How Are We Caring for Our Mentally Ill Post Deinstitutionalization?

(Article published in Street Speech by the Columbus Coalition for the Homeless) 

What is deinstitutionalization? It was a political/social/economic movement which began way back in the 50’s to close state hospitals where mentally ill patients were warehoused for years and released them into the community and the community mental health system.

Part of the impetus for this move came from patient advocacy groups and the civil liberties movement who wanted to end the neglect and abuse of patients in state facilities around the country which were notorious for poor living conditions, lack of hygiene and overcrowding.

Another reason was economic. States thought it would be less expensive to take care of the mentally ill in outpatient treatment, especially with the advent of new antipsychotic drugs which came on the market in the 50’s and 60’s.

A further impetus came when President Kennedy passed the Community Mental Health Centers Act in 1965. It called for a 50% reduction in the number of state psychiatric patients. This shift away from custodial care to outpatient care became known as “deinstitutionalization.”

Communities were expected to put in place a whole range of services including supervised group homes, walk-in clinics where medication could be administered, and enough case workers to oversee patients’ compliance with their treatment plans. As the economy got worse however, many of these programs were discontinued – some were never implemented. It was a good idea which never got the necessary funding and left thousands of mentally ill without any support at all.

Even when communities provided clinics and screening centers, the caseloads of social works were too big to allow the degree of supervision and evaluation needed. John Hughes, the Workforce Development Manager for the Columbus Coalition for the Homeless, spent 30 years working with at-risk people with substance abuse, mental health and housing issues. He says “a caseload can be as high as 70-75, or higher, for a social worker in the field.”

A small number of people who are chronically mentally ill need some level of supervision on a regular and consistent basis, both for their protection and the protection of the public. The average length of stay in our state hospitals today is only between ten and fourteen days. This does not meet the needs of our most seriously ill patients. Hospital stays on acute care psychiatric units in our general hospitals are even shorter.

Patients are then discharged back into the community with a one to two week supply of meds and told to follow-up with their local mental health agency. This requires patients to have the insight to realize they need to stay on their medication, and to take it regularly without supervision, and the ability to be proactive with phone calls and appointments to keep themselves supplied with their medication. Sadly this is often not the case and it is one reason why so many mentally ill people “fall through the cracks” in our system.

Without a support system in place many suffering from mental illness become homeless. Food kitchens thankfully are available to feed the homeless in Columbus. Most are run by charitable organizations and the homeless are grateful for them. But housing is another matter. Our shelters have long waiting lists to get in and as cold weather creeps up on us this will become an even greater problem than it already is.

Barrie Currie, a homeless paper vendor at the Columbus Coalition for the Homeless said, “People go to shelter for many different reasons- most of all because they’re supposed to be safe. However nothing could be further from the truth! There is a lot of violence in places like these.” The mentally ill are especially vulnerable, both in shelters and on the street.

In a recent segment on 60 Minutes this past fall, the lack of adequate mental health services was discussed in light of the recent rise in mass shootings. Dr. E. Fuller Torrey, one of the country’s leading psychiatrists, said: “These were preventable tragedies, symptoms of a failed mental health system that’s prohibited from intervening until a judge determines that someone presents an imminent danger to themselves or others. The consequence is a society that’s neglected millions of seriously ill people hidden in plain sight on the streets of our cities, or locked away in our prisons and jails.”

Most of us would be shocked to learn how many mentally ill people are in our jails and prisons. According to Human Rights Watch somewhere between two and three hundred thousand men and women in U.S. prisons suffer from a mental disorder. Using our jails instead of state hospitals to incarcerate those with mental illness who are considered unmanageable or a danger to others on our streets has been referred to by some as a form of re-institutionalization. Ironically, the country’s three largest mental facilities now are the Los Angeles County Jail, New York City’s Riker’s Island and Cook County Jail in Chicago. It seems we have moved from warehousing patients in state mental institutions to warehousing them in jails instead.

The Cook County sheriff, Tom Dart, says, “The prisons and jails have become the new asylums.”

Dart went on to describe how mentally ill prisoners are put into a tiny, confined space, sometimes with another mentally ill cellmate who may or may not be violent. The confinement and lack of stimuli can cause inmates mental state to deteriorate further or exacerbate existing symptoms like depression and psychosis.

“Not treating people with mental illness is bad enough,” Dart said. “But treating them like criminals? What have we become?”

