How is a homeless shelter expected to maintain the health and well-being of individuals with a mental illness or emotional issues, when no doctors are on staff? How is a homeless shelter expected to ensure the safety and comfort of individuals who require respite care, when no nurses are on staff? How is a homeless shelter supposed to help individuals with substance abuse or addiction issues, when no therapy is ever offered?
These questions run through my head often, as I observe chaos wreaked on the shelter by a few individuals. Individuals who need care that a homeless shelter is ill equipped to provide.
When there is yelling in the men’s area, the cause is usually someone fed up: a mentally ill client, a client who requires respite or a client with substance abuse issues. A mentally ill veteran who is told every day to shut up because he talks too loud isn’t receiving quality treatment. Having people yell at you every day, telling you to stay away from them, doesn’t feel very honorable.
Clients in need of respite care that hear ridicule when their walkers are screeching across the cement floors in the middle of the night have a heavy burden. Having people complain when you go to the bathroom or dispose of support garments in the bathroom can cause more embarrassing accidents to occur.
A client with substance abuse issues who is delusional and talks and moans all night while others are trying to rest doesn’t help anyone’s mental health. And not having any sort of programming in place to encourage treatment is a disservice to everyone.
But yet the county continues to be unable to provide solutions to the problems it is well aware of.
I’ve written about the inadequacies of the shelter environment before and I’m writing about it again due to the county choosing to build a new jail rather than building a mental health facility. Even though the urgent need for mental health services has been well documented. The public favors such a facility since the county is severely behind in providing treatment services.
Nationally, roughly 20% of people in jails suffer from serious mental illness. In California, that rate is even higher: 31% of the state’s jail population had an open mental health case in 2019. About 44% of individuals in the Santa Clara County jail suffer from a serious mental illness. According to a recent study, the county has approximately 18 inpatient mental health beds per 100,000 residents, below the state average of 21 per 100,000.
So with all this, and probably more, information about the urgent need for an adequate mental health treatment environment, the county chooses to put this problem on the back burner again. Apparently pursuing a split project—a jail and a new mental health facility—or multiple projects at the same time is too daunting of a task for our county.
Although the county is open to exploring alternatives other than incarceration for those with mental health issues, with the governor proposing CARE Court, which largely focuses on severely mentally ill homeless individuals, I don’t see what alternatives the county will be seeking.
If CARE Court orders a homeless individual to a mental health facility that does not have enough beds—which is currently the case for the county—or even worse, ordered to a facility that does not yet exist, where does that individual end up? They end up in jail. Again taking mental health treatment from medical professionals and placing it in the hands of the correctional department.
Currently the county is placing its mental health responsibilities in the hands of unqualified nonprofit agencies, by sending mentally unfit individuals to congregate shelters. The management of these nonprofits continually place their employees in a position to fail by allowing the county to dump severely mentally ill clients at shelters along with disabled individuals who are in dire need of respite, and substance abuse individuals who are in dire need of treatment.
The county has a location it utilizes for homeless individuals who require respite, and it’s obvious one location isn’t enough. And addiction treatment facilities would be included within the mental health facility plan, but who knows when that facility will ever break ground.
It’s hard to understand why a new jail takes precedent over building a mental health facility, given the known trend of homelessness increasing in the county. If more and more people are becoming housing insecure and larger numbers of people are becoming homeless—because tiny homes and shelters aren’t homes—then I would hope additional relief services would be put in place to help people deal with the trauma and difficulties of being homeless.
So when a mental health emergency occurs—that’s when and not if—there’s other options to a jail cell. We’ll just have to wait and see what alternative solutions the county comes up with in this too long fight for people’s dignity and rights.
Jerome Shaw is homeless and living at a HomeFirst shelter in Sunnyvale. He’s a leader in the Sunnyvale Clients Collaborative—a union of homeless shelter residents in the region—and is part of a group of homeless columnists writing for San José Spotlight’s In Your Backyard column to shine a light on the homeless experience in Silicon Valley.