A homeless woman waits at the door of the shelter. It is not long before someone opens the door.
"I'm back on the street. I need a place to stay," she says quickly.
"Come on in, we'll talk," a staff member replies.
This scene is unfortunately too familiar to all providers of shelter for women. It reflects what some call the recycling of homeless women: the coming and going from shelters, in and out of homelessness. It refers to women who move from shelter to shelter. For some, this has become a way of life. And it refers to those who leave a shelter and either work or receive financial assistance until they are homeless again a few weeks or months later. This phenomenon, which is as old as the shelter movement itself, is a constant frustration to the providers. How does it happen?
It happens as a result of several factors: society's prejudice toward homeless women, flaws in services offered to them, a lack of understanding of their special needs and a lack of programs in shelters.
When we say "homeless" women, we are being somewhat misleading, since a majority of them suffer from mental illness. Yet when we focus on the words "mental illness," too often we foolishly believe these words represent a state of mind that separates the population into two parts: healthy and sick. As long as we look at mental illness in such a destructive way, the goal tends to be to push into oblivion those we have defined as sick.
On the other hand, when we focus on the word "homeless," the tendency is to find a home for these individuals and totally disregard their emotional difficulties. We need to focus on the three words -- "homeless mentally ill" -- if we intend to end the kind of recycling now going on.
For those who are already in a shelter, therapeutic treatment should be established. Unfortunately, the shelters are not equipped to provide such treatment. One reason is that most lack the necessary funds to hire mental health professionals; the other reason is that these professionals tend to stay away from settings such as shelters.
Furthermore, for those shelters in which some kind of therapeutic assistance does exist, it has become quite clear that traditional therapeutic treatments are very limited when used with shelter residents. A different approach has to be developed -- one that might combine Eastern and Western World approaches and that could produce behavioral as well as intellectual changes.
Another phenomenon that occurs inside the shelter is spoon-feeding -- the too-frequent tendency of providers to do things for their residents: to make decisions for them, to behave as caretakers without allowing them to think or do for themselves. This kind of "help" can only foster dependency and block anysense of responsibility. It ignores the uniqueness and special needs of each individual.
True, allowing someone to make her own mistakes and perhaps learn from them may be more time consuming, but it can guide her toward independence, responsibility and self-esteem. We should remember that we are not parents for a population of homeless women, no matter how great the temptation to believe so; we are providers of services.
Just as the rest of us need support systems of friends and acquaintances, so do the women we are serving. Yet once our residents leave the shelter, they are faced with new lives with little or noth systems. We should consider shelter programs that would allow residents to deal with others in their communities long before they leave the shelters.
Any resolution of this disgraceful situation depends on changes in our attitudes toward the homeless mentally ill. Shelter providers, professionals and individuals from outside the shelters need encouragement to work together. Just as we are proud of our technological advances, so let us be as proud of our willingness to face the problem of mental illness.