You are walking through downtown Washington. As you pass various buildings, you probably notice a number of men and women sitting on the sidewalk, on a park bench or just standing in front of a door. You recognize the same look of confusion and sorrow on each of their faces as well as their shared shabby appearance. Some often mumble out loud or shout at an invisible enemy. Others look at you, a stare of anguish in their eyes. Who are these people? They are the ones we call "the homeless."
If you are shocked by this apparently sudden flow of homeless people, it might interest you to know that the so-called homeless are not a new phenomenon; they are redefined mentally ill individuals, whose disorders range from mild depression to severe psychosis. According to statistics gathered during the past year at Sarah House, a shelter for homeless women, 97 percent of all residents suffered from some form of mental illness. Most shelter providers agree that a similar percentage of their populations also exhibit symptoms of mental illness.
What are mentally ill people doing on the streets? The answer is quite simple: society still hasn't learned how to deal with them. No matter what methods have been used from century to century, history clearly shows our constant inability to care for these people properly. The mentally ill have been killed, abused and neglected as though they were a curse to be eliminated.
During ancient times, mentally ill individuals were believed to be possessed by an evil spirit, and a surgical procedure called "trephining" was used to expel the spirit. Later, a shaman -- a witch doctor or medicine man -- was used to expel the spirit by physical means (beating, bleeding or starving the possessed) or by exorcising the spirit through psychic means (tricks, prayers).
During the Greco-Roman period, for the first time humane therapies were provided: the mentally ill went to special temples set aside as asylums, where they could recover with the help of rest, exercise, music and other therapeutic activities. Furthermore, physical explanations were offered for mental disturbances.
After the decline of the Greco- Roman era, humane threatment of the mentally ill disappeared. Demonology was resurrected to account for the many natural disasters that beset Europe during the Middle Ages. The mentally ill were viewed as the victims of Satan; while they were rarely killed, their treatment was often quite harsh.
After the Middle Ages came lunatic asylums and special methods of physical treatment -- both inhumane. In the asylums, the patients were chained, caged, starved, preyed upon by rats and left lying naked for years. The physical treatment consisted of bleeding, purging and cupping (placing small hot cups on the skin).
From the 1800s to the 1960s, state hospitals were the main source of custodial and therapeutic care for the mentally disturbed, who still were treated as outcasts unworthy of stepping into society.
Then came the "deinstitutionalization" movement, stemming from a belief that mental patients would receive better and more humanitarian treatment outside of hospitals. Another factor was the concern that in institutions, mentally ill individuals were deprived of their civil rights -- for example, the right to vote. But since neither the hospitals nor the localities planned proper transitions, large numbers of discharged patients found themselves on the streets with no support system.
Then, instead of getting the mentally ill out of sight, society gave them a new name, less repulsive: "the homeless." As a result, the symptom of homelessness was confused with the problem of mental illness, and the shelter movement began. So today, shelters have replaced the inhumane asylums of the Middle Ages, to become the humane asylums of the Age of Technology.
This means that once again society has found a way of segregating the mentally ill in shelters that, for the most part, exist in the worst areas of the city, where residents would never dare to take a leisurely walk.
We are kidding ourselves if we believe that by sheltering the mentally ill we are answering the problem. We are just putting a Band-Aid on a very deep wound. We are still not addressing the real issue: mental illness.
Quite a number of programs exist for the mentally retarded; they are given opportunities to live and work among everybody. Why not the mentally ill as well? Are we too frightened to look at those who suffer from emotional disturbances? The mentally ill are people who can, through a proper system of comprehensive services, become active participants in their cities, towns and neighborhoods. In Washington and elsewhere we shouldn't have to enter yet another century without having tried to address seriously the real causes of "homelessness."