Tag: homelessness

Mom Was Homeless for Christmas. Never Again!

Mom Was Homeless for Christmas. Never Again!

mikegaeta

(This is a revision to a post I wrote in December 2016. It lost its focus halfway through, I recently realized.)

The end of the year holidays and winter cold were some of the hardest times for me and my family, since around 2010. Since then, my mom’s housing was unstable at best. The worst of it was punctuated by her being effectively homeless for two of those years, 2010-2012. In that time period, very short housing stints aside, she primarily lived in a car.

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Mom and I on our way to Marie Callender’s for Thanksgiving in ’15.

I’d do my best to spend Thanksgiving and Christmas with her, regardless of her immediate living situation. From the Bay Area, I’d drive down to meet her in Bakersfield or Fresno, take her to Marie Callender’s, her preferred restaurant choice, and usually put her up in a hotel room, so I could spend extra time with her.

I’d, also, take her shopping for some clothes and undergarments.  She’d regularly have minimal clothing. Clothes that she’d buy or I’d buy for her would, typically, disappear within a couple of months.

She’d claim people would steal them from her car or from the places she was living in. I knew, though, that she probably threw them out. That was her modus operandi, after all. When pressed enough with questions, she’d say they became contaminated with toxins or spoiled by evil spirits. “The devils tried them on!” she’d exclaim.

This is what the holidays were for me. There was no real respite or joy from my time off of work. It caused me immense emotional pain to visit my mom, since I knew my mom preferred to live with either me or my sister. I despised the system for her feeling abandoned and/or unloved.

We had tried to care for her, of course, in the past. Me, in San Francisco, in the summer of 2009. My sister, for a few months, in San Diego in 2005. But it proved to be too difficult and stressful.

My mom, unfortunately, refused to accept psychiatric treatment. While she had her “good days” and could appear functioning or “normal,” going back to at least 2009, I could discern she was in a psychotic state a majority of the time.

Delusions were definitely there most of the time. She believed and openly claimed people and the F.B.I were spying on her and following her. She, also, experienced hallucinations. The “good voices” were the “Gods.” The “evil voices” were the “devils and witches.” She would “talk to herself” for hours, including throughout the night, at times. Interestingly, in more recent years, she learned to talk to herself quietly, outside of acute episodes.  If I couldn’t hear her, I could still see her lips move.

Her medical and psychiatric conditions would both deteriorate over the years, from her not being able to take adequate care of herself. In fact, beginning in around 2014, hospitalizations would become a regular occurrence. In my estimation, she’d be hospitalized every two months, on average.

By this time, she had developed congestive heart failure, cataracts and a schwannoma (a “benign” brain tumor), to go along with her diabetes. Like clockwork, she’d regularly stop taking her various medications, which would then exacerbate her medical problems. Her CHF would cause breathing/respiratory problems and her glucose level would become life threatening, often times reaching over 400! In 2015, this would culminate in my mom and I spending our Christmas in a hospital. She would be intubated for four days, including Christmas day.

By then, I had had enough. I couldn’t take seeing my mama’s health deteriorate, particularly her physical health. At only 63 years old, she’d have to walk with a cane and, sometimes, a walker. There were even times when she had to use a wheelchair.

I remember the first time I saw her in one. She looked so feeble and dejected, with her head hung down and food on her shirt. My mom was prideful, beautiful and strong! Despite all she was going through, she’d still do her best to assure me she was doing OK and getting better, when I’d inquire about her condition/situation on a visit or on the phone.

In mid-2015, I decided to start looking for housing for my mom and I. It took me longer than it should have. One place I secured, in December of 2015, fell through when the dishwasher sprung a leak and flooded the floors, the very first week I moved in. When I began my search, I certainly didn’t think I’d end up in Modesto. I signed the lease for a nice single family home in mid-February 2016 and moved mom in the following week.

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Mama after helping decorate the tree in ’16.

As difficult as most of this past year has been living with my mom, I find much peace and consolation in knowing she’s physically safe. In the least, I don’t have to spend any sleepless night worrying about where and how she is, like I used to before. It hit freezing temperatures for the first time this winter this past week. Letters my mom would write to me, exclaiming how cold it was living in the car, have given way to complaints that the house is too cold at 65 degrees.

Tomorrow is Christmas and my mom has been able to enjoy her first Christmas tree in about ten years. She’ll, also, have presents to unwrap and a delicious meal made by our friend, Shari. She’s still greatly distressed psychiatrically, but I have, more or less, been able to help medically stabilize her. She takes her medicines and goes to all her doctor appointments, mostly.  For me, my blood pressure is the best it has been in years. For these things, we are grateful.

(My beautiful mama passed away in late February last year. While she was weaker, from stage 4 kidney disease, and more aloof in her last months, I did the best I could to make sure she had a good Thanksgiving and Christmas, nonetheless. She was, of course, greatly missed this past holiday season. I love you mom! Happy New Year!)

