Hello, and welcome to America.
Today I found out that the great city of Detroit has decided to clean up its streets for the benefit of all the Super Bowl tourists. To get the unsightly homeless people off the streets and out of the way of the big spenders, Detroit has decided to throw a nice big Super Bowl party especially for the indigents! From an article about the big plans:
As Detroit prepares to host its second Super Bowl and only the third held in a northern city, the finishing touches are being applied in an effort to spruce up a city that has somewhat of an image problem.
One somewhat controversial aspect of the Super Bowl makeover involves the city's significant homeless population. Homeless advocacy groups in Detroit are "throwing" a three-day Super Bowl "party" for homeless Detroiters beginning Friday. Shelters will be significantly augmenting their normal services, including around-the-clock operation, big screen tvs and extra counseling services.
While some see this as a way to bring attention to their plight and improve the outreach of the advocacy groups, others see it as merely a way to temporarily sweep the problem under the rug in an effort to let Super Bowl attendees party on without the stress of seeing all those desolate people on the streets.
Bill Weld-Wallis, a vice-president of Neighborhood Service Organization, one of the participating groups that is banding together to expand services this week, has no pretense about the perceived need to get the homeless out of the way of the tourists, but he hopes that the opportunity to get them into counseling will be worth the effort:
We understand the city's not going to let these folks be in the way, so how can we take advantage of that and use it to benefit the homeless?
Unclear is how involved the city itself is in the plan, which from most accounts is portrayed as a collective voluntary effort on the part of the advocacy organizations. But the money for such ramped-up efforts--which include driving around in vans to collect the homeless — has to come from somewhere, and as these groups are chronically underfunded, questions about ultimate authority for the plan remain.
I feel as though I've been yelling into a void about this sort of thing for years, so this gives me an opportunity to vent. Sorry in advance for the length of the following diatribe, but aside from the Iraq war, the only issue that's been personally important enough to me to actually get me off my lazy butt and badger my congressman (when I lived in South Carolina) was health care, specifically health care for the mentally ill. It was an infuriating experience.
In return for my concern, I received a few nice form letters from Washington. I'm surprised the letters weren't dripping with pork grease. One single barrel of the pork my esteemed congressman regularly presented to his influential good ol' boy cronies would have probably eliminated the problem of homeless mentally ill people for the entire state of South Carolina. But Charleston needed an Aquarium and a prettier bridge!
Here's my thing. If not for the accident of my birth - that is, if I hadn't been born into a loving, educated, and reasonably well-off family - I would be living on the streets right now. I have type 1 bipolar disorder with psychotic features and I'm a rapid cycler, which means that if I do not have the right medicine I am not functional. I slip into severe psychosis. Without the expensive medications I have to take daily - medicines I am only able to afford through Oregon's state funded programs - I lose my mind, my bearings, and my life.
Bipolar disorder has sidelined me to such a great degree that at the age of thirty-six I am back living with my (mercifully patient) parents while recovering from my second divorce. I have been forced by this illness to relocate to a place 3,000 miles away from my original home in South Carolina, partly because my parents live here, but mostly because Oregon has the best health care in the country. There's no way I could get the treatment or afford the medicine that I need in South Carolina; the health care system there is worse than you can believe. I am just now coming back from a year-long period of healing. It's been crippling and horrible, nearly all of my relationships - including my marriage - have been decimated by its fallout, and my scars are so deep that sometimes I despair of ever living a truly normal life.
But at least I am not on the streets. I am not living in the subway collecting change for a living. I am not pacing the lobbies of fast food restaurants drooling and mumbling to myself. But I should be. It's only because of the luck of the draw - because of familial support, the right counseling and medication, and the amazing Oregon health care system (the progressive state of Oregon actually seems to care about its disabled residents, thank god) - that I am not one of them.
There's no way I could ever have even navigated the health care system had it not been for my mother. She bullied and cajoled and insisted and beat her way through the miserable excuse for an American health care system, and she got me what I needed. What the government refused to provide, my family did - at great cost and personal sacrifice. But if my mother hadn't been around? If I had been disowned or abandoned by my family as well as my husband? Then I would be on the streets, plain and simple. I'd be Detroit's worst nightmare, one of those folks they don't want the fucking tourists to see.
And this society, this bullshit government, does not give a shit.
What I'd really like to see is universal health care in America, but I know it will never happen. I understand the mechanics of capitalization, and I also think that the free market has done a lot for advances in treatments for illnesses like cancer and heart disease. There's simply more of an incentive to become a doctor — a good doctor — in America, because doctors are paid with dump trucks full of money. I know that people from other nations — the people who can afford it, anyway — routinely come to the US when they need special care or treatments. Yay America, rah rah rah.
But between the apathy of big pharma, the greed and indolence of politicians, and the American cultural tendency to warehouse people who make them uncomfortable — like the elderly, disabled, and mentally ill — people who suffer from severe mental illness are shit out of luck. No one's lobbying for them in DC.
