Exposing the Complexity of Mental Illness Among the Homeless

By TRILBY BERESFORD | Reporter

The Pacific Palisades Task Force on Homelessness gathered with local community members on Monday, May 21, to discuss the kinds of mental illnesses affecting those who live unsheltered on our streets and how we can be of service.

Dr. Roderick Shaner, medical Director of the Los Angeles County Department of Mental Health, was the guest speaker. He has lived for 30 years in the Palisades and offers a wealth of experience dealing with psychiatric patients and homeless individuals who refuse help despite being in need. Shaner noted that accurate psychiatric diagnosis is critical because it tells medical professionals what the likelihood of different treatments is.

The homeless community in California suffers from a wide range of conditions such as schizophrenia, delusional disorders, mood disorders, mental retardation and autism, dementia from traumatic brain injuries, PTSD and associated panic disorders. Many of these cause disorganized thinking, severe social withdrawal, lack of motivation and difficulty dealing with other people.

It is common for homeless individuals to refuse treatment because they are suspicious, or they’ve been given bad treatment before, or they misunderstand the treatment, or they are desperately afraid of losing their autonomy (i.e. when locked in a hospital). Those who accept treatment are often grateful for the food, shelter, rest, medication and someone to talk to, but then they decide they’re fine and demand to be released. Inevitably, the destructive cycle continues. The process of dealing with the mentally ill is hugely complex.

Shaner shared a specific case where a former engineer became homeless after a long history of delusions. Although highly skilled and educated, he felt socially isolated and demoralized, constantly feeling that he was being undermined. In and out of hospital and care facilities, his future is uncertain—like so many. He is not so impaired that he poses an imminent danger to himself or others; therefore admission into a psychiatric ward isn’t the answer. Though, clearly, he is in need of imminent help in order to regain his confidence and live up to the potential he undeniably has.

Shaner shared that several important bills are going on right now. They seek to expand the definition of grave disability, appoint a conservator for a person who is chronically homeless, and expand the processes for medical professionals to transport mentally ill individuals to appropriate care facilities. Results of these bills will be known at the end of the summer.

Sharon Browning, PPTFH vice president, gave a closing remark at the end of the meeting. “This is about individual human beings. It is so complex. That is the challenge to all of us, because we all want recipes—we want the answer to come quick and fast. We’re going to patiently identify the gaps. We want a point of view as a community. I’m hoping that you will continue to attend meetings and develop that point of view.”