MENTAL ILLNESS AND THE HOMELESS COMMUNITY.

an essay by R.Marcus Gaudry
June 2009

In a recent edition of the Province newspaper, an article written by Staff Reporter Lora Gindlay indicates a great deal of residential unrest concerning a pair of low barrier shelters set up on Granville and Howe street. These shelters were originally set up in response to the record cold winter we had this past year. The complaint being first that the shelters were set up without residential consultation, and are being kept up much longer than anyone expected. Also, the residents feel threatened, as they have noticed a distinct rise in crime, noise and pollution in their neighbourhood. In the article, Lora quotes city councillor Kerry Jang, who responds to these complaints:

“We’ll see the nature and scope of the problems and if there’s anything emerging we’ll be on top of it right away. You’ve got to remember that area has had a large homeless population for a long time, long before the shelters ever opened.”

Jang admitted there was a lack of public consultation on the shelters because time didn’t allow it. *

A common thread can be found in newspaper articles like this one across the country, in the United States, and likely around the world. It seems the most frequently asked question in regards to the ever growing homeless populations in major cities everywhere seems to be "Where do we put these people?" It seems fairly rare that much comes up in the news to ask about helping these people with any real, lasting solutions to their current life situation. There are some exceptions, like one article from New York that was offer educational opportunities, but for the most part the news media appears to be all about housing issues, and it would appear nobody wants the housing in their neighbourhood. In the commentary of an editorial written by Daniel on CityCaucus.com entitled getting HEATed**, one of the commentators posed an interesting challenge in regards to this particular article. Where do these people come from? Are they genuinely Homeless, or merely tourists? Honestly, I cannot say for certain one way or another, nor is it really the subject matter at hand, but it is an interesting point to ponder.

While I do not dispute that finding housing for these people is an important element to look at, what strikes me as being even more important is looking at what sort of circumstances would lead one to a life on the streets. It may be easy to dismiss the matter to being caused by laziness, and to simply say they need to get a job, but before we can go there, it might be wiser to first take note of some of the obstacles many of people who live on the streets face in any effort in getting a job. I have had opportunity to to talk to several members of the homeless community - and I assure you they do indeed have a community among themselves - and have learned a few things from some very direct sources. To start with, many of them would "get a job" if they could, but since they have no set address, nobody will hire them. Since nobody is willing to hire them, they cannot establish a fixed address. Many of them have also pointed out that there are way too many "hoops" to jump through in order to get any real help. Out of frustration, they lose motivation. Clearly this would indicate a systemic problem.

To add to this conundrum, several are rendered unemployable due to physical and mental disabilities, and of course there is a very prevalent matter concern drug and alcohol addiction. In response to addiction, it may seem the easy answer is to say "then they should just stop drinking or using" I can assure you that this is much easier said than done, and anyone who is currently in recovery will likely tell you the same.






In light to what a profound factor addiction has on our growing homeless community,I am compelled to take a moments to speak to the crippling effects such a disease of body, mind and spirit can have:

addict: -n- a slave to a habit or vice, esp drugs.
addiction, therefore, is to be as a slave to said habit or vice.

Actually, Webster pretty much nails the seemingly hopeless state of body and mind, and the desperate state of spirit that is addiction to drugs and alcohol. Now to some of you that might sound silly. You may want to say "What do you mean? If someone doesn't want to drink or use, then they shouldn't drink or use!" Others may want to say "But many do stop, and that says a lot about their willpower! Kudos to them!" To that, let me say this:Many people, under their own power, quite simply can not stop. Every day they might tell themselves that today they are not going to have a drink, and by the end of the day they find themselves drinking. Sometimes only one or two, sometimes enough to be far beyond drunk. Often, it happens before they even really know what they are doing.

Sounds crazy, doesn't it? It's plenty more common than many might think.That is what it means to be a slave to a habit or a vice. When in an active addiction, there seems to be no choice. One becomes quite literally helpless. Bear in mind this state of body, mind and spirit has very little to do with the volume of consumption. What it has more to do with is the role it plays in ones' life. For the addict, the object of their addiction becomes absolutely central. It's like a deadly obsession, dictating every aspect of life and livelihood.

