Your editorial (Dec. 23), "Help for the Mentally Ill," is right on the mark.
As a staff psychiatrist for Los Angeles County Mental Health working with the homeless on the Westside, I experience the misery and suffering of the mentally ill street people as overwhelming.
Los Angeles, with a total estimated 60,000 homeless, can indeed be considered the Homeless Capital of the United States. It well deserves funding from the Robert Wood Johnson Foundation to help develop a model program for assisting the chronically mentally ill to live independently.
On the Westside, with approximately 30,000 homeless, up to 40% of the homeless may be mentally ill. If one is not mentally troubled when first on the streets, street life certainly can pave the way to mental illness. Women are at the highest risk to develop mental illness due to the certainty of rapes and assaults. It is a common misconception to believe most of the homeless are solely panhandlers, alcoholics and drug abusers. This belief facilitates society's denial of the problem of the homeless and decreases our sense of responsibility to address these issues.
The parks on the Westside, and the heavily concentrated population of homeless on Skid Row (approximately 10,000), are examples of walking state mental institutions without walls. On our homeless patrols in the parks, we find a large percentage of mentally ill homeless do not want or desire any sort of assistance. Does our responsibility end? Do the mentally ill homeless have a right to live on the streets? Are walking mental institutions, the parks and streets of our city, to persist, flourish and worsen? Has the responsibility of Sacramento to finance new solutions ended?
The homeless problems will not fade away as many have hoped. Community psychiatric services, as our own in Santa Monica, are beginning to address the needs of the homeless by seeing them on the streets, in the parks, and at the shelters. Many mentally ill homeless will not come to outpatient mental health clinics. The desperately needed help, when accepted by the mentally ill homeless, can only be provided by motivated and energetic mental health workers. Such workers share the goals of improved organization, coordination, enhanced availability of services and increased efficiency.
Thank you for your editorial. I do sincerely hope that all governmental levels in Los Angeles and California respond to your urging to make a determined effort to improve the plight of the homeless mentally ill. Your editorials and continued coverage of the homeless issues help to ensure a continued public awareness of this persistent and growing cancer of society.
PAUL STEVEN JOSEPH MD
Joseph is Outreach Service coordinator of the Santa Monica West Mental Health District of the Los Angeles County Department of Mental Health.