June 22, 2005

Homelessness and Schizophrenia

A reverse approach to homelessness

About a dozen years ago, Dr. Sam Tsemberis started a program called Pathways to Housing. The program, unlike most housing programs for the homeless, provides housing before the person "gets better." Tsemberis "says the concept of housing the homeless before they receive treatment for drug addiction or mental illness isn't something he thought up. "It's what people told me they wanted," he said, referring to the men and women he met as an outreach worker in New York in the 1980s."

Most cities in the United States only reward the homeless with a home after they've sobered/cleaned up. But, Pathways for Housing,"sets up mentally ill homeless people in apartment buildings with other New Yorkers rather than hotel-like residential facilities with teams of social workers."

The people behind Pathways, realize that "for some homeless people, especially those with mental illness, staying clean and rational for an extended period is impossible," especially when they're on the streets. So, Pathways attempts to take the homeless off the streets and provide them with shelter while teaching them "to function in a rational world." But Pathways isn't unrealistic. One social worker for the program says,"We understand that (they might not) stop getting high," Marzan says. "But we can get (them) to take a bath and make sure (they) get...food stamps."

Pathways' harm-reduction model, which stresses protection over everything else, is winning converts. As word of its success has spread - 85 percent of the program's clients remain housed - duplicates are cropping up. Philadelphia, San Francisco and Denver are among a growing list of cities with "housing first" initiatives. Pathways serves 400 to 500 people a year and has an annual budget of $12 million. Funding sources include grants from foundations and the government, as well as benefits already available to clients such as housing vouchers and food stamps.


Full Story:


My son Jason was homeless for about 7 months. He was living at home but when he was hospitalized for a suicide attempt the social worker suggested that he join a program where they would have him in a dorm-type setting until he could find a job and a place to live. It was located in the same building as the homeless shelter. Everyday he walked around the streets of Nashville. He did not look for a job, he did not find a place to live. The only thing that he learned was how find drugs. It was a huge mistake for me to allow him to be placed there. When he missed curfew he moved to the Woodland Street bridge and lived under it for 7 months.
Thankfully he is now in an apartment, however he wants to leave and find his family that he believes is in Virginia (a delusion) I don't want him to just wander but I don't know how to stop him. He does not take medication (it's poison) He knows that he has some mental problems but refuses to believe that it is schizophrenia. I don't think that it is good for people to wander around with no one to help them. Any suggestions?

Posted by: Jason's Mom at June 29, 2005 08:37 AM

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