By Susan Partovi, M.D. Santa Monica
I wanted to write in response to Mr. Jankowski’s letter entitled “Send the homeless packing” (SMDP, July 13, page 4). I probably cannot change Mr. Jankowski’s view of homeless people. However, I would like to educate the Santa Monica people who read this paper, who may have been persuaded by Mr. Jankowski that most homeless people are “freeloading, filthy … and act like a bunch of wild animals.” I am a home owner in Santa Monica and a physician who works primarily with homeless people at the Venice Family Clinic, UCLA’s Student Homeless Mobile Van, Homeless Health Care L.A., the JWCH clinic and Harbor-UCLA’s emergency room.
Firstly, as of January of this year, there are 91,000 homeless people in the county of LA, counted by the LA Homeless Services Authority. That’s more than any other metropolitan city in the country. All the shelters in LA County can only accommodate 9,000. Forty-two percent of the homeless in LA County are considered chronically homeless. Fifty-five percent of the chronically homeless have three or more disabilities. One-third to one-half are mentally ill. These are the people we see that don’t care about their hygiene and are often easily agitated. According to USC Keck School of Medicine Assessment’s of Mental Health Needs Among Homeless People, “the increase in the number of homeless mentally ill in the United States has been associated with the closing of state mental hospitals, a lack of housing, and a dearth of other critical support services for the mentally ill.” A study of the LA winter shelters last year showed that 11 percent of the winter shelter residents had come directly from being released from a psychiatric hospital — another 13 percent from a medical hospital.
Without the proper support services for the mentally ill, they will go off their medications, not be able to keep their outpatient appointments, and thus, will not be a functioning part of society. If they have no family to take care of them, they will end up homeless. From my experience, there is a higher incidence of mentally ill among the homeless on the Westside — most likely because it’s safer. One-third to two-thirds of the homeless population in LA County are substance users. Medical professionals consider substance addiction to be a chronic disease, much like diabetes or asthma, in need of chronic treatment and care. Many of these people are homeless because of their disease. Therefore, Mr. Jankowski, half of the chronically ill can’t “pull themselves up by their bootstraps” if they are physically or mentally ill.
Secondly, the Institute of Study of Homelessness and Poverty at the Weingart Center presented many statistics last year about the homeless in LA County. They found that 20 to 40 percent were currently — at the time of the presentation — had just been employed, however bringing in an income less than the level of poverty. In 1997, 76 percent had been employed for two years before they became homeless, 75 percent had had jobs for more than a year and 54 percent had had jobs for more than two years. You see Mr. Jankowski, many homeless people had “their act together” but lost their job. Without family support, if you don’t have a job, and you can’t pay the rent … then you are homeless. Most of the homeless people I have seen who aren’t physically or mentally ill, work or are looking for work. The decline in the economy doesn’t affect the affluent much — I will always have a job, a residence, food. But to the poor, it’s the difference between having a job or not; having a place to live not.
I can assure you I don’t enjoy seeing filthy people who smell on the beach or the park bench, or seeing people urinate in the alleys. Can you imagine, though, how hard it is to sleep on a park bench or on the beach every night? Can you imagine how hard it is to ask people for food or money? I can’t. I don’t think the answer is easy or quick, like a fence around a park. It probably involves long-term goals such as creating more affordable house in LA, creating proper support systems for the mentally ill, better healthcare availability for the poor and attempting to eradicate severe poverty in the U.S. in general by providing better education and child mentoring in high risk areas. Compassion for these people — and thus activism — is what we need to motivate our policy makers to make these goals become reality.
Originally published in the Santa Monica Daily Press print edition on July 28, 2005. Read the original PDF.