Saving Money and Doing Good for the Mentally Ill

The weather’s getting warmer at last, which means we’re going to see more shoppers on the sidewalks and more homeless folks seeking donations. We can argue about ideas like banning panhandling Downtown, but there’s one thing most people agree on: the root cause of homelessness is usually mental illness, and like many Americans with mental illness, homeless people tend to refuse treatment, and only get it when they do something illegal and get arrested. (For more on that, see this book.)

I was pleasantly surprised to read an article in last week’s Journal of the American Medical Association praising Allegheny County’s special program for mentally ill offenders. I didn’t even know we had one. Turns out that since 2001, we’ve had a special court system that tries to divert offenders into treatment instead of jail. It doesn’t always work, because they have to agree, but a few hundred more people are getting treatment as a result. More importantly, the county saved about $18,000 per patient (estimated at about $3.6 million by the JAMA article). That’s a big chunk of change.

We don’t often get stories around here of our local government doing the right thing and saving money, and I’m glad to have something positive to call attention to.

2 Comments so far

  1. Rob (unregistered) on April 24th, 2007 @ 6:03 pm

    “The root cause of homelessness is usually mental illness.”

    I’d debate that. The chronically homeless do tend to have far more mental illness, especially if one includes substance abuse (which is often an attempt to treat underlying mental problems).

    But if you look at all the people who have been homeless, the most common number of days that they were homeless is one. The second most common number of days is two. Homelessness is often a breakpoint. The mental illness aspect of chronic homelessness may not be cause but effect in a large number of cases.

    The Pleasant Hills Community Presbyterian Church tried to set up a place for suddenly homeless people to learn about getting housing and assistance, but the local zoning board shot that down, saying that PHCPC ought to engage in more local efforts, in their opinion. The government told the church what the government thought was appropriate for the church to do.

    The current system, with shelters and other programs, is horribly inefficient. It’s often cheaper to provide rudimentary housing than the standard shelter system available in a lot of cities. It also provides access to emergency housing for the suddenly homeless, and can prevent families from being torn apart or descending into chronic homelessness.


  2. Alik Widge (unregistered) on April 24th, 2007 @ 9:10 pm

    I agree with you 100% about the shelter system being inefficient, and with the fact that government (and our favorite local NIBMYs) needs to interfere less with the efforts of groups that are just trying to help.

    I do object to the idea that “The mental illness aspect of chronic homelessness may not be cause but effect in a large number of cases”. That doesn’t have face validity. Sure, being homeless can exacerbate mental illness (no ability to get meds or other health care), and it could trigger an underlying depressive disorder, but things like schizophrenia aren’t *caused* by homelessness.



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