On the Streets: Will Any Leader Make a Difference?

Some may feel that if we only elected the right President, all of the homeless people would be off the street and would receive the health care they need. Having taken care of these fellow folks in many years past, I can tell you that if it were that simple, that life would be a dream for all of us.

Nearly 90% of indigent individuals living on the street suffer from mental illness. They are on the street because they are using the freedom given them ever since the deinstitutionalization of mental hospitals was realized in the 1950s, with the new availability of miraculous agents such as Thorazine. One need only peek into the cavernous emptiness of the ancient state mental hospitals, such as Dorothea Dix Hospital in Raleigh, NC, one of the pioneer facilities of the late nineteenth and early-to-mid twentieth centuries, and one will know that the inmates have long since departed to the streets, and they prefer to stay there (or, many, in municipal shelters). They will also be notoriously non-compliant with non-psychiatric medical care. This is both the price and cost of freedom, for even the "least" of us.

My concern, when I hear misguided, resurrected ideas that government, and government programs, know best how and where these individuals should live, is that I am hearing echoes of liberal fascism's past: in the state lunatic hospitals in the Germany of the 1930s, where such persons were taken out of sight of people on the street (and ultimately out of sight of anybody). The point is that one cannot have it both ways.

Health care is certainly on the agenda of both presidential candidates, but we should all focus on what is helpful, reasonable, and possible health care, without depriving people, both mentally infirm and mentally productive, of their freedom. Thinking with a bleeding heart rather than a brain is a sure way to stumble badly on this problem.