By GUEST COMMENTARY BY DAVID SIRKIN
I am another Santa Monica resident who is upset by the number of homeless people sleeping on the sidewalk and in the park. I am a psychiatrist, and I am pained by the sight of numerous homeless people, many of whom are probably mentally ill, lying on the ground next to their belongings. It angers me that in one of the wealthiest towns in one of the wealthiest countries in the world, we cannot take better care of our disabled persons.
I read your editorial, “Make the homeless uncomfortable” (SMDP, Oct. 28, page 5), and found much with which to agree. It made sense to me that if we report persons lying on the ground to the police, and the police pick them up, more homeless people might be channeled into shelters and into programs that might help them.
I work part-time at two community mental health centers, one of them in Santa Monica, that have contracts with the Los Angeles County Department of Mental Health. Both of these clinics are running under capacity. In fact, at one of them I recently received a memo urging me to schedule patients for more frequent appointments so that the clinic would not be forced to reduce my hours. Some of the patients at community mental health centers have relatively mild mental illness, while some of the most severely mentally ill, especially those who do not have family members or friends involved in their care, are living on the streets and are “out of the system,” meaning they are not getting mental health care and likely are not receiving disability income.
I called the police station and asked what they would do about any person I reported to be lying on the ground. I was dismayed to find out that if the person were in Palisades Park after midnight, the police only would ask him to leave the park. If the person were in a doorway, the police would do nothing at all unless I were the owner of the building. I was even more dismayed and shocked to discover that there is no cold-weather shelter in Santa Monica. Apparently, there are four buses leaving downtown Santa Monica between 5:30 p.m. and 8:15 p.m. for homeless shelters run by Volunteers of America in West LA and Culver City, but if a person is found lying on the ground in Santa Monica after 8:15 p.m., there is no place to which the police can direct him.
Recent news reports have informed us of the gross shortage of shelter beds in Los Angeles, but Santa Monica is supposed to be in the vanguard of helping the homeless. In a recent article, “Chronic homeless will get attention” (SMDP, Dec. 15, page 1), you reported one of our city councilmen as saying, “Santa Monica is considered one of the pre-eminent leaders on homelessness in the country.”
How can we claim to be a leader in homeless services when we do not even have the most basic homeless service there is — an emergency shelter to which people lying on the ground can be directed?
Let Santa Monica truly be an example to the rest of Los Angeles County and the nation. Let us make sure we have at least our fair share of shelter beds. Santa Monica has a population of about 85,000. Homelessness rates in the area are about 1 percent. Therefore, we should have at least 850 shelter beds. Given that Santa Monica is a particularly desirable destination for the homeless, and that Santa Monica is a particularly wealthy town, we really ought to have about double that amount.
What is needed is a large emergency shelter that actually should be open all year round, not just in cold weather. It should be located near the downtown area, so that it is walking distance from where homeless persons are concentrated. It should be able to accommodate a few hundred persons, and might include a separate room for overflow, or for persons who arrive, either voluntarily or at the urging of police, after 9 p.m. The overflow room could be less comfortable in order to encourage those in need of shelter to arrive early in the evening.
Once we have an emergency shelter in place, then it is reasonable to enforce laws and ordinances against spending the night in the park or on the sidewalk. We would need to have some new ordinances.
Lee Fernandez, in his letter, “There ought to be a law, or two” (SMDP, Dec. 3, page 4), suggested some good ones, including forbidding camping on city property. Others might include forbidding a person to bed down outside a building unless the person has access to toilets and showers inside the building. Enforcing such ordinances, and having the new shelter be limited in size, even if large, would prevent the shelter from being too much of a magnet attracting more homeless persons to Santa Monica.