San Francisco Liberals Are Split on How to Help People with Serious Mental Illness. They Also Don’t Want to Spend The Money.

San Francisco Liberals Are Split on How to Help People with Serious Mental Illness. They Also Don’t Want to Spend The Money.

mikegaeta

The homelessness crisis in San Francisco has put a spotlight on another crisis, the plight of people with serious mental illness (SMI) who are too sick to help themselves.

According to the Treatment Advocacy Center (TAC), approximately 3.3% of the U.S. population (8.3 million) live with bipolar disorder or schizophrenia.

As any SF resident knows, the intersection between homelessness and SMI is a significant one. According to TAC, around 30% of the chronically homeless are reported to have a SMI.

Of course, mental health services for this group are available. But for too many, they are inadequate, if not impossible to receive. In fact, about half of people with SMI are untreated at any given time. Without effective treatment, too many are left to suffer in the streets or their cars, under bridges or subway tunnels.

To address this crisis, local State Assembly representative Scott Weiner, with support from SF mayoral candidate London Breed, is sponsoring SB 1045. The bill would make it easier for a court to place a conservatorship on individuals who are deemed unable to adequately take care of themselves, as a result of their serious mental illness. As a former conservator, I understand they are absolutely necessary for many people with SMI, but Weiner’s and Breed’s solution falls well short.

In socially liberal San Francisco, from Patient and Disability Rights groups, to the ACLU to social justice activists, the bill has plenty of critics and opposition.

Yet, how humane is it to let people with SMI suffer from psychosis, and in many cases, untreated and deepening psychosis? The research is clear that the longer people go without adequate treatment for their SMI, the more difficult it is for them to recover. This group is also extremely vulnerable to physical and sexual violence. On Twitter, Wiener regularly makes this point.

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And the reality is current law already allows authorities to involuntarily hospitalize (i.e. 5150) someone. Part of the problem is that the legal concept “gravely disabled” is interpreted far too narrowly.

Basically, one is gravely disabled when he or she is unable to provide food, clothing or shelter for themselves, as a result of their mental illness. However, authorities, from police officers to field clinicians, often say that homeless people are “self-directing” enough to not warrant a 5150 hold “as long as a person on the streets can say where they are going to sleep for the night,” even if it means sleeping behind a dumpster.

This despite the same person endangering themselves by running in traffic thirty minutes earlier and not actively being under psychiatric treatment for their known SMI.

Weiner’s bill recognizes this absurdity and includes a person’s medical and psychiatric history in evaluating whether or not a person needs to be involuntarily hospitalized and placed under a conservatorship.

Where will these people be treated, however? As mentioned above, about half of people with SMI are untreated at any given time, meaning their chances of experiencing acute psychotic episodes are very high. They will require immediate stabilization. For many, that means both medical and psychiatric stabilization and treatment.

Are there enough inpatient psychiatric beds available for the necessary medium to long-term stays? Nationally, the number of inpatient beds available has been slashed in the U.S. over the course of many decades. For example, from their historic peak in 1955, the number of state hospital beds in the United States had plummeted almost 97% by 2016.

This no doubt has contributed to the fact that prisons and jails are the biggest mental health treatment centers in the country.

Beyond a small number of advocacy organizations and outraged family members of loved ones with SMI, nobody talks about this national disgrace. As one such family member, imagine my surprise when I learned SF mayoral candidate Mark Leno makes this very point.

From his webpage: “Mental health policy experts recommend supplying 50 in-patient psychiatric beds for every 100,000 residents in the total population. In San Francisco, that would add up to over 430 beds. And yet, a 2016 policy analyst report showed that San Francisco only offers 163 beds.” He goes on to say that he will add 200 inpatient mental health beds, doubling the supply.

homeless-chicagoWithout doing this, Wiener and Breed are putting the cart before the horse. At worse, it looks like they are trying to appease business interests in the city that want the streets desperately “cleaned up” more than they are trying to help those with SMI and their families.

Because you have to wonder, why is this all of a sudden an issue now? No SF official was interested in helping me when my mom was living with me in SF in ’09. In fact, SF General Hospital released my mom prematurely on more than one occasion, even though she clearly needed psychiatric treatment. They fail to treat or release people prematurely because they don’t have the bed space. A representative in SF Behavioral Health told me as much.  I was her conservator at the time and the city failed to help me help my mom.

So again, why? Yes, part of it is the increase in the homeless population. The other part is the “nuisance problem” being caused by increased homelessness. It is hurting the business climate, plain and simple. This should not be the main basis for helping people that are homeless, especially those with serious mental illness and addictions.

The U.S is ranked 29th among 34 countries in the Organization for Economic Cooperation and Development (OECD) in supplying psychiatric beds. It is a sign of inadequate healthcare, not freedom.