Our Fractured System...
Many of you know that my sister had been homeless for years, addicted to drugs, and suffering from mental illness. She was in and out of emergency rooms, inpatient behavioral health units, crisis housing, and the like. I’d get the call most of the time, whether from police, PERT, or hospital staff.
It was a profoundly frustrating experience, especially for a fairly well connected person in health care and politics, because the system is so broken. I mean, seriously freaking broken. I was not afforded the tools to help her help herself.
“Oh, you’re an interested and resourced family member who would like to help? Too bad.”
Road block, road block, road block...everywhere you turn. If I couldn’t navigate the system, knowing what I know and who I know, then how the heck is anyone else doing it?
“Want conservatorship? Tough. She needs to be on the verge of death for you to get conservatorship in this County.”
Other counties? Much easier, but the second she crossed a county line, that conservatorship from another county was null and void.
I was told by some people that as long as she got housing, everything would magically turn around. It’s about her having a roof over her head, don’t you know?
Now, I’ve worked in politics (and Emergency Medical Services) for too long to not be highly skeptical of such promises. I didn’t believe it. From my experience and perspective, unless you address the underlying behaviors and illness that led to her being homeless, she would simply become homeless again.
And that’s exactly what happened...the underlying behaviors would invariably rear their ugly head and she’d be homeless again...over and over and over again. Been there, done that.
Then late last year she went missing. As in, she dropped off the face of the earth. Law enforcement couldn’t help much because missing persons cases for someone who is not on a conservatorship are not a high priority.
I didn’t tell anyone at first. Only some people in the family knew. When we hit dead ends, I decided to do the detective work myself. Tracked spending and phone records up until the moment she disappeared. Talked to countless people. I even took to Facebook to talk about what was happening. I revealed this private information at several speeches I made on the challenges in the mental health system.
I kept pushing, mainly with friends in and out of law enforcement and health care. Most of the people I spoke with privately told me to just keep checking the morgues. This was the inevitable, predictable outcome of someone at the mercy of a broken system that has been neglected by society for far too long.
Then, after weeks of searching, one of my personal connections found her. Alive. She was living at East County Transitional Living Center in El Cajon. She had finally decided to address the underlying behavioral issues.
Fast forward to today: She’s been clean and sober for more than eight months. No alcohol, drugs, or even tobacco. She works (something she’d never done before eight months ago). She has a community that doesn’t involve drug dealers and people who take advantage of others. Her community now is made up of people who made the same decision to move away from mistakes of the past and take a different path.
I guess the key takeaways here are several fold:
- The system is broken and is so because of decades of neglect at the government level. Misaligned public policies, poorly thought out regulations, terrible financial reimbursement, limited overall investment, and an ever changing set of ideologically driven fix it plans have further fractured an already broken system.
- If we want to address poor outcomes—the downstream impacts—then we must get serious about proactive, preventive, upstream efforts. We absolutely have to address the underlying behaviors that lead to homelessness and a variety of other social ills. That means taking responsibility, acknowledging that certain behaviors are not conducive to successful outcomes, and changing those behaviors.
- There are countless, thoughtful, intelligent, experienced people working in the behavioral health space who have ideas that need to be heard and pursued.
- There is no single thing that needs to be done to fix what is broken, but rather a series of reasoned, rational approaches pursued, implemented, tracked, and adjusted over the course of time. You can’t make up for decades of neglect in one year or one budget. It’s not a partisan issue, or at least it shouldn’t be. People need to work together.
Let’s get started.