Monday, August 3, 2009

The Tragedy of Chronic Homelessness

The Dallas Morning News' current installment on homelessness in Dallas County sheds important light on a very tragic situation.

The easiest thing in the world is to talk expansively on what these people ought to do - at the end of the day, they will never be someone else's problem; they are our challenge. And, to use an old bromide, Kim Horner's excellent article proves that, its not whether or not we will pay for them, it is what and how much we will pay for.

Here's an excerpt from yesterday's article...

"There are between 6,000 and 10,000 homeless people in Dallas County, depending on who is counting and the method used."

"Of that total, an estimated 10 percent are defined as chronically homeless because they have serious mental illnesses, addictions and disabilities and have been on the streets long-term.
Experts say that even though the chronically homeless represent just 10 percent of the overall homeless population, they use at least half the services. Studies across the nation have found that each chronically homeless person costs taxpayers between $35,000 and $150,000 a year.
"With their random ricocheting through mainstream health and law enforcement systems, they are some of the most expensive people to the public purse," said Philip Mangano, former head of the U.S. Interagency Council on Homelessness in Washington, D.C."


"In Dallas, that ricocheting might go like this: A mentally ill homeless man gets arrested for public intoxication. After a couple of nights in jail, at $55.60 a night, he's released and back on the streets. He gets beaten up and spends a week at Parkland hospital. Then he goes to a shelter, where he becomes suicidal. He ends up at a psychiatric hospital at a cost of $373 a night. Then he's back on the downtown streets all over again."


"Patients often do not get adequate substance-abuse treatment, or the best medications for their illnesses under the existing system, said Dr. Ed Nace, a psychiatrist and president of the North Texas chapter of the Texas Society of Psychiatric Physicians."


""The bottom line is, it's very easy for people with chronic mental illnesses and addictions to fall through the cracks and to not have insight and emotional stamina to follow through with the care they would need," Nace said."


"Just three local homeless people had bills totaling $183,000 for 169 days in Dallas-area psychiatric hospitals and substance-abuse treatment centers between April 2008 and March 2009, according to ValueOptions, the company contracted to provide mental health care for the poor in North Texas."

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