Thanks to Samantha Sangenito for sharing research about holocaust survivor children with schizophrenia on ACEsConnection. The source of schizophrenia is an important issue we should address as a member of the ACEs community. Although you can find advocates who state that there is no relationship between childhood adversity and schizophrenia, the research is starting to show that those diagnosed with schizophrenia actually have a higher rate of childhood adversity that the general population. And as we have learned, this alone would lead to higher adverse outcomes for mental health later in life. [LINK HERE] How can we use this information to help change policy in a way to help address childhood adversity in meaningful and productive ways. Here is one possibility by addressing the issues faced by the homeless.
Early in my career, I was inspired by a community activist who was addressing the needs of the homeless in Anchorage, Dr. Lynn Ballew. [STORY HERE] Bean’s Cafe was founded to help feed the homeless Anchorage street population. A few years later, the Brother Francis Shelter opened and offered a place for homeless to spend the night. [STORY HERE] The Anchorage Gospel Rescue Mission is another haven for homeless men in Anchorage. I became aware of its existence when I saw that my mother contributed some of her small income, and later when my nephew became homeless and spent many nights there and at Brother Francis. For me, being around homeless people seemed ordinary. Many of the homeless I encountered were like adults who came in and out of my life through my mother.
I have listened to homeless people being demonized for all of my adult life. They are told to pull themselves up by their bootstraps, get an honest job and stop panhandling, give up drinking. I thought I would share some facts about the homeless. First, there are approximately 575,000 homeless people in the U.S. on a given night. [LINK HERE] Of that number, a third have serious mental issues, primarily schizophrenia and bipolar disorder. [LINK HERE] And because of their higher level of ACEs, they have all of the other issues we face and have to fight against. The research article I cite has a table that shows the correlates for the studied population of 569 people with schizophrenia. [TABLE 4] So with 200,000 homeless who have either schizophrenia or another serious mental disease, any public policy must address the issues faced by this population.
Fortunately, there are various policies that help address this population. Housing First is a program started in Anchorage in 2011 with the conversion of a hotel into housing for the homeless. [STORY HERE] The converted hotel was where a relative died in a fire, probably assisted by alcohol abuse, so it doesn't hold fond memories for me. Its conversion though, offers a beacon of home to some. But as you can tell from the story, misconceptions are guiding the effort, along with data stating that Housing First programs save money in communities where implemented. [LINK HERE] With cost savings in excess of $40,000 per homeless person housed, the benefits are significant.
The Housing First program was initially conceived without any barriers to acquiring housing. There are no tests, income requirements nor social services forced upon the applicant. This is not appreciated by many citizens. The first goal was to provide housing and save the costs associated with homelessness. To do this in a way that provides a possible pathway to the homeless should be a part of policy. Can we find ways to inspire and motivate those who are housed with a pathway to healthier and happier lives? For some we might, and others we might not.
If we address homelessness as the tip of a system that produces poor outcomes for many who experienced significant childhood adversity with a lot of ACEs, then we need to include addressing this adversity early on, in prevention as opposed to reaction. Think of this way. Table 4 that I referred to earlier lists 276 of the 569 people with schizophrenia studied as having children. The number of adverse events inflicted on those children starts with having a parent with a mental illness and extends to many of the traumatizing events studied. If we don’t help this population of homeless, one third with severe mental disease, we steal hope from their children.
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