It's Causes are Many Part II
Mental Illness and Homelessness
Back in July, I wrote about the proposed city of Des Moines ordinances to ban sleeping in public, designed to target homeless encampments and unhoused individuals in public spaces. Sadly, the ordinances passed in September, and Little Village Magazine asked me to write an article about it.
Around the same time I was working on this article, I listened to an episode of the excellent podcast Schizophrenia: Three Moms in the Trenches called “But Where Can They Live? : Housing For Those With SMI.”
In the episode, the hosts and their expert guests discussed how access to affordable and supportive housing remains limited (Des Moines struggles with this issue) and how individuals with mental illnesses are significantly more vulnerable to housing instability and homelessness. According to the National Alliance on Mental Illness, more than 20% of unhoused people have a serious mental health condition.
Challenges individuals with SMIs face that affect stable house are unmanaged mental health symptoms, job loss, inpatient treatment, or involvement with the criminal justice system. (My family member with an SMI has been homeless because of every item in that list.) The crux of this issue, though, is without stable housing, recovery from mental illness becomes virtually unattainable.
In my experiences working with my relative, he vacillates between periods of moderate stability and psychosis. During times of moderate stability, he talks about long term goals, like finding a job, creating a budget to pay for an affordable apartment, getting his license back and possibly buying a car. He’s also more open to counseling, and working with a psychologist and service agencies.
During psychosis, he lapses into grandiose monologues about discovering coded messages in the English language, how he’s uncovering secrets of the universe, and is prone to paranoia and angry outbursts typically directed at his close family members or perceived enemies. While he talks about a special ability to “crack” secret codes, he’s unable to perform basic living skills like hygiene, managing medical appointments and medication, and keeping track of his belongings. He’s had countless phones and bags lost or stolen while sleeping outside. During these times, keeping a job, managing finances, and navigating the multi-step process of securing housing is out of the question. When he’s not writing his “codes,” the rest of his time is spent figuring out how to get food in his belly and where he can go to get warm for a few hours.
Our Eight-Year Shameful Ranking
I’m not naïve to or unsympathetic to the larger issues of homelessness for nearby residents or business. But, I also know firsthand that fining homeless individuals for being homeless in order to “coax them into housing or homeless shelters” when there’s a devastating lack of affordable housing, shelter beds, and psychiatric beds is nonsensical and, quite frankly, ridiculous.
Last week, I attended an advisory committee meeting on mental health legislative priorities for the upcoming year. A member of our committee voiced her frustrations over the continued missing priority to add more long term psychiatric beds around our state. Which, by the way, still ranks last in the nation for psych beds per resident. We have 64 state-managed in-patient beds to treat adults — just two beds per 100,000 residents — ranking Iowa 51st on the list of 50 states and the District of Columbia, according to a 2023 TAC report.
Dead last since 2016.
For some people, like my relative, a fifteen dollar fine and throwing away their meager belongings won’t help or change a damn thing.
988: Mental Healthcare in Iowa is a reader-supported publication. To receive new posts and help support my work, consider becoming a free or paid subscriber. And thank you for the generous support from my new paid subscribers!
I’m a proud member of the Iowa Writers’ Collaborative with my “988” column.
We’re a group of writers from all around the state and contribute commentary and feature stories of interest for those who care about Iowa.
thanks for sharing this! I agree: "a fifteen dollar fine and throwing away their meager belongings won’t help or change a damn thing."
So here we go again.........
Our Legislature and Governor tidy up the corridors of the Iowa Statehouse and we are left with sixty-four beds. Where is the humanity and willingness to reach folks who cannot help themselves? The wheels keep turning but not for the least among us.