How do the mentally ill fare in Ohio jails? Ohio is now considered a model for the country for providing mental health care behind bars. Following a 1993 class action lawsuit claiming that the care of prisoners with serious mental illness was constitutionally inadequate, sweeping reforms were instituted in the state’s prison system. These included the establishment of Residual Treatment Units (RTU’s) to provide care and supervision for inmates who required special housing separate from the general prison population. Individualized treatment plans are developed for each inmate and in extreme cases they may be moved to the Oakwood Correctional facility for short term stabilization. Ohio is one of only twelve states that has a prison psychiatric hospital. At Oakwood inmates are treated like patients rather than prisoners.

Ohio should be proud of the efforts it has made to provide treatment for mentally ill inmates but our goal must be to provide psychiatric care for the mentally ill in our communities so they don’t end up in prison in the first place.

One such effort to do this is provided by Netcare, serving Franklin, Jackson, Delaware, Fairfield, Hocking, Ross, Fayette, Licking, Madison, Pickaway, and Union Counties. It provides assessment services for the courts to determine the proper disposition for arrestees. Offenders with a mental health disorder are referred for supervised treatment rather than incarceration.

Similarly, Sheriff Drew Alexander, of Ohio’s Summit County took action last year by implementing a new policy which requires violent, mentally ill arrestees to be treated at a hospital or mental health clinic before being referred to the county jail.

“We’re not going to be a dumping ground anymore for these people,” Sheriff Alexander said.

Once released from our jails or prisons, many mentally ill face the same challenges as those discharged from psychiatric hospitals. Homelessness is often one of the main reasons for the high recidivism rate among ex-felons.

Reggie Wilkinson, Fmr. Director of the Ohio Department of Corrections said, “Any person released from prison who does not have a pretty good support system, including stable housing, will have a difficult time staying out of prison. Most stop taking their medication fairly soon after being returned to the community.”

Bridgeview Manor, a residential facility for the severely mentally ill in Ashtabula, Ohio is home to sixteen adult men, most of whom are schizophrenic. It is a residential home in Ohio that provides a place to live and on-site mental health treatment and case management for both indigent clients and ex-felons. More such facilities are needed for the thousands of inmates awaiting release back into the community.

Clearly this situation will continue to be a problem until funding is made available to provide adequate community mental health services. Sadly it appears that this is a population that people don’t care about and so the resources are not there in our communities to care for them humanely.

Home

“It’s tough when you go home because if you‘ve lived all those other places, 

and had all those different experiences, it’s hard to relate to the people you 

grew up with…You can’t unsee what you have seen, unlearn what you have 

learned. The only way to live entirely at ease with one’s hometown is never

to have left”  (The Little Way of Ruthie Leming). 

My husband and I recently took a road trip back to the town of Peekskill in the Hudson River Valley region of upstate New York where my grandparents had lived. I spent almost every summer there growing up and moved back with my family when I entered high school. The visit was a bittersweet experience.

Trying to recapture what I felt at seventeen is not possible. You can have those experiences and those memories for the first time only once. I had been seduced by my own yearning to return to a sense of roots and connection with my family and my home. It was not possible. Not only was I not that person anymore, my home was not the same either. We had both changed and become something different.

Is this why Thomas Wolf said, “You can’t go home again”? Borrowing from his stream of thought on the subject I would say:

I can’t go back home to my family, back home to my childhood, back home to summers and the illusion that the sun is standing still and the future is keeping its distance, back home to evenings of three generations on the front porch glider listening to crickets chirping, back home to one's youthful idea of falling in love, to adolescent moments of pure groupness, those rare, but exquisite times when it feels like everyone is equal and respected and liked, back home to a time when I fit perfectly in my little piece of the world, back home to a young girls dreams of a life of purpose and meaning, to becoming a nurse and to that being enough, back home to belief in forever after.

Nostalgia is defined as pleasure and sadness that is caused by remembering something from the past and wishing that you could experience it again. That seems to describe in part what I was feeling on this visit.

C.S. Lewis reminds us that this longing inside us that pierces the heart with such exquisite pain- what we call Nostalgia and Romanticism and Adolescence - are all only cheats. He says in the Weight of Glory, “These things that have captured our hearts have done so because the Romance was calling to us through them; but if they are mistaken for the thing itself they turn into dumb idols, breaking the hearts of their worshippers. For they are not the thing itself; they are only the scent of a flower we have not found, the echo of a tune we have not heard, news from a country we have never yet visited. It was not in them, it only came through them, and what came through them was longing.”