How does one get to this place? What causes this to happen to anybody? There are several factors to consider:

1) Mental illness Some people are born ill, or become ill later in life, and the illness goes unchecked. Chemical imbalances in the brain occur, and in order to compensate, a person may very well turn to alcohol or drugs as a form of self-medication. This, of course, may go on unknowingly and undiagnosed for years on end.For awhile, this self-medication trick may appear to work, but what happens is a dependence on the drug of choice develops, and the person seemingly cannot function without it, and over time, cannot function effectively because of their dependence.

2)Genetics It is also common to pass this disease, this allergic reaction in body and obsessive thinking from generation to generation. In short, some people are simply born this way. This again can actually be ultimately rooted in mental illness.

3)Abused/traumatic childhood In some cases, the distress associated with with a traumatic childhood can manifest itself into the same biochemical and neurochemical changes and imbalances that lend themselves into a variety of anxiety and depression disorders. For some, being brought up in an alcoholic environment, having drugs and alcohol prevalent in all affairs is what they are accustomed to. In many ways, these are things they associate with everything from mealtime to big family functions to any social event. Such an association is a difficult thing to rid oneself of. It quite literally becomes a fact of life, and is perceived as a necessity. That, and having grown up in a highly dysfunctional and abusive household as a direct result of alcoholism, many initially turn to alcohol and drugs as a form of escape. When under the influence, the illusion of escape has a very attractive and seductive lure. None of the concerns or worries of life might seem to matter anymore. As a result, much of life happens around them, good and bad, and went by unattended to. All for the illusion of freedom they believe they find in either a bottle or a drug of some sort or another. In more extreme cases, this illusion takes over so completely that one is willing to sacrifice everything to keep the illusion alive. Clearly what also tends to occur in such cases fairly often is a pattern of learned behaviour.

In short, what seems evident is that addiction and alcoholism is a prevalent issue in the homeless community. While this issue is indeed a very illness, a sickness of mind and body and most certainly of spirit, what also seems evident is that often addiction to drugs or alcohol or both in combination are initially a symptom of an even deeper issue that would pertain to each individual. Often, Alcoholism and drug addiction starts off as an attempt to self medicate.



I recently read a most compelling article on canadianchristianity.com The article, written by Dr. Colleen Hammermaster,*** addresses a very real social concern regarding the growing levels of depression in our communities. I am not talking about being "all bummed out" when something sad happens, it is typically difficult to accept. When some form of tragedy strikes, it is normal to be sad about it, or even profoundly upset or distressed by sad news. Anything else would be strange. No, I am referring more to a state of clinical depression.

Research reveals that cases of clinical depression, which is triggered by biochemical changes in the nervous system, tends to be significantly higher in individuals from families that have relatives that also suffer from this particular ailment. That is not to say that it is limited to family heritage, nor that we are talking about a case of "bad genetics", but that a family history of clinical depression may predispose an individual to developing the symptoms of such a challenge. Clinical depression can also arise due to situational stresses. Work related difficulties, family troubles, anger turned inward, feelings of guilt, etc may also build up, causing the body's biochemistry to shift and lend itself to a significant drop in serotonin, thus begins the onset of clinical depression. It is also fairly common that a combination of both causes may exist. A person with a genetic vulnerability to depression may become overwhelmed by an event or series of events, thus triggering that biochemical or neurochemical response.

1) Sad effect: A depressed person has a sad look. He or she often cries or feels like crying. He or she may look tired, or as if ready to "call it quits". An apparent loss of interest in personal appearance is also fairly common. One may try to hide their depression by smiling, but still the "sad, tired effect" tends to show through.

2)Negative/distorted thinking: Also called perception error. Often, a depressed person will exhibit a very introverted thought process-usually in a negative fashion. Self defeating thoughts that suggest he or she is not good enough(inadequate) or smart enough (stupid/dumb) or attractive enough (fat/ugly) will likely be prevalent. Also, one who is depressed is like to dwell on past mistakes, past wrongs, and worry about future situations, typically projecting what bad thing will happen next. In this negative self image, one will often expect that others see them as they see themselves, somehow "less than" or not measuring up to their expectations. As a result one will feel rejected or unloved. This manifests into an overwhelming sense of low self worth and insignificance or irrelevance-as if they are a nobody or do not count.

