The Stigma Surrounding the Mentally Ill and Homelessness Needs to Go

As of January 2018, there are approximately 77,000 people considered homeless in New York’s five boroughs; 3,900 of them live on the street. It’s easy for New Yorkers to blame city hall for this devastating statistic, especially due to its prominence in Mayor Bill DeBlasio’s recent campaign. However, despite the administration’s lack of deliverance, it isn’t entirely the current regime’s fault. There are many factors that have contributed to the increasing numbers, such as the social misnomer equating mental illness with ‘crazy,’ and subsequently labeling the swelling homeless population as dangerous or undesirable. This has led to a social stigma surrounding the homeless epidemic that has swept the city. Many unfairly blame the homeless for their own plight and write them off as “public nuisances.” This in turn has created strong community backlash against the city’s efforts at building homeless shelters. Perhaps a better narrative is in good order, one in which the truth about mental illness, substance abuse, and unstable housing is told to a public that considers the homeless a problem to be dealt with rather than people to be cared for.

It’s very important to understand where this stigma came from in order to properly assess the root of the issue. To begin with, only a small fraction of those considered homeless have a mental illness. Also, mental illness in the homeless population tends to correlate with being single and/or female. Therefore, there isn’t a large number of crazy, dangerous homeless people to begin with; it’s an urban myth. However, those with a mental illness (including substance abusers) are less likely to use the shelter system or remain in stable housing than other demographics, such as families with children. According to The Encyclopedia of Homelessness, authored by Beth Weitzman and Sean Fischer, during the economic upheavals of the 1970’s and 80’s, many affordable housing projects were burned, condemned, or never even built. At the same time, the city deinstitutionalized a large number of inpatients to local community centers that were never built or funded, causing many who were suffering from mental illness to become homeless or incarcerated; the effects of this policy are still evident today.  To be clear, most people considered homeless do not live on the street and generally have families. However, the homeless on the street are the most readily visible to the community, which has produced a disproportionate representation of the homeless as substance abusers or mentally ill. This has warped the general perception of homelessness, resulting in community resistance to the construction of homeless shelters. In 2017, the construction of a homeless shelter for men was slowed by three months due to a lawsuit brought against the city. Community members felt (and largely still feel) that homeless men are dangerous and bring crime, although the homeless are more likely to be the victims of crime than the perpetrators. So, we can blame the DeBlasio administration for falling short of its 20-shelter goal for 2017, or we can reevaluate the way communities view the homeless and homeless shelters.

In fact, a good way of recasting our view of the homeless is by looking at a case study. Benjamin Weiser wrote just such a piece for the New York Times, published on March 3rd, 2018, which highlighted the life of Nakesha Williams. Williams was raised in Camden New Jersey, and had excelled in High School, graduating third in a class of more than 200. She attended Williams College in Berkshire County, and became involved with African Dance, going on to create a show in her senior year illustrating African dance from its origin to modern hip-hop. She was awarded a prize named after the school’s first black graduate “for best scholarly work submitted by a Williams undergraduate in the field of Africana studies.” She was an inspiration to everyone who knew her. That was in 1993.

Fast-forward about thirty years or so, and Nakesha had taken up residence in front of the Helmsley Building located in Midtown Manhattan. She relied completely on passersby to supply her with basic amenities. Pamela Deardon, an executive with JPMorgan Chase, became good friends with Nakesha, often buying her packages of socks and undergarments. Sometimes she would have conversations with Nakesha that were not only cognizant but rather intellectual; sometimes, Nakesha simply talked to herself about people spying on her and watching her. Nakesha refused many offers of help from friends and family over the years, mainly due to paranoia, asserting in one email that “I’m [Nakesha] not homeless.” Nakesha died outside of a Barnes & Noble on July 22nd, 2016. She had faced years of turbulence as described in detail in the case study, which is well worth the read. Nakesha’s story illustrates how many people become victims of circumstances beyond their control, such as a mental illness, and wind up inexplicably living on the street. Sadly, there is no knowing how many others have suffered her fate, or how many will continue to suffer at the hands of ignorance and prejudice unless something is changed.

What is to be done? Currently, the DeBlasio administration has focused on building a record number of homeless shelters, a feat which they seem unable to accomplish in the face of community criticism. However, even if the shelters were completed, would the homeless demographic even take advantage of the shelters? Nakesha herself appeared in a televised news segment and was asked by a reporter her opinion on the Governor’s executive order requiring the homeless to be forcibly moved into shelters when the temperature dropped below freezing.

She replied that it “isn’t that easy… is it sanitary enough? Is it safe enough?” It was a moment that really displayed not only her intelligence but highlighted the issue with public homeless shelters: they typically aren’t clean or safe. Now this may appear to give credence to the complaints of community members against building the shelters, however increasing the number would lessen the demand on the few already in place, resulting in a greater number of cleaner and safer shelters. However, building shelters alone isn’t going to permanently help those who are homeless.  There need to be real, institutionalized programs in order to help those struggling with mental illness and substance abuse to find and keep housing.

There is so much that a few simple reforms could do for the homeless. For example, it’s a common practice to require substance abusers to go through treatment programs or even all-together stop the use of drugs or alcohol in order to be eligible for assisted housing. However, a study done by the New York University School of Social Work, authored by Deborah K. Padgett, found that just such “treatment first” programs had a negative effect on the retention of housing, which led to future relapses in patients. If someone is being forced into treatment, it isn’t particularly effective. This causes relapses, which leads to a loss of housing, defeating the purpose of providing intervention. Furthermore, although programs in which housing was offered regardless of substance use did not have a wildly different effect on future use, it did have a positive effect on housing retention, meaning that if housing isn’t tied to forced treatment, people are more likely to stay in that housing. If this policy was adopted, there would be many more people safely in assisted housing and off of the street. A similar issue exists among those considered mentally ill; many affordable housing establishments have very few onsite resources, such as an advocate, doctor or counselor, which makes it difficult for those with a mental illness to retain affordable housing. Most can live independent, normal lives; however, they may be unable to advocate for themselves in the event of a housing dispute, and often become the victims of other tenants or unjust landlords. Not to mention that a large number of the mentally ill spend time in and out of jail. The Corporation for Supportive housing has come up with an alternative to incarceration methods and has had great success in increasing the housing retention rate. This can even save the city money; it costs more to keep the homeless as inmates than to provide them supportive housing.Therefore, simply altering the services attached to affordable housing can greatly aid the mentally ill as well as the entire homeless population. Just making these few changes could drastically change the city for the better.

Knowing this, it’s safe to say that there is hope for the homeless. If communities can be informed about the truth of the homelessness crisis, and housing reform is achieved, then there could be real progress for an issue that has plagued the city for more than a century. The DeBlasio administration has promised a staggering number of shelters. Let’s hope that he can bring housing reform as well.