What was it that I was longing for? What was stirred in me by this visit home? It had to have been more than just a desire to recapture experiences from my past. Some of those memories I had romanticized. In my mind I made them better and more appealing than they really had been. Even so, they still had the power to stir something in me. As I think about it now, those poignant memories were in reality pointing to something else. Something I could not even name, much less describe. It was like trying to describe the face of God.

Again, I turn to C.S. Lewis for his take on this. He says, “Apparently our lifelong nostalgia, our longing to be united with something in the universe from which we now feel cut off, to be on the inside of some door which we have always seen from the outside, is no mere neurotic fancy, but the truest index of our real situation. And to be summoned inside would be both glory and honor beyond our merits and also the healing of that old ache.”

Here then perhaps is an understanding of what I have been feeling about my visit home. It’s not just that I wanted to recapture something special from another time, even if that were possible, but that the image in my mind of home awakened in me a longing for something much deeper.

I’ve heard Christians say we want to merge with the Other; to be one with God. ‘Christ in me the hope of glory.’ These all sound so mystical, but I think they touch on something about this deeper longing.

Standing on the corner of Orchard Street and North Division in front of my old house, I realized I didn’t belong there anymore. Now I understand it was not just because I had changed and my home was not the same, but because it never was what I was longing for in the first place- just a whisper of it.

Grecian Recollections: A Short Story

I woke at six with a feeling of vague unease, as if my mind were struggling free from the last clinging threads of a bad dream. I had slept fitfully, tossing and turning most of the night. Fully awake now, I slowly oriented myself to my surroundings. I was in fact not at home, as my dream state had led me to believe. I was instead lying in a narrow bunk bed in the economical inside cabin of a stateroom aboard the MTS Renaissance on a 7-day cruise of the Greeks Isles with my sister and a teacher friend of hers, named Cindy.

By the time I had my first cup of coffee and walked out on deck, the unease I had awakened with had faded. I found myself thinking of my first trip to Greece fifteen years earlier. Memories collided in my mind spawning both pleasant and painful associations.

Any visit to Greece would resurrect thoughts of my former boyfriend John, a classics major at Fordham University, and of his Svengali influence in my life when I was in my early twenties. The relationship had ended painfully, but I was grateful for the crash course he gave me on the history and culture of ancient Greece, especially the myths of this land. I learned about the battle of Thermopylae, Pericles and Homer. John was a born teacher and he made those ancient heroes and battles come alive. I was particularly fascinated by the legends of Heracles and Oedipus, the abduction of Zeus’ daughter Persephone by Hades, the god-king of the underworld, and of the Minotaur- the offspring of the union between a woman and a bull.

Putting all further thoughts of the past aside, I excitedly prepared to disembark at our first port of call for the day, the island of Santorini. It is a place steeped in mythology. Many believe it is the location for Plato’s story about the lost civilization of Atlantis which disappeared without a trace, sunk into the sea supposedly by the anger of the gods. More likely the legend arose in connection with the cataclysmic volcanic eruption of Santorini during the Minoan period.

Of all the islands in the Aegean, Santorini is, in my opinion, the most extraordinary. To reach it we sailed into a strange enclosed bay surrounded by sheer cliffs topped by gleaming white villages that resembled snow-capped mountains. The effect was dramatic and spectacular. The beauty of this place must depend on light and line. When dawn comes the light is instant and brilliant against the starkness of the volcanic earth. Yet it has an uncanny fascination of its own. It has rightly been called the black pearl of the Aegean. We have been told that the sunsets here are among the most amazing aesthetic experiences that the Aegean can provide. We unfortunately will not get to judge for ourselves, as we will have sailed on to Crete by late afternoon.

The island didn’t have a cruise terminal. Instead we were tendered ashore by small boats and then conveyed up a steeply cut stone staircase by donkey, ascending high above the blue Aegean to the town of Thia.

This unorthodox conveyance was quite terrifying since these “beasts of burden” kept slipping on their own copious deposits of excrement dropped over countless prior treks up this same path. I hung onto mine for dear life. His loud incessant braying sounded like the anguished wheezing of a dying creature. To distract myself from looking over the precipice, and certain death should I fall, I tried to recall my favorite impressions of our time spent in Athens a few days before we sailed.

However, instead of focusing on the amazing sight of the Parthenon sitting majestically high above the city like a beacon drawing all eyes to her beauty, I recalled instead the deafening noise of the city. Athen’s streets were substantially noisier to my ear than New York's because of the ubiquitous motorcycles and the incessant horn-blowing. Traffic is anarchic, cars simply drive over curbs and motorcycles wanting to pass weave through pedestrians on the sidewalks. The air pollution is suffocating due to the lack of any vehicle emissions control laws, but people seemed completely oblivious to it. Gone was the romanticism from my former visit.

