Photo courtesy of Business Insider
(3-27-20) Local, state and federal officials need to begin thinking outside the box if they intend to help homeless Americans, especially those with serious mental illnesses.
The trillion dollar recovery package proposed by Congress includes direct payments to those who qualify. (Click here to learn how much you will receive.)
But many homeless Americans don’t have permanent addresses, direct deposit or bank accounts, especially homeless young people and those with serious mental illnesses.
I serve on the Corporation for Supportive Housing board of directors with Matthew Morton, a Research Fellow at Chapin Hall at the University of Chicago, and an expert on youth homelessness. He’s written about options officials can take to get cash into the hands of homeless Americans. Some four million young people are without housing.
“You face extraordinary difficulties,” he writes about the young, “that most young people don’t and may not ever have to. Chances are, you first fell into homelessness through a path of trauma and family adversity. Now you have to manage the stress of not knowing where you will sleep or where your next meal will come from. You face the very real risk of being abused, exploited or trafficked. You endure repeatedly dehumanizing experiences that undermine your sense of self-worth. These hardships disrupt your ability to thrive during one of life’s most critical developmental windows. Now, add COVID-19.”
Some homeless Americans with serious mental illnesses receive Social Security Disability checks each month, but those living on the street who aren’t on the government roles and who didn’t file income taxes last year will likely be overlooked.
Being checked for virus also difficult
Homeless individuals living on the streets are expected to be highly susceptible to the coronavirus. As in other localities, Fairfax County where I live, has opened a drive through site where residents can be tested. But there are barriers to getting tested for those who are homeless, especially if they have a serious mental illness.
You must have a note from a primary care physician stating you need a test. Most homeless individuals, whom I have interviewed, don’t have a primary doctor. In Virginia, you can call a phone number to be linked to a doctor for a tele-medicine evaluation.
But that requires you to own a phone and have insurance to pay for the consult.
Many Americans with serious mental illnesses do not own a car nor do they have a driver’s license. The District, Maryland, and Virginia all reserve the right to refuse licenses to individuals with histories of severe mental disorders.
No Safe Place To Shelter
Homeless individuals, including those with mental illnesses, often spend their days in libraries, especially when it is cold or raining. Libraries are closed because of the virus and many shelters require the homeless to leave each morning and stay away until nighttime. Where do they go for shelter in a social isolation world?
Writing in The National Review, mental health advocate and author D. J. Jaffe has suggested ways the federal government can assist the serious mentally ill.
People with serious mental illness often need medications to keep them from becoming psychotic and delusional. To ensure that this key connection goes unbroken, the federal government should issue emergency orders requiring all psychiatric prescriptions to be written and filled for 90 days, rather than just 30 days. This may require amending Medicaid, Medicare, or insurance regulations, but it will reduce the need to travel for refills (or even eliminate it, if the patient uses a mail-order pharmacy, which requires a prescription of 90 days).
Jaboa Lake, writing in the Center For American Progress, points out that lawmakers have not included any specific provisions in their emergency legislation for the homeless.
“Among the bill’s necessary actions to protect low-income people, for example, the needs of individuals and families facing homelessness are not explicitly mentioned in any of the proposed solutions.”
Lake’s common sense proposals include this recommendation:
Policymakers should also support direct street outreach and care. Barriers to access to traditional medical care suggest street- and shelter-based care is more efficient for people facing homelessness. Experts suggest adopting community-centric health care models within shelters to reduce the burden and cost faced by hospitals as a result of the pandemic. States and localities should develop specific, actionable plans for outreach to homeless people—who are already at higher risk for infectious disease and have higher rates of chronic illness—to make sure that their health care needs are met during this time. If COVID-19 becomes present in encampments and unsheltered group living spaces, rapid education about how to prevent spread and the distribution of soaps, sanitizers, and other preventative materials should be made readily available.
Another of Lake’s recommendations should surprise no one. Giving homeless Americans housing!
Lawmakers should prioritize immediate assistance to provide safe and resourced housing for unsheltered people. The National Low Income Housing Coalition, Coalition on Human Needs, and other organizations have called for increased funding to support housing needs through federal grants such as the McKinney-Vento Homeless Assistance Grants Program and the Disaster Housing Assistance Program. Providing housing availability for unsheltered individuals and families would ensure immediate access to space to socially distance and self-quarantine as well as to consistent showers, hand-washing, and toilets—basic needs that are hard to access or completely inaccessible when living unsheltered.
Immediate housing solutions, such as emergency and transitional shelters that service 350,000 people on a given night, help individuals and families gain temporary access to the benefits of sheltered living. Furthermore, long-term and permanent housing solutions, such as Housing First and other approaches, help vulnerable groups gain stability; improve health; lift individuals and families out of poverty; and promote social and community inclusion. Importantly, safe housing with clean water access is necessary to adhere to WHO and CDC recommendations for the prevention of the spread of COVID-19.
Homeless Americans, especially those with severe mental illnesses, don’t employ any high-priced lobbyists in Washington and have little voting pull. They must rely on our elected officials’ compassion and concern for the least among us.
We need to insure our public officials are reminded of the needs of those on the margins whose voices are rarely heard.
Is your community doing something innovative to help homeless Americans, especially those with serious mental illnesses? If so, please share on my Facebook page what’s happening – good and bad.
About the author:
