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Mentally Ill Swelling Homeless Ranks

Homeless Snow GuyHordes of mentally ill have blended into the homeless urban landscape for decades now, a permanent fixture on subway trains and bus stations, in abandoned buildings and tunnels, under bridges and overpasses, and riffling through rubbish bins for breakfast.

It’s disturbing. We’re never quite sure who they are, or what they need. Either we dig deep for a buck walking by, or we pad past with callous indifference, making the quick calculation that they’re probably just alkie crackhead doper slackers who are their own worst enemies anyway.

Either way, they’re harder than ever to miss these days, unless you live deep inside a non-urban bubble. If you haven’t looked up lately, the vast numbers are beginning to overwhelm like hungry zombies that you and your smart phone are doing your best to ignore.

It was only a matter of time. For decades these mostly adult individuals have been shuffling along silently, muttering to their voices, moving into the shade in the summer, the sun in the winter, while we go our way.

Homeless shelterBy now, year on year rises have pushed the terrifying math beyond the capacities of community shelters and mental health facilities.

More recently, the face of homelessness has taken on a younger complexion as adolescents and the children of unemployed parents are elbow to elbow, competing with the mentally ill and other societal cast offs for discarded food scraps in bread lines and at rubbish bins.

Today’s Boston Globe reports on a Department of Housing and Urban Development census showing record numbers here in Boston, with more and more children of working families on the forage.

If you happen to have a mental health issue, then you are three times as likely to dine from a dumpster here in the Land of Plenty.

If the homeless are rolling like large waves through Massachusetts, the blue state land of the Kennedys, where the economy is good, life must be grim indeed in the red heartland.

The federal census reported by the Globe showed that 6,992 homeless men, women and children live on the cold streets of Boston, 5 percent more than the year before and 17 percent more than in 2001.

Statewide, the homeless population in all of Massachusetts has expanded by 14 percent since 2010, to nearly 20,000 people.

The number of Massachusetts homeless students, preschool through 12th grade, has doubled in the last decade.

Meanwhile, the mentally ill are hit hardest here and across the nation.

“It’s like a mental ward on the streets.”

About a third of America’s nearly one million strong homeless population suffers from untreated schizophrenia or manic depressive illness—some 300,000 individuals, roughly the size of the population of such cities as Dayton, Des Moines, Ft. Lauderdale, Grand Rapids, Providence, Richmond, or Salt Lake City.

As the New York Times reported three years ago, in Berkeley, California, “on any given night there are 1,000 to 1,200 people sleeping on the streets. Half of them are deinstitutionalized mentally ill people. It’s like a mental ward on the streets.”

Studies have shown that more than one of four discharges from mental hospitals here in the Bay State winds up homeless.

In New York it’s even worse. There, 38 percent of discharges from a state hospital have “no known address” within six months’ time.

I thank my lucky stars my sisters are tucked away. Some of them have been  homeless before and we are no strangers to poverty either.

If more and more mentally ill are on the streets (where, if you are among them, you are far more likely to be robbed, beaten or raped) incarceration is increasingly the one way to get off them.

No wonder rising homelessness and rising crime go hand in hand. In nearly all towns, large and small, direct correlations have been found between the lack of psychiatric hospital beds and rising crime rates and homelessness.

Like an old joke that was never funny in the first place, it keeps looping around–from hospitals to homelessness to prisons and back to homelessness only to go back to jail again.

There, in prison, you’re far more likely to be pepper sprayed and tossed “in the hole” than non-mentally ill inmates.

Whatever progress you might have made, your head is now thoroughly wrecked after all that.  It’s almost guaranteed that you will now require far greater treatment to recover or prevent relapse.

“When we remember that we are all mad . . . .

Here’s another telling statistic: If you are homeless and mentally ill, then you are about ten times as likely to be imprisoned as the non-homeless mentally ill population.

There your isolation without treatment will make you three times as likely to reoffend when you get out. Of course, you’ll probably be homeless because your chance of finding a job that pays a liveable wage is slim to none. Your very background makes you suspect.

So the whole system is like one big, self-perpetuating feeder system on a loop from hospital care to prison confinement via the mean streets.

Yet with one in six inmates receiving mental health treatment, commiting a crime is, unfortunately, their one and only treatment option.

What’s truly, deeply mad is that no one sees the irony.

Or, if we do, we don’t care.

In the words of Mark Twain: “When we remember that we are all mad, the mysteries disappear and life stands explained.”

Mentally Ill Swelling Homeless Ranks

Patrick Tracey

PEN winning author of Stalking Irish Madness: Searching for the Roots of My Family's Schizophrenia (Random House/Bantam Dell). London correspondent in early 2000s, Washington City Paper contributing writer throughout 1990s. More recently writing for Salon and now blogging here.

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APA Reference
Tracey, P. (2014). Mentally Ill Swelling Homeless Ranks. Psych Central. Retrieved on May 25, 2020, from


Last updated: 13 Jan 2014
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