When I was here before with John, we stayed in a tiny pension on a side street off of the wide Syngrou Avenue. The neighborhood was lined with small shops: a butcher, a vegetable market, a TV and appliance store, and a laundry. Sandwiched in between were the quintessential Greek icon stores with rows upon rows of saints on display. The more expensive ones had ornate gilt frames with semi precious stones embedded in them. Women tended to buy them and faithfully lit incense in from of them in their homes.

John said this practice dated back to Byzantine iconoclasm. Now it just seemed depressing to me, dead idols demanding propitiation like a child's desperate attempts to please a remote, angry parent.

John and I often had heated debates about our faith. He was a staunch Irish Catholic, I was German Baptist. I never understood how anyone could believe so emphatically in a religion of hollow rituals and ostentatious ceremonies. Still, I kept the small medal of the Madonna he had given me, which he said had been blessed by the Pope when he did a semester of study in Rome.

Back in the moment, I vowed never to ride on any four-footed beast again. I found a lovely taverna to soothe my nerves with a cool drink.

All over Greece tables are traditionally set out in a plaza under shady thick-trunked old plane trees. The sun shone through the branches while the wine flowed. We enjoyed a simple but delicious meal of bread with humus and tzatziki (yogurt, cucumber and garlic dip) with a large salad of slices of onion, ripe juicy tomato, cucumber, olives and thick chunks of feta. There was music and laughter as villagers and tourists alike sat eating, joking and gossiping. The was even a goat tethered in the yard behind us. I felt like I had fallen into a scene from Zorba the Greek.

After a lovely half day of browsing in the shops and soaking in the cliffside view of the cauldera, we set sail again for yet another jewel in the Aegean.

I can't help but wonder what it would be like to live here suspended among the clouds?

War

“War, what is it good for?” This was the question asked by the blatant anti-Vietnam War protest song produced by Motown in 1969. It seemed appropriate for what I want to explore here. (Remember the Seinfeld episode where Elaine claims this was Tolstoy’s original title for War and Peace? But I digress). Is war ever good for anything? According to the song the answer to the question is “absolutely nothing.” This was certainly the sentiment held by many, myself included, during those turbulent times with regard to this particular war. But is there such a thing as a just war? Was Vietnam wrong, but WWII wasn’t? And if so, what constitutes a good war?

Many times we hear that war is wrong from a "Christian" perspective, because it breaks the commandment that says "Thou shalt not murder." Such an absolute statement creates obvious problems. For example, what does a Christian do in the case of being attacked by another nation or, as is currently the case, by a group of people bent on destroying our country?

It was the great church father Augustine of Hippo who first sought to give some specificity to a definition of a just war. In fact, his position, which he articulated in the early Fifth Century, has long been the Church’s traditional definition of a just war. Augustine held that a just war must have five components. A just war:

(1) Must be waged for self-defense, rather than conquest, plunder, or political oppression;

(2) Must be initiated by the proper authority, i.e., lawful government, rather than an angry mob, etc.

(3) Must be fought with the right intention: peace. It should not be fought to gain land, power, wealth, etc.

(4) Must have a reasonable chance for success.

(5) Must use means proportionate to the goal. If the goal of a war is to liberate an oppressed people, for example, it makes no sense to destroy all their cities in the process, or to bring them under further subjection.

Unfortunately, throughout the Middle Ages, as demonstrated especially by the Crusades, Augustine’s definition was usually not followed. European governments, all of which considered themselves Christian realms, routinely waged war against one another, and rarely for the purposes of self-defense. Even the Pope had a standing army, and he, too, invaded other nations.

Because of the endless European warring, and even more because of the teaching of Scripture, Martin Luther saw few valid reasons to go to war. For him self-defense and the restoration of peace were the only valid reasons to go to war, and even then war had to be begun with great deliberation.

