Amongst the comments comments to my post Dear Homeless Guy was one from Claire McCarthy. Who is Claire McCarthy? I don’t know but she took the time to write a lengthy, if erroneous, comment and I’m somewhat irascible today, so I thought I’d parse her comments and reply.
So people in this situation deserve our contempt? I’m sure this particular situation varies state-to-state, but if you can afford a bed in a private psychiatric institution, you are not the problem.
Not necessarily true. Private hospitals can afford to be picky because there are more patients than beds. I have a friend who is psychiatric nurse. Right now, his job is with a private, for profit mental health facility. If they beds are full, they are fussy. If not, they are less so. That’s not his decision, that’s the bosses. As to contempt, you’re assuming that all homeless are mentally ill and vice versa. I see nothing to support that contention.
The problem are state-run hospitals that accept all people in theory, but in practice are so direly underfunded and undersized that their patients are being sprung too early, without a proper support system in place and without a place to go. They get out, without a job or a place to sleep, and quickly discover that the $200/month antipsychotic prescription they have is not possible, and then what?
This is what liberalism has wrought, Claire. Until the 1970s there were a lot of state run facilities, now most of them are closed. That was a conscious decision made by liberal progressives who convinced both legislatures and courts to close the state run hospitals.
In my particular city, the vast majority of the homeless are psychiatric patients with poor medication and counseling compliance (as a result of their illness and spotty funding) who don’t seek shelter for whatever reason. Maybe they think the staff there are out to get them. Maybe the shelter requires them to be medicated to stay there. Maybe the shelter fills every single night and more often than not they can’t get a bed or even a space on the sidewalk to crash for the night. And maybe they live in a state like Texas, where we rank 49th in the U.S. in per capita mental health care spending, leaving jails, the grace of private charity, and whadda ya know, EMS and ERs to pick up the slack. Even our prisons warehouse the mentally ill in huge, barren wards. That’s how fucked our mental health care system is.
I can’t speak to conditions in Texas specifically, but in general unless the mentally ill are a clear danger to themselves or more usually others, no state provides for the mentally ill to be forcibly treated. Around here at least, I’ve not had one mentally ill person tell me that they couldn’t obtain or afford medication. What I DO hear is that they don’t want to take their medications because they “fuck me up” and as a result they are non compliant. Around here at least, there are resources for free or reduced cost medications. Do you think that most mentally ill patients need to be institutionalized? That was the conventional thinking up until the early 1970s, as I’ve noted. It’s a larger societal problem that I don’t have the answer to. If you do, please share it with the world, we’re all waiting.
Oh, a lot more mentally ill live in their own homes than do in shelters. In fact, the vast majority of the patients I see live in their own homes, whether they are compliant with medications or not. We only get called when they are so out of control that someone calls 9-1-1. They don’t seem to get much, if any, better service than do the homeless mentally ill, they are just less visible.
I totally get that responding to non-emergent, shelter-seeking calls for the homeless must get old after awhile. But you’re a public servant. If you want to pick and choose which segments of the public to be civil to, you need a new line of work. These people are no better or worse than anyone else. They should be treated as well as anyone else.
Actually, I wasn’t talking at all about responding to calls at shelters or for the homeless in general. Like all other populations they have medical needs. Which are compounded by a generally high level of non compliance with medications. Those are call to which I respond with no problem. Actually, there is a problem, but it’s the shelter staff who call for an ambulance as a means of shirking their responsibilities. That’s a different story, and one that just about every EMS provider who responds to shelters knows. I could rail on and on about how the shelter system perpetuates homelessness, how some people absolutely refuse to go to shelters no matter how bad or cold the weather is, and other things homeless. I won’t because it’s not what I was talking about. Nor for that matter was mental illness among the homeless. You projected your own beliefs and prejudices onto my post and assumed facts not in evidence. Which is why I decided to elevate your comments to where they have their own post and I could do them justice.
Great post. I urge your commenter to take a walk through the Boston Medical Center ER, then Solomon Carter Fuller, next door. That’s all I’ll say.
For years I would get totally PO’d when I would be sent to a psych call. In fact a psych call made me walk away from EMS for a brief time until I attended CISD gatherings. Coupling my counseling and education I received in collage classes while I was away from EMS I was suddenly enlightened to why we respond and why we are there. After I learned about culture and how to understand it and embrace it,
I came back to EMS with a complete new mindset. Once I comprehended that the culture the patient is immersed in dictates their actions and functions and realized that even though I am in the same city, I do not live in their culture. I am a huge part of their culture though as I am their gateway to help. I have also found that quite a few of these street people will actually be the sickest people you will meet on the streets. Many have lived with their disease process so long that they will not outright show signs of illness.
