuff…Wouldn’t that be amazing if we just started popping these things up? Wouldn’t it be great…no offense to volunteers…if the volunteers were never needed again?

Kadinsky

Appreciated…and we are trained in grad school how to challenge people without being jerks about it and I have many times. “((name here))…we’ve sent you to this shelter several times. Why haven’t you stayed?”

“I had things to do”

And it goes on like that with the short, simple answers that appear to avoid what I am really asking. Though to be real, how much can someone get done by talking for such a short time. Fortunately, humanity is still intact. I am just temporarily compassion fatigued from doing this so long and perhaps this was the perfect time to move on. Apparently, the average time for someone to do crisis work is on the order of 9-12 months. I actually love the ER. Loved it on the ambulance, internship, and now. Just time to get doing what I really want to do

FyreByrd

Point VERY well taken. Stings a bit, but then sometimes honesty hurts eh? I agree that the “care” should be more a societal issue than my own personal one. I still have 2 state facilities, but they are to be used only for truly psychotic, suicidal or homicidal members who have been hospitalized several times with no improvement. Our state facilities are typically 2-3 months stability stay…a lot has changed from when I was a medic a decade and a half ago

Also, to be fair, and with respect to your second to last sentence, I was inquiring only about someone who is homeless, not mentally ill. Sometimes, not always, but sometimes they are not one and the same.

Onequestion

We may not have agreed in a few past posts, but I am right here on this one. The amount we spend on defense along could solve much of this issue

AzureSky

In these specific cases, I do not believe they are panhandlers

GENERAL EYES

They certainly do though…I have a ew cases, homeless and not, that would live on one of my units if I let them

Burdman30ott6

I agree and believe that is fine for all. I don’t think however it is such a bad thing to see where some members of society stand on such issues. Look at the members in just this thread who have been homeless and seeking. I personally have not and it is good to be told what life is like outside my bubble. That’s always been something I was afraid to do…look outside my doors. But that all changed a good 4 years ago and I like to keep looking outside. Maybe it’s a wake up

FissionSurplus

We have seen several folks move from county to county and then we get called asking why. By virtue of where I work, many people from three major cities tend to land here. Regardless, I do still care about those who seek help even though some days it is difficult.

GiulXainx

Yet another solid bite of reality and I thank you for it. Outside my bubble…good to learn isn’t it?

Gosseyn

I have been what I believe to be very pleasant here. And there is absolutely nothing wrong with asking for subjectivity. Look around. In the first two pages I have had three people who have lived what I am curious about send me a wakeup call and that is good. My issue with your post, not you, but with your post is that recognition of inequality, while a massive reality and quite true, unfortunately right now does not solve the problem because people in society as a whole would rather just toss a few dimes at the issue and look towards the luxury condos of Brazil and not the favelas.

Either way, there is nothing at all wrong with this thread or any, including my own, responses. I asked for a dose of reality, but mostly I was seeking a bit of subjectivity to give myself a chance to get over myself, and move on. None of these answers will supplant in my mind and cause me to directly live through other eyes, but this sort of discourse is a good thing. But how am I a victim? If anything aren’t I the perp in some ways? Yeah I can admit to having previously closed notions right? I can man up and say that this, among other life moves are my methods to wake up and serve the greater good

th3dudeabides

Apathy is a crime yes…but to be truthful and genuine, there is a difference between someone who is homeless and someone who is homeless and mentally ill. People DO pretend to be mentally ill ((even those who are not homeless)) for secondary gain such as drugs. People have feigned anxiety for Xanax bars and Ativan which can be highly addictive. So I won’t speak for your specific situation, but I cant say people have and will fake it.

a reply to: Tangerine

Individual rights. Not mob rule. At no point does one persons rights matter more than another. Whether they are drunk, crazy, or strung out.

a reply to: Xtrozero

ok time for the next set of replies...sorry for that error -shrug-

But let me throw some devil's advocate at you if I may. Despite my past ((and believe me if you search my post history you'll see...)) I am starting to see a balance is needed as opposed to a pure Socialist attitude. Capitalism, when regulated, can be a fine enterprise. People compete, better products and advancements are made, and jobs are created to avoid issues like massive unemployment. I would throw in a healthy dash of social policies such as temporary unemployment or full term disability for someone unable to work, but my point is capitalism isn't terrible if watched. Now while I agree by definition that Capitalism itself doe snot live and breathe, we the people make, support and define Capitalism thus I contend that while the idea is not tangible in and of itself, the structure and outcroppings are concrete and real because we make them. So the issue I have is, while I may be irritated by these 4 or 5 guys, in many cases, our definition and self-created Capitalism has increased homelessness. The structure dictates as you say it does. Profit is the end game and thus if outsourcing to India is more profitable, then outsourcing is chosen. But then at some point in time, we decided that it was perfectly ok to keep making what I think to be poor decisions by either caving to massive conglomerates like Walgreens and offering severe tax breaks while allowing crappy pay and crappy benefits. Or they decide they don't like our offer and send droves of jobs across the sea. How else do we explain it then? We as a society have determined such large scale actions are ok and thus we as a society have largely decided that the results, one of which can be homelessness, are likewise ok...so long as it isn't in my back yard.

I do agree there are some people who would choose substandard living if it meant not working, but I am not so sure that said percentage of people are a vast majority but I am no a sociologist or have researched this personally. So then I suppose now that we have really gotten deep into this conversation that started as a question of mine, then let me ask this

Instead of saying at what point can I, Kyo, morally be ok with not caring and change it to, at what point should I, Kyo, start doing more about it?

Yes I have to protect my psychiatric wards and leave those precious few beds open for someone who has legitimately broke and needs desperate and immediate help, but do we then owe society to help resolve or prevent the problem of homelessness?

Just open ended questions of course

Tangerin

SSRI or Selective Serotonin Reuptake Inhibitors are a class of anti-depressants which can on occasion be used to relieve long term anxiety, that offer an increase in Serotonin uptake in the nerves. People who are chemically depressed or chemically anxious can find themselves losing Serotonin, the hormone which helps n at ease and happier feelings, to the void of the neural space or by returning to the neuron that fired it. If much of the Serotonin is not absorbed properly, depression and anxiety to a lesser extent can be the result. The SSRI prevents a good portion of that loss and increases positivity.

As far as the right to be removed, it is only legally possible if that person represents a clear, imminent and actual danger to themselves or to others by way of suicide, harm, homicide or torture/assault/rape, or if the person is so psychotic or catatonic that they are unable to care for themselves, in which case it's believed by law and ethical standards that said person cannot make a clear decision for their safety or the safety of others.

As far as being able to tell...I have been fooled a couple times both ways in that I have had people I didn't think were so ill and they were and I have had people fake it so well that I bought it hook, line and sinker

LadyGreenEyes

I am sure you can see if you've read my few responses that I am very much a fence sitter on this. I do feel the call to help. But what you've described is a rather common story for the individuals I am discussing. It becomes infuriating when it's an every single day thing for me.

But something occurred to me and I would genuinely love to hear your ((or anyone's)) response to this

There are some people who act in ways that are inappropriate and can help their actions ((or so it is believed)). So my question is as follows...

If someone like the person LadyGreenEyes talks about acts as she is stating, do we shuffle them off as a person who clearly wants to piss on the system or do we begin to wonder why, even though they could change their situation, do they not try? As in, did something happen to them that cause this history?

Finally, even though we may or may not be done, I love how calm this has stayed. I am so thankful for all who have responded.