“move on,” — Our current situation of having community mental health centers that are underutilized while many of the most severely mentally ill are lying untreated on the streets, neglected, or only told, is a cruel absurdity that has persisted far too long
We need a special detail of police to enforce these ordinances and direct persons intending to spend the night outdoors to the shelter, or to transport them there if necessary. In the daytime, persons lying on the sidewalk could be directed to community centers — or perhaps part of the new shelter — could be kept open for persons who need to rest in the day. Most homeless persons would soon learn to arrive at the shelter in the early evening or else to leave town. Our hope would be that nearby communities would soon follow our lead and open emergency shelters of their own.
Los Angeles County was just awarded $60 million by the U.S. Department of Housing and Urban Development to fund services for the homeless. Some of this money is earmarked for new housing in Santa Monica for 40 chronically homeless persons. While that is good news for 40 people, it will not reduce the number of people sleeping outdoors to the extent that a large emergency shelter could.
We should make funding such a shelter, along with the extra police officers to encourage persons into it, our first priority. As Lee Fernandez said, “If we don’t have enough shelters, then we just have to raise the money to build them,” (SMDP, Dec. 3, page 4). To add to what we can get from the federal and state governments, we might raise money locally by means of a progressive increase in the property tax rate. Wealthier homeowners and businesses should be glad to pay a bit more to the city to decrease the number of homeless people sleeping on the sidewalk and in the park.
It is difficult for social workers to work with homeless persons when they are scattered in the streets and parks. But once homeless persons are collected in a shelter, social workers could meet with them in the mornings to help them get services they need, including not only mental health care and substance abuse treatment, but also disability income, so that they can eventually pay for housing.
We also need to urge changes in the federal and state procedures for distributing disability checks. It makes no sense to give a $1,000 check to a mentally disabled person at the beginning of each month, when so many of the mentally disabled have poor money-managing skills and often also poor judgment and substance abuse problems.
Disability checks should be given to a housing provider directly — landlord, relative, or board-and-care-home operator — to pay for housing, and to disburse the remainder to the disabled person. The disabled person would be free to transfer check distribution from one housing provider to another but not to himself. In the meantime, until such changes are made, the city could take persons with incomes, but who nevertheless end up in the street, to mental health court to get a payee appointed.
Having a large shelter and instituting a no-living-on-the-street policy in Santa Monica could help encourage local hospitals to devote a greater effort to placing homeless patients at least in temporary housing when they are discharged. We recently learned from news reports that downtown Los Angeles hospitals have been “dumping” discharged patients on Skid Row. Well, our westside hospitals, including UCLA and the West LA VA, have their own variation, as I know from first-hand experience during my recent residency in those hospitals.
A patient being evaluated for treatment of mental illness can and should be held in a hospital involuntarily if he meets criteria for “grave disability,” which includes the inability, due to mental illness, to accept food, clothing, or shelter.
Not infrequently the conclusion of an evaluation interview at a westside hospital goes something like this: The patient is asked what his plan would be if he were allowed to leave the hospital. “I’ll live on the streets in Santa Monica,” he answers. How would he eat? “I’ll panhandle,” he says. Had he ever lived like this before? “Sure. I’ve done it for years,” he says. The patient is released from the hospital, and it is recorded in his chart, “Patient has a viable plan for self-care.”
If hospitals learn that living on the street in Santa Monica is no longer a “viable plan,” they may make more of an effort to place a discharged mentally ill homeless person in a shelter or in a board-and-care home.
Unless we go back to having large mental hospitals, and we send most of the severely mentally ill to them for long stays, there are going to be at any given time some mentally ill persons without housing, probably untreated, and possibly without income, who will need to be channeled to the resources that can help them in both the short and the long term. Our current situation of having community mental health centers that are under-utilized while many of the most severely mentally ill are lying untreated on the streets, neglected, or only told, “move on,” is a cruel absurdity that has persisted far too long. Let us show the nation that Santa Monica is truly a leader in caring for the homeless.
The essential first step is to open a large emergency shelter where all of those who are currently sleeping outdoors can have a roof over their heads. (David Sirkin is a M.D. living in Santa Monica.)
Originally published in the Santa Monica Daily Press print edition on December 30, 2005. Read the original PDF.