My friend was a popular, promising artist - how did he end up on the streets of Portland, addicted and dangerous?
My friend was a popular, promising artist - how did he end up on the streets of Portland, addicted and dangerous?
When I first met Evan B Harris he was fizzing with talent and kindness. So I was shocked to hear he had become homeless and out of control. What happened to him is a story playing out in cities across America
Seems like they are over complicating it...
"Evan’s younger brother had experienced some serious mental health issues and he was awaiting news of a diagnosis."
"his mother was a schizophrenic and a heroin addict who often paid for her drug habit with sex. They were homeless, moving constantly. Often she would head off for days at a time, leaving Evan with friends or relatives, or sometimes on his own, without food. When he was 11, she took her own life"
"Evan’s father began to suffer with mental health issues. By the time the pandemic arrived, he was in full crisis, using drugs and worried enough about Covid that he had locked himself inside his house. For a week, Evan stayed with him, and they shuttled back and forth to hospital as his father experienced mounting phobias and suicidal thoughts, but refused treatment. At the end of that week, his father took his own life."
Dude literally had the deck stacked against him.
"The real problem came when Evan inherited his share of his father’s estate – $170,000. He used some of the money to rent an apartment. “But I had extreme schizophrenia and I just filled it with trash because I was so out of my mind,” he says. “I was seeing faces dripping down the walls, I couldn’t even be in there.”"
And this, kids, is why the "Housing First" model won't work. Mental Health and addiction treatment have to come first THEN housing.
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Mental Health and addiction treatment have to come first THEN housing.
Some people will struggle with mental illness and addiction their entire lives. Would you think it'd be easier to fight those things when you're homeless or when you aren't?
I'm Finnish. It's hard to even speak to some Americans, because I genuinely can't fathom some people who consider others to "belong on the street", "they deserve it" and one that has even made it some of my dumbo liberalist Finnish acquaintances "homelessness is a choice".
Ofc housing first works. Because it's not "housing first" in the sense that it purposefully houses people before getting them mental health or addiction help. It's "housing first" as in "having a place so you don't need to sleep on the street is a priority".
We have "housing first" (we don't call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you'd obviously go through a ward to handle the most acute effects and get you on a basic functional level, during which they'd probably communicate with social workers who'd get them some sort of housing.
The system is good but in practice people aren't perfect and both sides make mistakes; some people are too addicted and have problems and hard to be helped, but also sometimes the bureaucracy is fucked or some social workers / doctors suck.
Still, as long as those people have an apartment to go to, it's more or less fine.
People are rarely as fucked up as that, even actively schizophrenic people. (Like literally my upstairs neighbour. No joke.) You shouldn't use a psychotic episode to argue that housing being prioritised is a bad thing. That's just a non-sequitur.
You put them in permanent medical care to treat their mental health and addiction, THEN, once they're stable, you move them to housing.
If they are too mentally ill to become stable, you keep them in medical care.
You don't understand how long-term psychiatric care works.
You don't "cure" schizophrenia, buddy. Most patients are mostly stable.
I know people with mental illness who sometimes stop taking their meds and start fucking about and being manic, and once they get to be too disruptive, someone calls the cops, the cops go check it out (ours don't murder the mentally ill — which is a massive difference between our countries — ours are bastards still, but less murdery ones), and take him to the ER from which people who can't be helped right away because they're psychotic due to drugs go to a closed ward and people who are psychotic for non-substance reasons go another closed ward.
Usually though, with cases such as I know, it's quite enough for the cops to take the person to the ER where they give a slow-release IM injection of some antipsychotics, and the people won't be as bothersome for a week or two (there definitely are side effects to these meds, context really matters), but they will be able to go home and won't need to be taken into a ward — because outpatient care is a lot cheaper than inpatient care.
Stable being "no longer collecting garbage and seeing faces on the walls".
In the case cited above, the guy had housing but was still in a mental health crisis. Housing First cannot and will not provide that stability, only professional mental health care can do that.