The big money is in the development of yet another designer drug to treat ADD or simple depression or stress-related insomnia. Really sick people — psychotic people, the kind who actually do wind up living in cardboard boxes — usually don't have the funds to pay for their drugs, so the incentive for big pharma to spend billions of dollars to develop good drugs for schizophrenia and other debilitating mental illnesses simply isn't there.
These sorts of illnesses are horrendously destructive to individuals and a blight on our society, but there's just no money in treating this unsexy sort of mental illness, so the problem gets swept into back alleys and soup kitchens. It's a terrible indictment of our incredibly prosperous country's value system, and it's a sobering reminder that only certain illnesses — illnesses that affect wealthy people and their children — receive the attention they deserve.
The homeless issue is significant not because there are vast numbers of people who enjoy eating out of dumpsters, being ignored or treated like filth, and freezing to death. I'm sure that a tiny minority of the homeless are true urban outdoorsmen, living on the streets by choice. Honestly, though, the reason a homeless problem exists in cities like Detroit is that America in general and Washington in particular refuse to take care of our society's weakest, most needy members. Period. It's atrocious.
What eats me up about this story is that Detroit is willing to spend valuable, scarce monetary resources on things like TVs and potato chips to attract the homeless. Mentally disabled homeless people like chicken wings as much as anyone, and I'm sure they'll enjoy watching the game. Gosh, a volunteer might even sit down during a commercial to chat with some of them one-on-one! That would be swell!
But the greater issue, the real elephant in the room, is simply this: what are these people going to do on Monday? Even if a few sick people are encouraged to come back for help, the funding isn't there to do much good at all.
Mental illness is tricky. It isn't like any other disability. It's complicated to diagnose and treat, and it requires committed follow-up care. The majority of homeless people who are severely mentally ill are homeless because they don't have families willing or able to help them. Mental illness is draining and difficult on families, and many times the illness itself is precipitated or exacerbated by familial abuse.
To make matters worse, an attitude of "treat 'em and street 'em" pervades the entire health care system. It's understandable, I suppose. It's easier, and certainly less expensive, to throw some pills at a schizophrenic or psychotic bipolar patient rather than provide costly, labor intensive longer-term treatment.
But that sort of treatment — longer hospitalizations followed up by counseling, the option of halfway houses, and vocational rehabilitation — is really the only way to adequately care for the severely mentally ill. How many psychotic people remember to take their medicine, especially when they're booted back out on the street after a one-night emergency room stay? Observation and a calm, stable environment are crucial for the treatment of all mental disorders that have psychotic features. The brain is the most complex organ in the body, and the human brain is the most complex organ in the known universe. When a human brain breaks, it takes a lot of time and a lot of work to fix it.
People from upper middle class families who are depressed don't generally wind up eating in soup kitchens. Most middle to upper class sufferers of depression and other mood disorders can afford the medicine and counseling that allows them to live a relatively normal life. Thanks only to the support of my family, I fall into that category. But it's the poorest mentally ill people who populate the alleys of urban America.
It doesn't help that the mentally ill don't have cute, sad eyes like puppies and bunnies and kitties. Maybe if they did some socialite might throw a fundraiser for them, but the truth is that mental illness is ugly and dirty and gross. It's scary, and people don't like to look at it or deal with it. Add to that the fact that many of these men and women self-medicate with a variety of terribly destructive street drugs, which makes it even easier for society to dismiss them as flotsam. Just write them all off as lazy drunks and tweakers, and poof! Instant alibi for not giving a shit.
But there is a vastly higher incidence of mental illness among the poorest members of our society. I'm talking about the severest kind of mental illness, the sort of psychosis you see in the filthy woman at the bus stop who mutters to herself and eats garbage. Poverty itself is grinding and crazy-making, and the higher rate of abuse within the poorest communities combines with crushing ignorance to create a pitiful subculture of homeless, desperately sick, destitute people.
Organizations like NAMI (the National Alliance for the Mentally Ill) do everything they can to help mentally ill people, but they can't do it all. There is precious little funding set aside for need-specific programs to help the severely disabled in general, and even less to provide the indigent mentally ill with the means to get off the streets. And funding to pay social and health care workers adequate compensation — hell, a living wage — for their backbreaking labor? Are you kidding me?
Homeless shelters and soup kitchens are nothing more than a band aid on a festering sore. These people need proactive, aggressive care, and this society would rather turn its well-fed face away from the ugly problem than pony up the resources — public or private — to care for its neediest, sickest members. I read once that the health of a society can be accurately judged by the way it treats its weakest members. If that's true, America is far sicker than the people it tries so hard to ignore.
I like one single thing about this Super Bowl "plan". Maybe it really will help some people who are fearful, psychotic, or near death get some actual help. Maybe at least one person will meet the right social worker, someone who isn't beaten down by pitiful wages and a broken system. Maybe that social worker or volunteer might champion that sick person, might shepherd him through the confusing, labyrinthine bureaucracy that passes for American health care. Maybe someone will get a happy ending.
If one single person gets actual help, maybe the money Detroit spent on the fucking big screen TVs and onion dip might have gone to good use.