Saturday, May 16, 2009
Heckuvaday, Part II
In Which We Make Unexpected Connections
After I got home from the hospital, I ate lunch, decompressed a bit, and headed off to the NAMI walk here in town. I've been intending to join NAMI, or at least get more information about it, for ages now, but this is the first time I've actually done something, thanks to a woman I met at church -- actually, at our visiting Lutheran congregation -- who announced the walk.
Because I got there late, I didn't get to do the actual walk or hear the speakers. But I did get to meet the keynote speaker, Patrick O'Bryan, a local police officer who helped start the Mobile Outreach Safety Team to serve the homeless mentally ill and addicted. O'Bryan is also the head of the Reno Crisis Intervention Team, a police unit specially trained in mental-health issues. He's a huge force for compassion in Reno, and it was an honor to talk to him.
It turns out that O'Bryan's wife is a lecturer in my department; I'd heard her name a million times, but never met her, so he called her over. She'd heard my name a million times, too: small world! We had a nice chat, and have many interests in common.
O'Bryan was also featured in an article in the February 13, 2006 New Yorker. Among other things, the article discusses the social costs of homelessless; a very small number of chronically homeless people account for most of that cost. (In other words, 10% or less of the homeless account for 90% of the ER and other costs in any given city.) To save money, a few cities -- including Denver, Washington D.C. and Seattle -- have started programs where the hardcore homeless are given free housing, no strings attached.
The hardcore homeless are those who've flunked social services, been washed out of every available treatment and recovery program, and keep showing up in emergency rooms. To get the housing, these clients don't need to be straight, sober, or medicated; in fact, they need to have proven unable to maintain consistent recovery. A social worker is attached to the building, and I think some basic healthcare is provided too, but the clients do nothing to "earn" any of this. Nonetheless, once they're in safe, stable housing, the hospital visits decrease dramatically. Society saves money: a lot of money.
Although these programs are successful from an economic standpoint, they're also very controversial. Critics object to "rewarding" people for being a social burden, and think it's wrong to help people who've repeatedly proven unable to help themselves.
As you can probably guess, I'm a huge fan of this program. The minute I read the New Yorker article, I started talking it up in the ER, which gets its share of hardcore homeless. I intensified my efforts after the infamous scapegoat episode, and even got one of our more conservative physicians to admit that it sounded like a good idea. I hadn't heard anything about a program like that in this area, though.
So today I asked O'Bryan about it. He's a huge fan of the program too, and -- yay! -- he's trying to start it here. He thinks it's possible. He's been talking to the legislature. I asked what I could do to help, and he said, "Write about it. You blog? Blog about it."
So here I am, blogging. When I get more information, I'll let you know!