Gorfido Ashley
Cleveland-Marshall College of Law.
J Law Health. 2020;34(1):106-128.
The United States has failed its citizens who suffer from severe and persistent mental illness (SPMI). Homelessness is one of the most obvious manifestations of this failure. The combination of a lack of effective treatment, inadequate entitlement programs such as Social Security Disability Insurance (SSDI), and subpar housing options form systemic barriers that prevent people suffering from mental illness from being able to obtain adequate housing. Cultural beliefs within the United States regarding who is homeless and what homelessness means also play a significant role in the development of positively impactful social welfare programs. Part II of this Note reviews the history of treatment for persons with SPMI--specifically how that treatment has evolved, the history of federal policies regarding SSI, SSDI and housing, and societal beliefs regarding homelessness and mental illness that have impacted policymaking decisions. Part III looks at these same areas from a current perspective and addresses the current issues and some possible solutions. Part IV discusses how lack of effective treatment, poor disability programs, and the need for better housing options work together to form systemic barriers for people with SPMI. Part IV also address how the cultural beliefs in the United States regarding people who have SPMI and are homeless serve as an independent barrier to policy change. Ultimately, this Note argues that homelessness is a product of system failures rather than individual factors.
美国辜负了患有严重和持续性精神疾病(SPMI)的公民。无家可归是这种失败最明显的表现之一。缺乏有效治疗、诸如社会保障残疾保险(SSDI)等福利项目不足以及住房选择不佳等因素共同构成了系统性障碍,使患有精神疾病的人无法获得充足住房。美国国内关于谁是无家可归者以及无家可归意味着什么的文化观念,在积极有效的社会福利项目发展过程中也起到了重要作用。本笔记的第二部分回顾了严重和持续性精神疾病患者的治疗历史——具体包括治疗方式如何演变、联邦政府关于补充保障收入(SSI)、社会保障残疾保险(SSDI)和住房政策的历史,以及影响政策制定决策的关于无家可归和精神疾病的社会观念。第三部分从当前视角审视这些相同领域,探讨当前问题及一些可能的解决方案。第四部分讨论了缺乏有效治疗、糟糕的残疾项目以及对更好住房选择的需求如何共同为患有严重和持续性精神疾病的人形成系统性障碍。第四部分还阐述了美国国内对于患有严重和持续性精神疾病且无家可归者的文化观念如何成为政策变革的独立障碍。最终,本笔记认为无家可归是系统失灵的产物,而非个人因素所致。