Cries of the destitute

A.M. Rosenthal

November 26, 1990|By A.M. Rosenthal

NEW YORK — ON A FINE autumn morning in New York, just before Thanksgiving, when the streets were full of handsomely dressed people off to work, a gray-haired woman about 60 years old stepped off the curb at Park Avenue and 67th Street, raised her dress, bared herself, and defecated in the gutter.

I did what everybody else did. I turned my head in disgust and walked away toward the office.

But that morning I found it a little harder to walk away from the mentally ill of the city.

A demented man was stretched on his back, near Madison Avenue, eight blocks south of the woman in the Park Avenue gutter, shouting out loud to the demons of his mind.

A mile on, a few steps away from the office, a woman lay in a doorway as she does every day, in filth of body and pain of mind. She clutched the bottle of liquor almost never out of hand -- the gift of death by poison that passers-by give to her with their coins.

About 15,000 mentally ill people live on New York streets -- almost one-third of the homeless. But this is not one more New York horror story. I have seen the Park Avenue lady and the raw faced woman in the doorway in Chicago, San Francisco, Los Angeles, Houston, Miami.

If you travel America, try getting away from the homeless mentally ill -- try.

How did we get to this point, where Americans calmly accept the fact that we cannot deal decently with scores of thousands of destitute Americans who suffer so desperately in their minds that they cry their pain in the streets, where we send them to live?

When and why did this country accept madness in the streets as part of the city scenery, turn its back on the deeply disturbed, unless they happened to defecate in front of our delicate eyes?

In the mid-'50s, there were more than 550,000 patients in American public mental health hospitals. Now there are about 100,000.

The public saw the mental hospitals as snake pits. Some were, and some were not, but closing them was supposed to save the states a nice pile of tax money. A little later, tranquilizer drugs speeded the emptying of the wards.

But on the streets, without care or attention, the mentally disturbed did not take the drugs, and regressed rapidly.

The idea was to give the mentally ill post-hospital care in halfway houses or community centers. Officials and taxpayers never came up with enough money.

When the hospitals closed, the mentally ill poor went into the street. That helped push at least a third of them into even more nightmare worlds -- alcoholism and drug addiction.

They found friends -- organizations and individuals who try to help them get off the streets.

But, God help them, they also found some "advocates" who insist that living on the sidewalk month in month out, freezing or baking, the prey of human street rats, eating garbage and refusing treatment or even food and shelter is an acceptable alternative life style.

As long as they do not commit a serious crime -- not just the misdemeanor of befouling private or public property -- they have the right to live in the streets and the right to die there.

Some advocates argue that there is no such thing as mental illness, just another way of looking at reality. Maybe they are right. Is what we have come to accept really sanity -- that mental illness is a right to be exercised to the point of suicide rather than a disease demanding medical care for the victim?

Is it sanity to say that if you are bleeding from a car accident an ambulance will take you away, but if you are bleeding from the mind you can lie there until you rot?

Is caring for people too sick to know they need care truly a violation of their freedom?

It is a disservice to all the homeless to lump their problems together. That makes homelessness seem unsolvable, when it is not.

The economically destitute homeless need economic help -- and can respond to it as full members of society, not some murky, psychically troubled mysterious underclass.

The addicts or mentally disturbed -- estimated at 70 percent of the homeless -- need a range of treatments if they are to escape the streets into decent housing.

Is it beyond the American legal and medical mind to provide that help, even to those who do not grasp that they need it?

If we won't put enough taxes -- yes, taxes -- or attention into doing the job, let's have the honesty not to blame the governor or mayor.

Let's just shut up, keep on walking away from the lady on Park Avenue, and enjoy our next Thanksgiving.

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