3)Physical symptoms: Actual biochemical changes in the nervous system during clinical depression. Obviously, I would think, any biochemical change is going to have physical results. Usually in clinically depressed cases, we can see a decrease in movement, insomnia or other sleeping disorders, eating disorders (over eating or food deprivation/loss of appetite,resulting in significant weight changes) , physical symptoms such gastrointestinal problems related to a change in eating habits are also common. Tension headaches are common as well. Often, people will believe they have some other physical ailment, or would prefer they did, in order to avoid the stigma often attached to mental or psychological conditions.

4)Anxiety: An increase in anxiety and irritability is also quite common. A clinically depressed person may tend to worry about everything, which is something of a hallmark for what is referred to as Generalized Anxiety Disorder (free floating anxiety), and typically expect negative outcomes and exhibit a tendency to be easily agitated.

You will notice that among the indicators mentioned as symptoms associated with depression is anxiety. This is because the two have very much the same effect on the body, the mind, and indeed the spirit. It could be perceived that the two types of disorders are effectively mirror images of each other, or two sides of one coin. Also worth noting is they are both caused by the same types of biochemical changes within the body.

Clearly, anxiety in and of itself is not a disorder per se. Everybody experiences some degree of anxiety from time to time. For example, the mild distress a student might feel night before writing an exam, or in the aftermath of a minor car accident. In such scenarios, and under normal circumstances, anxiety may even prove to be helpful. In the face of such short lived feelings of anxiety, a person may be prompted to study harder, or to alter their study habits in order to feel better prepared for their exam, or use the accident as a learning experience to pay closer to attention to their surroundings when driving. Should anxiety become persistent and interfere with the person's ability to cope or starts to disrupt daily living, We may be seeing signs of a disorder. There are several types of anxiety disorders to consider. Some examples of anxiety disorders include:

- panic attack or panic disorder (sudden anxiety that occurs without warning) with or without agoraphobia (avoiding specific situations that trigger anxiety)
- specific phobias (many types of intense fear reactions of specific objects or situations, such as fear of spiders, flying, or heights)
- social anxiety or social phobia (fear of being embarrassed in social situations)
- generalized anxiety disorder-GAD- (general feeling of anxiety most of the time)
- obsessive-compulsive disorder-OCD- (unwanted thoughts or behaviours that are repetitive and unnecessary)
- post-traumatic stress disorder-PTSD- (anxiety associated with and that occurs after a stressful life event)****

Of course there are many other types of mental illness, but depression and anxiety, which tend to be interchangeable, and are viewed by some as cousins in the mental health sphere, are most likely the most common. A common misconception, especially it seems in regards to the homeless community, is that people with disorders like anxiety depression can and should be able to get over them on their own. The truth is that this often is not the case. what is also true is that if these disorders go untreated for prolonged periods of time, the difficulty to "get over them" increases, and the results can be devastating; not only for the person with the disorder, but also for their loved ones, associates, coworkers, and in the case of those in the homeless community, the neighbourhoods in which they dwell.

Wow. It seems like one will have a tendency to isolate and dig themselves into hole they cannot get out of. It seems pretty hopeless, doesn't it? how does one overcome depression and/or anxiety?

There is good news. There, are, in fact, several treatments available today that can help. For many people in western culture, it would seem the obvious treatment would be some form of medication. After all, how many commercials do we see on the television for a pill to treat everything from constipation to insomnia to erectile dysfunction to depression? While these medications are effective, they can prove to be costly, and are normally intended to be a temporary measure which deals with the symptoms rather than the disorder itself. many of them have serious side effects,and can prove to create a dependence on the drug itself rather than actually solving the problem. What also should be noted is the body can develop a tolerance to some of these medications, therefore require either a larger dose or a new medication. There are some who would recommend only using medications as a last resort,and to use therapeutic techniques first, but a more common thought is to combine medication use and therapy. One very effective form of treatment is known as Cognitive Behavioural Therapy (CBT), which basically is based upon working with the person to change their thinking pattern. To this end, also encouraged would be things like support groups, and lifestyle modifications such as:

reduce caffeine consumption
reduce or abstain from alcohol consumption
reduce or stop smoking
practice relaxation techniques (e.g., proper breathing, yoga, meditation)
eat a healthy diet, sleep well, and exercise regularly
gain perspective by talking about your feelings with someone close or with a professional counsellor****