If we look at the various wars America has been in how would they stack up with Augustine’s criteria? Let’s start with the American Revolution. It certainly was not waged for self-defense (no one was attacking us). After years of boycotts and protests in the colonies in response to British taxes and regulations, angry mobs stirred up by the inflamed rhetoric of the Sons of Liberty, took matters into their own hands in bloody skirmishes with the British. Wasn’t this against Augustine’s #2 criteria? (Reading about this time in our history I am struck by how familiar the themes are to our bipartisan bickering today and the American people’s complaints about taxes and government regulations!) Eventually, in the spring of 1775 British troop’s encountered colonial militia in the village of Lexington and that famous shot rang out. Though the source of the shot is unknown, it touched off eight years of war. The question is, were war, revolution, hatred and bloodshed the best way to achieve our independence? How would Gandhi have suggested we go about rectifying taxation without representation?

What about the Civil War? Some people think that the main agenda of this war was to free the slaves. But in reality this was a secondary consideration. The main reason was the preservation of the union. This seems to me to be in opposition to criteria #3- “Must be fought with the right intention: peace.” It should not be fought to gain land, power, wealth, etc. Who knows if it would have been so bad to have had a divided country? Europe does it with the European commonwealth. We know the approach Rev. Martin Luther King Jr. would have advocated we take- he modeled it throughout the civil rights movement of the 60’s. Malcolm X and Stokely Carmichael of course represent the militant approach to righting injustice. Who is right?

What about WWII, considered by most to be the epitome of the “just war?” The Second World War was a global military conflict lasting from 1939 to 1945. It involved most of the world's nations, including all of the great powers. It was the most widespread war in history, marked by the mass death of civilians, including the Holocaust and the only use of nuclear weapons in warfare. It was the deadliest conflict in human history, resulting in 50 million to over 70 million fatalities.

It is a popular misconception among Americans that the US voluntarily entered WW2, at least against the Germans. In fact, the US didn't. Although the US was leaning towards involvement in WWII, many people still saw it as a "European" conflict. That changed on Sunday, Dec. 7 1941 when the Japanese attacked Pearl Harbor. A good portion of the US Navy was destroyed. The sunken ship Arizona still remains there today. The emotional reaction to Pearl Harbor was very similar to the feelings most Americans had after the September 11 attacks on the World Trade Center: Shock and disbelief followed by anger. The US entered the general war as a result of the attack on Pearl Harbor. But the US entered against Japan and did not, repeat not, declare war on Germany. However, a few days after Pearl Harbor, Hitler declared war on the US, thereby putting an end to the US dilemma. Whether the Americans would have declared war on Germany had not Hitler made the decision for them is one of the great unanswered questions of history. Probably the US would have entered the war against Germany, but possibly not on the scale that it did, and almost certainly not with Germany being given priority over Japan. But nobody will ever know for sure. So it would seem that WWII was justified under the criteria of self-defense.

Other wars in America’s history clearly fail to meet Augustine’s criteria. We undertook the war in Vietnam to support the South Vietnamese in their fight against the North. We ended up with the longest war in American history and the devastation of the Vietnamese homeland. If the reasons for going to war are things like keeping the world safe for democracy by stopping the spread of communism and protecting the American way of life (Korean War) or toppling “evil” dictatorships who also supposedly had weapons of mass destruction (Iraq), are these legitimate motives?

But what about moral causes like freeing the slaves, defeating Hitler, getting rid of Saddam Husain, coming to the aid of Rwanda (I know we didn’t- but shouldn’t we have?) and Bosnia? In other words, isn’t it a noble and just cause to come to the aid of the oppressed? To free the captives and end tyranny?

One of my favorite Christian authors is Catherine Marshall, late wife of Peter Marshall, the famous Scottish-American preacher and Chaplain of the United States Senate. She had something to say about this: “Jesus chose God’s way to deal with the iniquity He loathed. Judas Iscariot wanted his Master to use the world’s technique by rebelling against Rome. Judas, the classic revolutionary, wanted armed political rebellion against the godless forces of Rome. Jesus deliberately refused, thereby telling us for all time, “No, the end does not justify the means.” He chose instead God’s way of changing men’s hearts, minds and lives via the cross. Certainly we cannot ‘love righteousness’ and ‘hate iniquity’ and then use any of iniquities techniques. Those who recognize in Jesus of Nazareth the First Rebel, see equally that his weapons were never those of unrighteousness. He will never allow us to do evil with the claim that it’s to achieve justice or right.”

This would seem to speak to America’s use of torture and other strategies of war which are so controversial. For example, the German’s introduced poison gas in WWI. It soon became used by both sides, though it never proved decisive in winning a battle. Its effects were brutal, causing slow and painful death, and poison gas became one of the most-feared and best-remembered horrors of that war.

No easy answers, but a topic worth thinking about since world peace doesn’t seem to be on the horizon any time soon.