And why do you think them not being homeless somehow excludes the option of mental health care?
It doesn't here. Where we actually use this policy.
Because right now, Housing First doesn't demand treatment. That's why it doesn't work.
It doesn't even demand you fill prescribed medication and take it on schedule, hell, it doesn't even require you get evaluated for prescribed medication.
So you get stories like the above, a housed undiagnosed mental patient filling their home with garbage and living in terror from things that aren't there.
You'll get those no matter what, until you manage to cure ALL undiagnosed mental illness. And undiagnosed mental illness is by definition undiagnosed.
Without "housing first" (again, a bullshit name) you'd have those people living on the street. You may not understand this, clearly living a sheltered life and having little to no actual experience on the matter, but homeless crazy people are a lot more dangerous than crazy people who get to go crazy in an apartment.
Oh no, did an undiagnosed mental illness result in an apartment that will take two men at least an hour and a half to fix? Oh no, that's acceptable, clearly we should not house people at all and toss everyone on the street to get even sicker and literally die.
"Housing first" is preventative. Living on the street creates mental illness, and a person NOT being homeless does NOT prevent them from getting mental health care. The main point of my last comment, nay, all my comments. Yet you can't answer it.
The fix for this is super simple, you get people healthy BEFORE getting them into housing.
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You collect up all the homeless people and evaluate them.
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Folks with mental illness are diverted to treatment.
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Folks with addiction issues are diverted to treatment.
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Folks with outstanding warrants are sent to corrections.
NOW...
Once people successfully complete treatment or have served their prison time, there needs to be a re-integration system, this applies also to homeless people who aren't part of 2-4.
- Job and clothing assistance. Resume building, job skills, access to laundry, a mailing address, phone, email and internet.
There needs to be specialists here specifically to help people with criminal records.
- NOW you bring in the housing assistance. You've given people the skills they need to get healthy, avoid addiction, and get a job. Now they're ready for housing. Not before.
As in step 5, there needs to be housing specialists just for people with criminal records.
If you put housing first, with no requirements for mental health or addiction services, it fails. Over and over and over again, it fails.
If you put housing first, with no requirements for mental health or addiction services, it fails.
We have housing first in Finland and literally no-one lives on the streets. In tve US, they create new mental illness every day because they have to live on the streets which are covered in human shit.
You do not understand psychiatry or social policies and you shouldn't pretend to. You're some sort of sheltered liberalist who doesn't get heard in real life so you have to do... this.
Over and over and over again, it fails.
I'm a billionaire, I'm a billionaire, I'm a billionaire.
....
Wait... just saying things doesn't make them true? Huh. Well that's a surprise for both of us, isn't it?
Seeing how we literally don't have anyone living on the street in my country. What country are you from and why do you keep avoiding my question of why do you think NOT being homeless prevents people from getting mental health care?
https://www.huduser.gov/portal/pdredge/pdr-edge-international-philanthropic-071123.html
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Do you think there's no professional managing the case? That they just give them keys, a pat on the back, and proclaim "Figure it out!" It's naive to think either solution is a magic bullet, but one approach has statistically better outcomes.
That's EXACTLY the problem with Housing First. Legally they are prevented from placing restrictions on the housing.
So they can't demand residents enter treatment, remain sober, take their meds or even obtain proper meds.
It's housing without restrictions and that plainly does not work if the people you are housing have severe mental illness and addiction issues.
You seem to not know what Housing First is. From the 2007 HUD report "The Applicability of Housing First Models to Homeless Persons with Serious Mental Illness"
And you also have a single image that people get better only through resident treatment. As the paragraph before that states, it's not well understood:
Again, you could try reading the sources already provided and quoted above. Here, I'll bold the important part just for you:
"Housing First forbids requiring beneficiaries, as a condition of receiving assistance, to attend drug rehabilitation programs, look for work, or even take their mental health medicines as directed by a doctor. They can accept services that might be—and often are—offered, but they are under no enforceable obligation to do so. If they take drugs, refuse work, or even are charged with crimes, housing is still available to them."
