The problem of medical-psychiatric illness in the homeless and its occurrence in the midst of a viral pandemic: A commentary

Psychopharmacologists and the Medical, Legal, and Societal Problems of the Homeless Mentally Ill

“…• With either voluntary or involuntary treatment, appointment of a significant other or designated long-term case worker to monitor those with chronic severe mental illness and ensure living and treatment needs are met. 6 • Revisions of laws to more specifically and adequately address the issue of impaired decisional capacity-the legal companion to subverted rationality. In the courtroom, judicial decisions regarding involuntary treatment need to focus on lack of insight into having a disorder, the need for medication, and the ability to perceive actual benefit achieved from treatment.…”

“…For these individuals, this help may save a life or spare them from assault, rape, or robbery on the streets. 6 It can also keep decisionally impaired patients in treatment. Use of Institutions for Mental Disease (IMDs) can serve persons whose treatment needs cannot be met in the communitythey can be placed in these institutions to provide food, clothing, and shelter while their behavior is closely monitored in a locked setting and needed medication administered.…”

Untreated Mental Illness Has Created a National Tragedy

“…1 People experiencing homelessness die in our streets every day, and the rate at which they are dying is increasing. 2 The determinants of homelessness are complex and different for everyone, with psychiatric illness and addiction as primary drivers. 3,4 The California Policy Lab at UCLA has found that mental health conditions affect 78% of unsheltered people, substance abuse conditions affect 75% of the unsheltered population, and 50% of the unsheltered are "trimorbid"-affected by physical impairments, mental health impairments, and substance abuse conditions.…”

“…We believe this is due to a longstanding historical dualism between medical illnesses and mental illnesses, when in fact they are scientifically one and the same. 2 Untreated schizophrenia, like all forms of psychotic mental illnesses, is a genetically determined, medical disorder. Many small genetic mutations-more than 100 at the time when we wrote this article-determine 80% of the known vulnerability for schizophrenia.…”

“…Homelessness was deemed a “crisis” before the economic disruption and devastating housing insecurity brought on by the COVID-19 pandemic 1 . People experiencing homelessness die in our streets every day, and the rate at which they are dying is increasing 2 …”