Homelessness in the Wild West

Wagon Train Oregon Trail

(Article published in Street Speech by the Columbus Coalition for the Homeless) 

When we think of the Wild West, we usually think of cowboys and Indians, Buffalo Bill and shoot-outs at the O.K. corral. In other words, we tend to romanticize this period in our nation’s history. 

Real life at this time was not like the movies.  Real life was generally much harder, much duller, hotter and dustier.  It had little of the glamour depicted by Hollywood.  There were gunfighters, but shoot outs were few and far between and rarely occurred as a face to face standoff.  Being shot in the back was a much more likely scenario.  There certainly were cowboys, though it was a very hard, unglamorous life.  There definitely were Indians, and yes, they were called “Indians,” not the “politically correct” term “Native Americans.”  What we don’t usually picture when we think of the Wild West is paupers and panhandlers, yet both were very much a part of the Western frontier.

Recessions, like wars, have always been an integral part of American history and both have always been major contributors to homelessness. Shortly after our War of Independence, the nation witnessed the first in a series of depressions that have caused tremendous economic havoc. One of the worst was the 1837 crisis and the six-year depression that followed. This was a formidable financial meltdown, even by today’s standards. The origins of the panic were risky speculative lending practices in western states, a sharp decline in cotton prices, a collapsing land bubble and erratic American banking policy. Wages throughout America fell by 30-50 percent. There were no unemployment figures kept at the time, of course, but had there been, they would have been horrific. All of this sounds eerily familiar, doesn’t it? History has a way of repeating itself.

Public demonstrations by out of work residents of Boston, Philadelphia and New York City brought out hundreds of thousands of people in 1839 and 1840.  Making conditions even more critical was the arrival of a massive wave of poor immigrants, many from the Irish potato famine.  Major port cities in the east became a hub for the growing concentration of the unemployed and the homeless, greatly taxing public resources.  

Thus the economic hardship in the east became the major motivation for those making the long, often arduous journey west.  The first wagon trains of pioneers headed westward in 1841 along the overland trails- the most famous was the Oregon Trail.  They were in search of cheap land and a better life.    

People looked to the West, specifically California Territory and Oregon Territory, as though it were a biblical “Promised Land.”  Even the farmers of relatively economically unharmed Midwestern and Plains regions felt the wanderlust and started selling out or abandoning their homes and farms to get in on the westward migration. 

       

Then in 1848 gold was discovered in California and thousands of young men set out to make their fortune.
Most of these fortune hunters left for California in 1849 and were therefore known as the “49ers.” Those lucky enough to arrive first were able to find nuggets of gold in the streambeds and made quick fortunes. The gold was literally free for the taking. Yet the majority of those who made the trek out West were not so lucky, especially those who arrived late.

In addition to the lure of gold, others headed west to join crews building America’s railroads.  Both of these opportunities to make money brought waves of Chinese immigrants to America in the mid-1800’s.  They brought with them the habit of opium smoking.  Opium dens, places where opium was sold and smoked, soon sprang up in the alleys of San Francisco’s Chinatown and the Barbary Coast district. 

San Francisco 1849

San Francisco was initially just a way station for picking up supplies on the way to the gold-filled foothills.  In this wide-open town every kind of vice was catered to in the numerous brothels, saloons, dance halls, gambling houses and opium dens.  Lawlessness was rampant.  Prospectors who came into town from the gold fields could lose their fortunes in a flash in a game of cards or find themselves assaulted and robbed in a back alley.

Surprisingly, some of California’s first millionaires made their wealth, not in gold, but in selling supplies to the prospectors.  When the hordes began to flood the city prices on everything rose astronomically.  Eggs could cost $50.00 a dozen and blankets sold for anywhere from $40.00-$100.00.  But just like the unpredictability of the miners striking it rich, it was the luck of the draw for these merchants too.  Some were wiped out by disastrous fires that swept through rows of hastily constructed wooden buildings. In less than two years the city burned to the ground six times.  

As the city of San Francisco grew in population, so did the ranks of the homeless.   The city went from a population of a few hundred in the 1840’s to over 20,000 by 1850.  Alcohol and drugs, particularly opium, were readily available creating a subculture of addicts.  Others became beggars after having failed to strike it rich in the gold fields. They were left penniless after spending everything they had getting to California and buying their mining supplies.  Still others blew whatever they made in panning for gold in riotous living.  Panhandling became a way of life- a life we see again years later among many of today’s homeless.

