"A staggerint two-thirds of those with serious mental illness end up homeless at some point during their lives."
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One overarching problem for providing mental healthcare to the homeless is that most homeless people do not have health insurance. Some benefit from Medicaid or Medicare; others with severe disabilities, including those who qualify as severely mentally disabled, receive social security. And in some states, like California, social security includes medical care. While the resources for providing the homeless with healthcare are allocated to those with the most severe mental illnesses, many others are left untreated.
Furthermore, the system for acquiring appropriate care is so fragmented that even a homeless person with full mental capacity, much less a mentally disabled person, may have difficulty negotiating it. Each service is funded by a different agency, or by several different agencies, each with its own agenda. Some services feed people and offer shelter and beds; others offer healthcare; still others aim their services at only targeted subsets of homeless people. Each housing program is run by a different agency, and there is no centralized list of available housing. Substance abuse and mental health are typically not treated together.
As a result, it is extremely difficult for homeless people with mental illnesses to obtain treatment and services to help them improve their lives, unless they are helped by experienced social workers who know the system. Lehrman uses her influence and knowledge of loopholes in local programs to help her clients, but she can only do so much. She copies ID cards because she knows that the people she helps will lose them and will then have a much harder time accessing municipal services. Lehrman also helps people fill out lengthy housing applications and accompanies them to obtain services they might otherwise be too intimidated to receive.
Safe Haven in Honolulu represents what Lehrman believes would be an ideal solution for her clients: low-income housing with mental health, hygiene, food, and other support services and staff on site. The object of Safe Haven is to treat mentally ill homeless people not as patients, but as clients who are recipients of coordinated support services to help them with their debilitating state. While it is a far from perfect system, Safe Haven suggests that a shelter that provides comprehensive services for mentally ill homeless people can help those who would otherwise go without treatment. But without national funding, most states continue to lack the facilities even to identify mental illness among the homeless, let alone to treat it effectively.
Katie Johnson is a sophomore in Branford College