We are forging a new vision from the apocalyptic landscape we now see for many too many people with serious mental illness. That vision is not simply about more treatment, although first-rate treatment is very important. It is a vision of what can — and MUST BE — AFTER treatment— to instill real hope for a decent and meaningful life. It is a vision that lives in the more permeable zone we call ‘community.’
We must recognize that a disproportion of those on the streets who are ill are Black and other minorities. While living without stabile housing confers a level of stress and illness, we are not here addressing the entirety of the unhoused population, but rather those with serious mental illness. Why are so many on our streets? This is the inheritance of shuttering our psychiatric hospitals without building community capacity and with ongoing inequities in the system. That capacity MUST include permanent housing, treatment (including for instance, the use of evidence-based medication/where Clozapine becomes a first rather than last-line of treatment), a pipeline to work, and what we call ‘connectivity’ — intertwined with creative endeavor. This requires new approaches to making our workforce more diverse and reflective of those served, but also opening up opportunities for those who have been shunted to the very periphery of our communities. It is indeed a tall order. How that gets done will vary by state and locality. Giant steps HAVE been taken in some states, including California — yet they become isolated steps without a coherent vision.
Our goals?
To lay out a vision – a visual road map, showing the spectrum of need and how we need to move from ‘either/or’ to ‘win-win.’ Community mental health and those most intimately afflicted has been characterized by deeply polarized and divided camps. While this is an oversimplification, we think it fair to say that one ‘camp’ has been focused on civil rights and the slippery slope that can occur in inappropriate reinstitutionalization (absolutely imperative), the other, by the essential nature of serious mental illness as a neuropsychiatric condition, for which medication, health care, housing and rehab are essential interventions (also absolutely imperative). Falling into the cracks of this? Hundreds of thousands of very ill people, criminalized and incarcerated, or foraging food and material goods out on the streets — especially those unable to follow a therapeutic and medication regimen due to anosognosia.
To move from polarized entrenchment to powerful advocacy for the most vulnerable — those with serious mental illness and substance abuse. This is NOT an ‘either/or — requiring inclusion of the elderly, children and families. There ARE enough resources for vulnerable groups IF we allocate and make use of these resources thoughtfully.
Our means? Through addressing the hard questions that divide us, our aim is to bridge between critical though currently adversarial voices — using deep interviews, podcasts and vlogs together with writing and linking with beacons of excellence.