Please take a moment, think, assess, and do your job. Yes, you are going to be exposed many times to system abusers that have no need for your services and are using you but always remember, you may still save a life, or at least make a positive impact on someones life and well being. I am actually writing a blog post about this exact subject at this time. In the past 5 years I have had a re-birth in EMS and am loving the profession every day. Six years ago you would of never heard me make that statement.
Alright. Well, I’m not going to continue discussing the facts because I learned many years ago that arguing with people who believe that providing aid to the homeless encourages homelessness is futile and just raises my BP.
“I could rail on and on about how the shelter system perpetuates homelessness…” Yep. That right there. (Also, dude, why bring up politics? Not what I was talking about. Don’t be That Guy.)
You and I disagree on a fundamental level, and it’s just not worth it.
Anyway, for clarity’s sake, “shelter seeking” = calls from homeless individuals designed in such a way that would get them shelter in the ER for a night. Assumes the call is not for a legitimate complaint. Not calls to EMS from shelters or people already in them.
I also didn’t say that all homeless people are mentally ill OR vice versa, and if your readers would go check they’d see that. I was pulling them out as an example of a group that really doesn’t deserve contempt. I stand by the statement that being nasty to people who are ill for behavior that inconveniences you and that really isn’t in their control is pretty crappy.
I will continue to help all people unconditionally because I believe in the beauty, power and awesomeness of humanity. I think that people are awesome. In the literal sense of the word. All people. Everywhere. Even people who believe that helping others encourages weakness instead of informing compassion.
Technically you are right, Claire. You said the “vast majority” of homeless are mentally ill. Can you put a percentage with that? Estimates vary widely, probably because it’s hard to quantify homeless people by diagnosis absent medical records or self identification. The latter is pretty unreliable, don’t you think? It’s easy to identify who is homeless, or at least who seeks shelter, but it’s much harder to classify them by illnesses.
With that in mind, which ill people am I holding in contempt? Is there a common universe of people who beg aggressively and mental illness? Good question, but I’d bet you don’t have the answer.
In short, you are, as I pointed out, projecting on to me behavior for which you have no evidence or information. My comments were directed at a particular subset of homeless people, some of whom might not even be homeless. For the benefit of Joshua and you, I’ll reiterate. I was talking about people who aggressively panhandle and fabricate tales of woe about being unable to afford food, gas for their cars, shelter, need a ride to Abilene to visit their dying mom, or other flights of fancy. Anything beyond that is projection by you.
If you want to give money to people, that’s your business, not mine. I choose not to because I’ve worked in the field long enough to know how the shelter system works.
Ms Claire McCarthy,
I’m not going to continue discussing the facts because I learned many years ago that arguing with people who believe that providing aid to the homeless encourages homelessness is futile and just raises my BP.
Might I ask how many people you house each night in your domicle?
If providing aid to the homeless isn’t futile, I’m sure you are doing your part to provide them shelter nightly, right?
How much of your income above and beyond that needed to provide basic clothing, sustenance, and shelter do you personally donate to help the homeless and those panhandling?
The original post was about panhandling and how so many of the sob stories are just plain fiction and have no basis in reality. If you want to fall for them, great.
If you have such compassion for them, I expect you’ll be able to honestly answer these questions and more.
How many times do you provide transportation to the panhandlers, clothing, bus tickets, etc?
I was pulling them out as an example of a group that really doesn’t deserve contempt. I stand by the statement that being nasty to people who are ill for behavior that inconveniences you and that really isn’t in their control is pretty crappy.
Frankly, I think you don’t know what you are talking about since I can’t find a single example of ‘being nasty’ in the comments here. Unless not giving the homeless anything and and everything they want counts, do you believe and help every homeless person you encounter?
But let’s focus on the last part of your diatribe there.
that really isn’t in their control is pretty crappy.
Just exactly what isn’t in their control?
Is it not in their control to take their medications?
Is it not in their control to follow through with their counseling/therapy?
Is it not in their control to tell the truth, to be honest about their addictions, drug use, criminal acts, with their families?
Is it not in their control to avoid stealing from their friends and family, therefore alienating many or most of them?
And if these things aren’t in their control, why are they allowed to roam the streets; refusing medication or hospitalization?
I think that people are awesome. In the literal sense of the word. All people. Everywhere
See I disagree with you on this point. As evidence just a few people — Hitler, Ted Bundy, Charles Manson, LAWRENCE SIGMUND BITTAKER & ROY LEWIS NORRIS, Gary Ridgeway, John Wayne Gacy, Henry Lee Lucas.
Should I go on?
We recognize that some people lie, that some people steal, some people commit fraud and much, much worse. Recognizing that fact doesn’t mean we lack compassion, it means we live in the real world.
So, a few things.