As was pointed out earlier, with only a few small exceptions, most of the media and political focus concerning the homeless community is placed on housing. On Tuesday, June 15, 2009, there was segment on the Bill Good show that again looked at the issues surrounding the shelters located on the waterfront on Granville and Howe streets. One of the panelists in this segment briefly suggested that we should be looking at how the people became homeless in the first place, but before anything could be said to address that inquiry, the focus shifted back to the question "where are these people supposed to go?" rather than "how did they get there?" To the best of my understanding, until we address the "how they got there" question, it won't matter where we put them, the same issues surrounding their inability to adjust manner of living will continue to persist, and continue to cause unrest.

Another question we may find ourselves asking is "What can I do? How can I help?"

These are very good questions. To tell the truth, every little bit helps. There are several churches, for example, that have started extreme weather mat programs to facilitate sleeping arrangements in extreme cold, snowy or wet seasons. Many of these same churches also donate clothing,toiletries and food to various charities, or run meal programs or offer food vouchers to those in need. Also worth mentioning is there are some organizations that even go so far as to offer both shelter and counselling for those who are interested. All of these are good starts.

Another important element that in some cases seems to be missing is communication. What I have found out, by actually stopping and having conversations with people who are living in the street, is that in many cases that act alone makes all the difference in the world. It tends to establish trust, friendship, confidence, and fosters feelings of acceptance. Establishing healthy lines of communication, to my personal experience, goes a long way to alleviate feelings of loneliness, indifference, and rejection. Some of the people I have stopped and talked to have even actually reported to me that that act alone has encouraged them to make an effort for themselves, that they started to believe they were worth the effort. Also, here some good suggestions to use in order to encourage new perspectives and ways of thinking:

-Stop trying to do it all. The attempt to be all things to all people is an exercise in futility, and is destined towards burnout, failure, anxiety and indeed depression. Remember that as we are the body of Christ, the body has many parts which serve different functions. Some parts are better equipped for different parts of Gods' work than others. Can an eye be an ear? Can an ear be a nose? Can a nose be a mouth? Can a mouth be an eye? And that is just the face I've addressed. Imagine the diversity of the entire body! Collen Hammermaster said it well in her article "A healthy self image is seeing yourself as God sees you-no more, no less." ***
-Change the way you talk to yourself. Have you ever thought about the manner in which you regard yourself? Seriously. We all make mistakes, so rather than talking down to yourself when you make a mistake, accept the error then take the steps required to correct it. We are Gods' creation, so to be constantly critical of oneself in a destructive manner is to be critical of Gods' creation, which is very much the same as criticizing God Himself. Doing this suggests God made a mistake in His creation, and such thoughts tend to alienate one from God, leaving a feeling of hopelesness and of course, depression.
-Build a sense of self worth. This is not to be confused with a sense of pride. The two are, in fact, very much polar oposites of each other. Pride focuses on the self, and makes all things about the self, and lends to living for oneself. Having a healthy sense of self worth is to appreciate what gifts God has granted one and then putting them to good use in His service

Excel in Giving

1 "Moreover, brethren, we make known to you the grace of God bestowed on the churches of Macedonia: 2 that in a great trial of affliction the abundance of their joy and their deep poverty abounded in the riches of their liberality. 3 For I bear witness that according to their ability, yes, and beyond their ability, they were freely willing, 4 imploring us with much urgency that we would receive[a] the gift and the fellowship of the ministering to the saints. 5 And not only as we had hoped, but they first gave themselves to the Lord, and then to us by the will of God. 6 So we urged Titus, that as he had begun, so he would also complete this grace in you as well. 7 But as you abound in everything—in faith, in speech, in knowledge, in all diligence, and in your love for us—see that you abound in this grace also."*****


**www.citycaucus.com (June 11,2009)
*The Province, June 9, 2009, Lora Gindlay, Staff reporter
***find more on Collen Hammermaster at www.canadianchristian.com
****www.bodyandhealth.canada.com
*****The Apostle Paul (2 Corinthians 8:1-7)