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Column: Mental health problems among homeless people is a concern coast to coast

12/09/22

 

More aggressive efforts are being taken to help people with mental illness living on the street, but that won’t make a huge dent in homeless populations.

But the actions will channel a subset of chronically homeless people into treatment that could ease what is a growing health and safety concern — both for those individuals and the public at large.

Representatives from San Diego and six other California counties met here last week to discuss their plans to launch a new legal process designed to get troubled folks on to more functional footing.

By remote, Gov. Gavin Newsom joined the meeting on CARE Courts, a program he initiated that will set up court-ordered treatment plans for certain people next year as an alternative to incarceration.

The development of the courts comes as public frustration continues to grow over homelessness, especially with unstable people in public areas who could be a threat to themselves and others.

Also last week, New York City Mayor Eric Adams announced an expanded policy to take people with serious mental illness off the streets. This would mean involuntary hospitalization for those who are deemed unable to care for themselves, even if they aren’t a threat to others.

Adams’ action came amid heightened concern about attacks by homeless people in a city still reminded about the death of Michelle Go in January. Go was pushed in front of a subway train by a homeless man who later confessed and was deemed unfit to stand trial by a court-appointed psychiatrist.

California doesn’t necessarily have a single iconic and unfortunate case that has reverberated over the past year. But there are countless stories involving either physical violence or threats from homeless people, and many instances in which people living on the street are unable to care for themselves, victimized by their own mental illness — which sometimes has contributed to their deaths.

There are heartbreaking accounts in San Diego and across the state from family members who have been unable to get resistant loved ones assistance because of the state’s high threshold for involuntary treatment, and in some cases, the lack of resources.

Everyone wants help for people with behavioral problems, whether homeless or not. But government action that potentially curtails individual rights is controversial — whether it’s a mayoral policy or the creation of a new court system that promises safeguards.

Tackling mental illness is often talked about as a big step toward addressing homelessness. The mentally ill may be one of the more visible aspects of homelessness, but they remain only part of the problem.

California’s homeless population is estimated at more than 160,000. The state expects between 7,000 and 12,000 people will be eligible to go through the CARE Court process. Some behavioral health experts believe that range is low because estimates suggest far more homeless people have severe mental illness.

Housing, other support services and economic assistance are what’s needed to help the majority of homeless people get back on their feet. All of that seems in short supply, despite increased spending at the state and local levels.

Officials say hardcore homeless people with mental health issues currently take up considerable resources and getting them off the street would help alleviate the overall situation.

“The CARE Act is a new tool that will help local communities address individuals struggling with mental health and substance use disorders, many of whom are sadly living on our streets,” San Diego County Supervisor Nathan Fletcher said last week.

In recent years, San Diego has increased public mental health services and created teams to reach out to homeless residents, providing assistance and direction.

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