I went back to the post Claire allegedly commented on. I don’t see her comment there, which leads me to believe it was deleted or not approved. Please do correct me if I’m just assuming facts not in evidence.
Also, you claim in your last paragraph that you weren’t talking about “mental illness among the homeless,” and yet in a blog titled “Dear Homeless Guy” you claim you understand of this homeless person that they “have substance abuse problems, psychological problems, are statistically likely to be mentally ill, a convict, or some combination thereof”. Now again, without seeing Claire’s original comment I have no context to compare your response, but it seems she made a reasonable inference given the title/content relationship of your post that you were in fact talking (at least in part) about mental illness among the homeless.
It seems to follow that maybe this individual’s assumed mental illness may well be what keeps him from “follow[ing] their rules.” Which may well go back to a point Claire makes about an inequality in the degree of assistance actually available to these individuals.
I suppose all of this is moot, however, as this is clearly your blog, and since Claire allegedly has a differing point of view deemed by you to be erroneous there doesn’t seem much point in offering a contention or even a point of discussion. There seems very little in the way of open discourse available here. It would seem that anyone who takes the time to read your blog and would like to offer a differing opinion in the comments are simply the product of “what liberalism has wrought” and deserve only to be parsed when you’re in a fit of pique.
Actually Joshua, as I pointed out in the title and body of the post, her comment in it’s entirety was included. All of the italicized part of this post, the one you are commenting on, is Claire’s comment. Which moots the rest of your comments since the only comments I don’t post are spam or those few that are so insulting in general that they have no value in the discussion. Your at length comments here are approved, even though they have no context because you didn’t understand that Claire’s comments were the basis of this post. Thus, you fail reading comprehension in this case.
Ah, see – I was expecting to be able to reference the comments as attributed to Claire directly (silly me) in the comments of the original post. That way I could see that they were, in fact, hers and not some contextual malformation thereof. That’s not so much a lack of reading comprehension as an expectation of integrity in the publication. In fact, without seeing her further response on this post (color me surprised), I’d have no way of knowing she existed at all.
I do appreciate in your response here to Claire that you make clear you are talking about a particular subset of the homeless, as that was not made clear in the original post. A number of sweeping generalizations were made of this one panhandler – which I will actually agree can be annoying – you do state he is statistically likely to be mentally ill and you do state an assumption that he has psychological problems. Those quotes are still in your original post. I don’t see that as Claire projecting – if you meant something else then by all means enlighten us.
But there’s the rub, isn’t it? Claire and I seem to disagree with you, and I suppose that makes this a non-starter anyway; my point – as proven by your response: there is very little in the way of open discourse unless I agree unequivocally with you. Which isn’t really discussion or debate at all. It’s herding. As such, I will respectfully leave your sandbox and return your toys just as I left them.
Well, Joshua since you insist on substituting insult for discussion, I can’t say that I’ll miss you. There was no contextual malformation if you read the original post, but I guess that would constitute work, so it was obviously not something in which you were interested until my reply to you. You still seem to have reading comprehension problems, which I guess are a result of your no doubt expensive, if sub optimal education.
I’m thinking the biggest problem with the homeless is sorting them out. Like anything that can be gamed, the unethical and dishonest find a way to subvert the system to the point it’s disfunctional. This is why panhandlers, con men and drug addicts mingle with the mentally challenged. There are opportunities and those that need the help the most are the first to suffer. The system bloats, money is limited and those with guile are the first in line.
So, what’s the solution? Cruelty, for lack of a better word. There’s not enough money (I don’t care what your politics are; there isn’t enough) and stopping the corruption requires eliminating the waste. Substance abusers only get one chance. Medical, or legal, professionals that misuse the system lose their license for years. Mental health is promoted as a good thing, instead of a stigma and psychotropic medications aren’t perceived as optional. This group of medications can mean the difference between survival and destruction.
How will this happen? I have no idea, but the system is broken. Drastic changes are required and necessary. Enabling corruption, or throwing more money at the problems hasn’t worked to this point and never will in the future.
Quite an entertaining thread about this post on Claire’s Facebook page.
You’re right, neither her nor Josh really excel at reading comprehension.
They do, however, excel at ad hominem attacks, and un-frriending anyone who dares voice a dissenting viewpoint.
I’m so broken up about, I may start singing “Feelings.”
Now I’m crushed that I don’t have Facebook. OK, just kidding. OTOH, I have been getting a lot of referrals from facebook and it’s driving my traffic up. Thanks Claire! Well, minus Claire and Joshie.
You ain;t missing anything. Most of the comments on the EMS pages are one small step above the average YouTube comment.
And the discourse there makes my IQ drop 10 points every time I read…
Textbook example of people so “open-minded” that their brains have fallen out.