Sadly, the Civil War seemed to be the saving grace of many of these destitute homeless.  It provided an opportunity for work for many unemployed, rootless, poor and homeless men.  Once it was over, however, its aftermath produced a huge new wave of destitute, displaced and dispossessed people. They included wounded war veterans, freed slaves, and widows and orphans.  The need for assistance was now beyond the capacity of local governments and charity organizations and the federal government became an actor now for the first time in helping the homeless.

Again, the end of the war encouraged many to venture West in search of land, work on the railroads and jobs as cowboys in the cattle industry, which in the late 1860’s started to drive cattle to new railheads for mass distribution.  By the turn of the century most of the opportunities for easy to find work on the frontier were gone.  The railroads were built, the gold rush had ended, the land fenced and in many places the transient cowboy was replaced by the permanent rancher.

Homelessness in Colonial America

"Sturdy Beggars"

(Article published in Street Speech by the Columbus Coalition for the Homeless) 

The problem of homelessness in America is not new.  As a matter of fact it is as old as the settling of the country by the colonists.  Just like today, people became homeless for a variety of reasons and stayed homeless for varying lengths of time during America’s first two centuries.  The first arrivals in the New World came from a broad cross section of English society and included many of England’s wandering homeless, vagrants, criminals, the mentally ill and misfits of all sorts.  Intent on increasing the population of the new colonies, English officials routinely offered criminals the choice of boarding ships headed for America as an alternative to going to prison.  Thus the potential was there from the beginning for the problem of homelessness to be introduced into the colonies by some of the new arrivals.  Many knew no other way of life and were ill equipped for survival on their own.  But not all new arrivals were reprobates.  Some who came were mountain men, hunters, trappers, and fur traders.  The movie Jeremiah Johnson accurately depicts this type of rugged individualist.  Others were seeking freedom, especially religious freedom or land and a chance at a better life.

 

The colonists needed hard workers to tame the wilderness.  Trees had to be felled, houses built, and land cleared for farming.  A strong community spirit quickly developed where everyone pulled together for the common good.  Those who were not willing to pitch in and do their part were called “sturdy beggars,” an English term for those who were fit and able to work, but begged or wandered for a living instead.  Since taking care of them put a serious strain on the meager resources of new communities, they were mostly left to fend for themselves and often starved or froze to death. 

As the colonies became self-governing communities, they enacted laws to keep order, levied taxes to generate revenue, and elected officials to manage town affairs.  Early welfare practices were modeled on the English Poor Laws enacted by the British. This included cash assistance known as “outdoor relief.”  Those eligible were usually long- time members of the community who had experienced a personal calamity like an injury, a long-term illness or the death of the family breadwinner.  The elderly, widows and orphans were also looked after.  Because local communities had to pay a special poor tax in order to provide this relief, assistance was neither generous nor frequent.  

Just as colonists believed they had a duty to care for their neighbors in need, they also believed they had the right to refuse aid to “outsiders.”  This led to the common practice of “warning out.”  It consisted of a notice ordered by the Board of Selectmen of a town, and served by the constable upon any newcomer who was likely to become dependent on town resources.  Communities thereby pressured or coerced undesirables to settle elsewhere or wander from colony to colony in search of aid.  The first “warning out” was recorded on June 6, 1654 in Plymouth Colony.  

As more and more settlements were established, skirmishes erupted.  As early as 1675 there was an Indian uprising known as King Philips War.  The effects of warfare quickly became the biggest cause of homelessness in colonial America.  It was a major consequence of the French and Indian Wars of 1756-63 and later, the American Revolution.  The classic, The Last of the Mohicans by James Fenimore Cooper, is a story about the conflict between the French and the English that takes place in colonial America.  It paints a visceral picture of this period in history.  It was not a safe time for homesteaders living in isolation in the wilderness.  When war forced them to flee their homes they usually lost everything.

Another contributing factor to homelessness at this time was the economy.  What early colonial prosperity there was resulted from trapping and trading in furs. In addition, fishing was a primary source of wealth in Massachusetts and from 1612 tobacco was grown in Virginia. But throughout the colonies, people lived primarily on small farms and were self-sufficient.  If crops failed or market prices on commodities fell, hard times followed.  The colonial economy suffered one such downturn in the 1720’s and 30’s which led to a rise in the homeless population. 

Immigration of poor people to the colonies also led to a rise in homelessness.  Immigrants often arrived penniless, having spent their savings on the trip to America.  Many also arrived sick and could not find work.  Some cities, like Philadelphia, responded by passing a law allowing local authorities to expel arriving indigent immigrants.  In 1719 the arrival of hundreds of improvised Scotch-Irish refugees led authorities In Boston to order one ship of immigrants to leave the community at once. 

