We have a lot of street people here. Some are mentally ill - they numbers grew huge when the feds opened the doors of the mental institutes about twenty years ago.
Yeah, <sighs>, thats a massive part of the problem here too. Part was the stringent budget cuts of the eighties (and now again). So many places closed - not just the 24/7 places, but the places that offered useful daytime shelter, work, activities. "Walk-in centres" for those sane enough to live on their own, but not to do
it all on their own. Most now cut - it was "soft", social work, not hardcore health necessity - and all the social and community work was totally cleaned out.
Part of it was the paradigmatical shift in what used to be called madhouses. Way back when, the crazies were put away in safe camps in the forests ... far from us. Last three decades, care has shifted drastically to reintegration. Gotta encourage, force them to take part as much as possible in normal society. For a lot of psychological patients, a liberation. No more being stuffed away in the forest - new opportunities! But for many others, deep insecuritisation. They usta have a life of certainty laid out - food, bed, care, activities, the same the rest of their life. Now suddenly they're supposed to do and manage all kinds of things by themselves. Live in their own place, or in shared semi-independent flats in town, etc. Deal with constantly changing circumstances, with expectations. Many fail.
Now we got two kinds of people on the street. One: those who are too unable to manage by themselves, but are not serious enough cases to "deserve" full-time care anymore in the new, do-it-yourself-as-much-as-possible system. They fall between ship and shore as we say.
There was a sad story in the paper of the psychological centre of a mother who told of her despair about her psychotic son. He wasnt sick enough to get full-time care - no, reintegrate, live with your own family! But she couldnt cope, either ... Kid had a certain number of hours of available care. He gets crazy at night - just try to make it to the morning. One night, he got crazy, and he walked away, to the psychiatric centre, started banging on the windows. They wouldnt help him (no emergency staff at hand), he broke three windows with his hands. What did they do next appointment? Rebuked him and fined him for the costs of the windows. This is 2001. Its called promoting self-responsibility, you know.
Plenty of young people, too crazy to manage by themselves, not crazy enough for one of the too few full-time places. Family needs to jump in, but it fails, they wander the streets. But the other category is much more serious still. Its the people who are too
sick for the system.
Again, the problem is part budget cuts (the people want lower taxes, you know ... "more efficiency" in health care) - and part paradigm change, again focused on "more efficiency". Locking people away the rest of their life is not efficient. Gotta reform/reeducate/reintegrate them. Target: to minimise intramural care, or what its called - 24/7 care. Get them ready for outside as quickly as possible again. But what of those who will never
Here's the director of the psychological care institute. He's grappling with budget cuts - and he's rewarded or punished by government based on his succesrate, his efficiency. How many people did he manage to reintegrate how quickly? He's got a limited number of beds. Who wants a patient who will never
reintegrate? Cause all kinds of problem, is violent perhaps, will just not adhere to rules, freaks out the nurses? The more of those you accept, the lower your efficiency rate - which means more budget cuts from above still.
So now they're peddling these people. Doctors and cops trying to find a place to accept them, cause jailcells arent meant for them either. But when
someone will accept them, its at best for emergency care - then back out on the street. Its a vicious cycle.
Are these people on drugs, when they're out on the street? Sure they are. Often hardcore. Do they drink the local equivalent of Thunderbird? Sure they do. What lead to what, which came first? Who the **** knows? They're walking by here at night, every coupla nights one is cursing and yelling and hitting the wall down this quiet downtown sidestreet.
Do I want people to accept that, yeah, for some kind of care there will never be efficiency rates to be met and succes targets to be fulfilled - you're just gonna have to pay a little more taxes - or learn to live with 'em on your street? (Well, mosta the people who vote for tax cuts live out in the sub- or exurbs of course, so I guess they wont notice much ...). Hell yeah. Will it happen? Probly not. And in the meantime?
They say perhaps half of the people on the street here have serious psychological syndroms. Can I realistically demand them to, you know, behave, act sensibly and rationally and spend the little money I give all on healthy things? Wont happen, will it? One thing I do know - last thing they bloody want is a lecture. And another thing: I will never have enough money to give 'em all a buck. I prioritise Streetnews vendors, but even those 9 out of 10 times I say no. Just too bleedin many of 'em. Twice, three times as many homeless as there were when I moved here. Thanks, people. Great job.