Lack to mental health services leading to more homelessness in Texas

From the intro to a story in the Dallas Morning News:

Richard Antwine's last home was the county jail.

The 47-year-old ended up there, again, after another round of homeless shelters, boarding homes and psychiatric hospitals. This time, it was because he failed to report to his parole officer. He said he missed the appointment because he was hospitalized. He has severe depression and was hearing voices telling him to hurt himself. His court-appointed lawyer said he doesn't belong in jail. "Somebody dropped the ball somewhere," she said.

Antwine's situation is all too common among the chronically homeless, those with disabilities such as mental illnesses who have been on the streets long-term. But it's not new.

Chronic homelessness resulted from a shift away from the institutions that once housed more than half a million mentally ill people. Get people out of the state hospitals, experts thought in the 1960s, and they can live on their own, thanks to medications that were new at the time.

But the mental health services that were supposed to help those people adjust came up short. And many of the people, including growing numbers of Vietnam veterans, were left homeless. In the 1980s, cities looking to revitalize their downtowns tore down the cheap rooming houses where the very poor lived. Finally, in the 1990s, the political climate made it difficult to get more government money for housing and mental health treatment.

The result is today's disjointed system of psychiatric hospitals, substance-abuse treatment centers and homeless shelters. It's a system that comes at a huge expense to taxpayers and doesn't come close to solving the problem.

"We've just come to accept the fact we have homeless people roaming the streets like we have rats roaming the alleyways," said Michael Stoops, executive director of the National Coalition for the Homeless. "We have grown accustomed to having human beings living on the streets. It's kind of a sad commentary."

On any given night, there are at least 1,000 chronically homeless people in Dallas and more than 124,000 nationwide. At the heart of the problem is a lack of mental health services, a deficiency that's especially acute in Texas.

The state ranks 48th nationwide in spending on mental health care for its poorest residents. And this lack of commitment goes back more than a century, if you believe Dr. J.A. Corley, the superintendent of Texas' first state hospital, the State Lunatic Asylum. He complained that the 9-year-old facility was overcrowded and underfunded after it had filled to capacity with 352 patients.

"Our sister state of California, though younger than Texas, has provided accommodations for over one thousand of her insane," Corley wrote to try to shame the Legislature. That was in 1870.

Such institutions were being de-emphasized by the 1960s, the first of a series of factors that have conspired against the chronically homeless. Among them:

•A shortage of affordable housing. Revitalization efforts in the 1980s led to the tearing down of cheap housing even as federal housing assistance programs were being cut. About 18,000 people are on a waiting list for housing assistance from the Dallas Housing Authority, and the wait is three to five years long.

"The bottom line is we have a housing affordability crisis, and it most negatively affects people on very low incomes," said Dennis Culhane, a University of Pennsylvania professor who has done extensive research on homelessness.

•Low disability benefits. Many of the chronically homeless receive disability checks of about $675 a month, hardly enough to rent an apartment and pay other living expenses.

•Disenfranchisement. People on the streets with mental illness have had little voice among lawmakers. This year, the mayors of Texas' largest cities asked for $50 million over two years to help the homeless. The measure is pending.

•Fiscal conservatism. Advocates for more housing and mental health treatment face a tough political climate.

"Over the last six years, there's no doubt that there has been a tone of fiscal conservatism that has perpetuated the reputation of Texas being stingy with mental health dollars," said state Rep. David Farabee, D-Wichita Falls, a longtime mental health advocate. Farabee said he's hopeful that federal stimulus money also will allow the Legislature to provide more mental health dollars.

•A fragmented system. Many homeless people fall through cracks because of a lack of coordination among social service agencies. A person leaving one psychiatric hospital, for example, may be told to follow up at an outpatient clinic. But if the person doesn't show up, the clinic is not likely to track him or her down because it has no funding to do so.

•Stigma. There's a lack of understanding that the chronically homeless are extremely vulnerable and need significant help putting their lives back together. Instead, they are blamed for their situation.