Mental Health and Substance Abuse- A Major Impediment to Resolving Homelessness

My work with The Salvation Army has brought me to a more thorough understanding of the issues and solutions in helping those struggling with housing instability, leading to homelessness.  One key factor has stood out as an obstacle to stability, which is the vicious and unrelenting pain of having anxiety, depression, and severe types of psychosis, as well as alcohol or other forms of substance abuse.  While challenging enough, when these problems involve children in families on the edge of instability, the work to resolve becomes even more intense, as I learned from a recent meeting with our local DFACS team in Augusta.

In 2024, there is an array of providers, including state and local government sponsored agencies, along with a variety of not for profits, focused on the care and treatment of behavioral health issues affecting our collective clients, who are on the edge of, or already experiencing calamity. Coordination among these agencies is lacking, as funding can be inconsistent, staff come and go, and while much good is being done, better collaboration is needed. 

A recent glaring example involved a woman in her 30’s, whose was from Augusta as was her mother. This young woman decided to live on the grounds adjacent to The Salvation Army’s Center of Hope in Augusta.  She wore a blanket like a veil over her head, resulting in the name “Mary Magdalene” being ascribed to her. Mary’s clothing was in tatters, and Mary was positioned close to a busy street, and was approached by many bringing her food, blankets, a sleeping bag, and clothing, and she was likely subject to forms of potential abuse. Various social service agency representatives coaxed Mary to accept help and move to a safer location, including the shelter nearby, yet she steadfastly refused to comply. 

Another tactic intended to help Mary was use of a “1013”, a legal mechanism for having someone sent to a local mental health facility for 72-hour evaluation, under the assumption that this person was essentially in a high risk for personal harm in this condition. Three times this was done, and Mary always returned to the same field, as she, on paper, complied with certain established protocols which meant she could not be held in treatment.  Later, I heard that Mary was treated for hypothermia as she was outside in 16-degree temperatures in February, which underscored the critical safety concerns of this problem, and the need for alternative solutions. Interestingly, there were opinions that perhaps Mary should be left alone to protect her freedom to do what she wanted, and somehow, we may be infringing on her liberties by forcing a solution against her will. That never made sense to me as her basic human dignity was under assault, and action must be taken to protect Mary from harm to herself.

A better solution was found when local judges assisted, especially the probate court judge, who was able to commit Mary to the local inpatient mental health hospital for longer term care, in the hopes that Mary could be treated and better, more humane solutions might be found for her. Using this approach, Mary could not be released until a care plan was developed and implemented, with the judge having to approve discharge from treatment. It has been over eight weeks since Mary was placed in inpatient treatment, and we pray for a favorable outcome for Mary.  I heard this week from the state hospital that Mary is doing fine, and her mother is now visiting her. It is hoped that Mary will live with her mother, although much clinical work needs to be done with Mary’s care and eventual release back to the community.

Homelessness is best addressed by finding simple wins, such as arranging for daily transportation from the shelter to the local outpatient mental health facility.  This would be just one daily route to and from two facilities. Perhaps local government transit could help. Maybe I’m a bit naïve, but this could be a less complicated accomplishment in the making.

Another solution, albeit more challenging, would be to train first responders to better utilize the 988 behavioral health hotline when dealing with acute psychosis-type situations. Taking patients to an emergency room might be counterproductive as patients often end up in holding rooms. Transport to a jail, of course, is a horrible alternative. In the Augusta area, there are behavioral health crisis stabilization beds where patients can be admitted for a 72-hour assessment, which would be a far better solution when beds are available. 

As work continues, prayer is a vital component in bolstering care givers and clients/patients alike. I would advocate for a National Day of Prayer and reflection on this crisis that cuts across all geographic and faith boundaries. The work needed requires coordination at a local, state, and national level, as people need hope and a sense of stability and sustainability.  With so many facing housing instability and other forms of poverty, particularly in a tough, struggling economy, the fabric of our society is being placed at further risk. Your support is needed and appreciated too!