Under a housing first model, they legally cannot require prospective residents enter treatment as a condition of housing.
That's literally the definition of "Housing First" and why it's doomed to failure.
They can't turn away someone who is in treatment, which is great, but they can't demand someone enter treatment, which is the failure point.
If addicts are given a choice without consequence, they will choose to feed the addiction, they won't seek treatment. That's the nature of addiction. They aren't going to make the right choice of their own volition.
Oregon saw this with the utter failure of Measure 110... Let's legalize drugs, if someone gets caught with drugs, we'll give them a choice:
- A $100 ticket with no enforcement.
- Call a toll free number and ask about treatment. You don't have to actually ENTER treatment, just call the number and ASK about it.
16,000 people ticketed. Care to guess how many people chose option #2?
"The agency did get the hotline set up, but had only received 119 calls related to the drug treatment program as of June 2022, at an estimated cost to the program of more than $7,000 per call.
Of those calls, only 27 people were interested in drug treatment resources."
It boggles my mind how you manage to dance around every request for science backed evidence focusing only on your preconceived notions. When you weirdly in the most internet way say I won't read the scientific article cited in the conservative think tank whose only purpose is to skewer housing first and misrepresent it's working. I read it and note that that they misuse the findings of the journal. Silence.
I ask for scientific studies to support your view. There is now several decades of systematic research to support it's role in addressing the homelessness crisis. Why? Is it just because you don't want to read a view that may complicate your prescription? Do you not feel comfortable reading scientific articles? What is going on?
Your definition never mentions the role of case worker in developing goals and creating buy in for compliance. Patience, even highly motivated ones, regularly lapse in compliance. Life changing transformations are not easy.
I provided a quote that we don't have understanding why people get clean. It's not because we force them, that's for sure.
Why do you now bring up 110? Does this have anything to do with Housing First? Or is it part of so opus that addicts are bad children who need to be forced to do what's good for them?
I don't think we're going to meet in a space of mutual understanding. I think your presumptions that there people get clean only if you force them. You just keep on shouting at me that this is true. Show me some evidence because everything I see from scientific studies to front line workers say, "On occasion or happens, but the harm it does to others is far worse."
It's some child trying his first hand at commenting online. Just overly confident and absolutely full of bullshit.
Fucking Trump empowering dipshits like this.
We have "housing first" (we don't call it anything like that lol) in Finland, and if you were homeless and extremely fucked up on a drug binge, you'd obviously go through a ward to handle the most acute effects and get you on a basic functional level,
Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century. So far there hasn't been much legislative movement to change this. There are also nowhere near enough psych ward beds nationwide to stabilize the existing number of homeless who are obviously severely mentally ill.
Should all these things be fixed? Yes.
The chance of the federal government or any state governments fixing it is absolute zero.
In fact, the federal government and the vast majority of state governments are making absolutely no attempt whatsoever.
Putting someone in the psych ward against their will is difficult to impossible in a number of US states, due in part to laws passed in wake of the extreme abuses which occurred in the asylums of the 20th century.
You're talking about indefinite holds. I'm talking about a definite hold of 72 hours, which isn't uncommon in the states either, being a de facto medical necessity, seeing how psychotic people exist. It's called an psychiatric emergency hold.
We're not talking about people taking over someone's whole life and their rights a la Britney or some much worse case. We're talking about taking someone who's having an episode and treating that episode, then letting them back out again. Sometimes that takes longer than a few days, but usually those people understand enough to actually voluntarily stay after the three days they've had to stay. And if not, and they actually refused medical care, one could take them to jail if they were being disruptive. I believe putting people in jail is something you also do in Aaaamericaa?
(the video isn't related just I imagined saying that with the same accent and incredulity as in the video)