While the “wandering poor” could be found throughout the colonies, it was in the cities where they were most conspicuous.  Some cities established workhouses where inmates could be whipped if they refused to work or they were put in jail and subjected to hard labor.  In the colony of New York it was customary to inflict various types of corporeal punishment on convicted vagrants, including stockades, pillory, ear-cropping, and branding.  The Puritan work ethic supported this punitive approach to vagrancy, a view which was strangely at odds with the Puritan belief that charitable giving was a religious duty with no distinction made between the deserving and undeserving poor. 

Boston passed an act requiring their homeless to be ‘bound out’ to families needing laborers or servants.  This was a form of indentured servitude dating back to the early years of the American colonies. Workers or servants were not paid wages, but received food and shelter and clothing instead. All of these approaches were based on the belief at the time that the “idle poor” were unlikely to work unless forced to do so.  Public policies like these kept the growth of homelessness, for the most part, within manageable proportions. 

Prior to 1700 homelessness was considered a minor problem in the colonies.  Compared with many parts of Europe where the number of beggars in rural areas reached massive proportions, itinerant beggars here were not yet a serious problem.  The growth of homelessness in urban areas was much more significant, but even in our most populous cities like Boston, Philadelphia and New York, they did not compare to London or Paris.  Homelessness in young America would not become a significant problem until well into the next century.  

Homelessness and Addiction: A Double Jeopardy Explored

(Article published in Street Speech by the Columbus Coalition for the Homeless)

I grew up in New York City where my father was a fireman. My first exposure to the homeless was at around the age of twelve when my father took me with him to the Bowery Mission. He, along with other firemen and policemen, belonged to the Christian Alliance of Policemen and Firemen. They served meals and presented the gospel to the homeless alcoholics who came into the mission for sustenance, and perhaps a bit of human compassion.

The Bowery area of lower Manhattan reminded me of a wasteland buried in a corner of an otherwise vibrant, thriving city. As I think of it now, the images it evokes are of broad streets, empty of traffic on a quiet Sunday afternoon. Only when you looked for them, or when pointed out to you, did you notice the bodies slouched in doorways, most clutching bottles wrapped in brown paper bags. They were so still; as if props placed there for a movie set depicting the morning after some invisible plague had struck. This was the face of homelessness I saw back in the sixties and it had a strong impact on me.

Has this image changed over the past decades? I think we would all agree that it has. Today the face of homelessness has expanded to include men and women of all ages who have been released from psychiatric hospitals and have “fallen between the cracks” of our current community mental health system. It also includes young Iraq and Afghanistan-era veterans- men and women, who are now joining the Vietnam-era veterans who are still homeless. Families have increasingly become homeless due to the current economic recession. Children who have run away from home for various reasons and sometimes women escaping from abusive situations also contribute to the new face of homelessness. In other words, there are as many reasons for homelessness as there are homeless people.

What hasn’t changed, however, is the fact that substance abuse continues to be the most significant problem connected to modern homelessness. Drug and alcohol abuse can cause people to fall into homelessness but the struggle to stay alive on the street often drives homeless people to drugs and alcohol. It’s a chicken and egg scenario.

A 2008 survey by the United States Conference of Mayors asked 25 cities for their top three causes of homelessness. Substance abuse was the single largest cause of homelessness for single adults (reported by 68% of cities). Substance abuse was also mentioned by 12% of cities as one of the top three causes of homelessness for families.

Emergency shelters, soup kitchens and job training help the homeless to regain their independence. But it is critical to develop resources with the focus of resolving not just homelessness, but addiction as well.

Public perception concerning homelessness and addiction is also a problem. Both are issues that do not elicit much public sympathy. For many people, providing support to homeless individuals who use drugs is counter-intuitive. This negative bias coupled with the economic disadvantages of people suffering through both homelessness and addiction can make it difficult or impossible to seek and obtain proper help. With resources already stretched thin in most communities, homeless people with addiction problems are generally not a priority.

Street Speech helps change that negative bias by providing public education about the complex issues of homelessness. It also puts a human face to an otherwise impersonal societal issue. Vendors connect with their customers and share a bit of themselves over time so that they both come away with an appreciation and respect for each other. I felt the same way about the exchanges at the soup kitchen in the Bowery with my father and the homeless he was there to serve.