‘Homeless’ in our own minds (Wendy Guerra’s opinion)

Publisher’s note: Wendy Guerra is a French-Cuban writer and a contributor to CNN en Español. Her articles have appeared in media around the world, such as El País, The New York Times, the Miami Herald, El Mundo and La Vanguardia. Among her most outstanding literary works are “Underwear” (2007), “I was never the first lady” (2008), “Posing naked in Havana” (2010) and “Everyone leaves” (2014). Her work has been published in 23 languages. The comments expressed in this column belong exclusively to the author. See more at cnne.com/opinion

(CNN Spanish) — Before living in the United States, and during my frequent visits to this country, I was impressed by the number of people I saw wandering dirty, lonely or abandoned along the avenues. When referring to the protagonists of this phenomenon, some preferred to call him homelesshomeless, and others simply labeled them “crazy.”

Although not all homeless people face mental health problems — not all people with mental health problems are destined to live homeless either — the fact of living on the streets, of being exposed to different phenomena, facing alone the night, the cold, cyclones and even shelters where difficult and unexpected people and situations mix, create challenges to their physical health, substance abuse problems, syndromes and complex reactions within these individuals. Not knowing where to go marks your life, changes your way of seeing the world forever and, when you try to get out of this labyrinth, you come across a wall that is difficult to navigate without specialized medical attention.

In 2015, it was estimated that about 25% of homeless people in the United States had a serious mental health problem and about 45% had a mental health problem of any kind. A 2016 study revealed that 4.2% of the general population had been diagnosed with a serious mental disorder. It can be depression, schizophrenia or bipolar disorder, among others.

Dr. Gonzalo de Quezada, a doctor certified by the Council of Psychiatry and Neurology of the United States, confesses to me that the subject of mental health is one of the most delicate and poorly treated by contemporary society, because nobody laughs, mocks or downplays a cancer patient, much less a patient on his way to an intensive care unit with a heart attack; however, a person with an anxiety crisis is often a victim of ridicule and is not taken into account for what he is, a high-risk patient. This, which is very evident to everyone, has become a social plague that affects not only the patient, but also those around him.

In Los Angeles I could see hundreds of homeless people crowded under the bridges, who spend the night, beg for alms, and some even go delirious before our eyes, while we advance through the streets, changing the visual point on what we find as uncomfortable as foreign. But beware, “Homo sum, humani nihil a me alienum” (I am a man, nothing human is foreign to me) wisely expressed Publio Terence Afro.

Many of us know someone who has lost the path of reason and has ended up wandering the streets. The difference between the United States and our Latin American countries is that there is usually a good support network, a neighbor, a friend, an older sister or a grandmother who finds enough time to locate them, welcome them and pick them up; In this country, with few exceptions, the pace of life does not allow leaving work to take care of them carefully.

There is a moment when the mind decides, like the shadow to Peter Pan, to take a different path from the body, and it is at that moment that society and loved ones play a fundamental role.

May is Mental Health Awareness month. This date began to be taken into account in the United States in 1949 as part of an initiative of the organization Mental Health America (MHA, for its acronym in English) previously known as the National Association for Mental Health. MHA affiliates and other organizations interested in the subject carry out a series of activities always based on different topics. This year, the selected theme is Back to Basics. This concept suggests focusing, going back, repairing the basic things in life, and was chosen with the aim of providing foundational knowledge about mental health and its different prevention and care pathways.

Thirty-six percent of Hispanics with depression received care, compared to 60% of non-Hispanic whites. Black and Hispanic populations used mental health services at about half the rate of non-Hispanic white Americans in the past year. Among black adults in 2018 with mental illness, 58.2% of those ages 18 to 25 and 50.1% of those ages 26 to 49 did not receive treatment. Mental health treatment was received by 28% of Asian American adults, 30% of Black adults, and 33% of Latino adults compared to the US average of 43%.

In recent years, the federal government’s cutbacks to affordable housing programs and mental health facilities in recent decades have had a lot to do with the increase in these figures, since all of this ends up being the responsibility of local governments, which They are overwhelmed and fail to provide medical services for all types of patients, including the homeless. CNN echoed the reports of the US Census Bureau and aid to Americans during the pandemic “although the country’s poverty rate increased to 11.4% last year, (…) the first two rounds of federal stimulus payments helped keep 11.7 million Americans out of poverty […] The payments, a key part of the unprecedented federal response to the economic devastation caused by the coronavirus pandemic, caused a supplemental poverty measure to drop to 9.1% in 2020,” the Census Bureau says.

How helpless are homeless people in America? There are several government programs, especially the so-called Homeless Assistance Continuity of Care (known as CoC) whose main objective is to help homeless individuals and families to move into temporary and permanent housing. Despite this, every day we discover more and more disoriented creatures that walk the streets victims of physical and mental health problems. They are obvious to us, citizens who walk alongside them, devoid of practical or scientific tools to relieve them.

“Many people struggling with mental illness in our communities feel like they have nowhere to turn,” said Sen. Vin Gopal, a Democrat from New Jersey. “Among them are our military veterans and, increasingly, our youth. Research has shown that early intervention support services, when made available, can be a lifeline for those in crisis.”

Mental health problems can affect us all. What are these emerging ways, and at the same time, early, to avoid falling into these crises? According to the Medical News Today portal, “people should seek help if they experience: persistent feelings of sadness, anger or anxiety, feeling overwhelmed, low energy, loss of motivation, loss of interest in things the person previously enjoyed, thoughts uncontrollable or intrusive, panic attacks, thoughts of suicide or self-harm, domestic or sexual violence, adverse effects following a natural disaster, relationship difficulties, addiction, persistent memories of past trauma, and prolonged periods of grief after bereavement. People should also seek help if an emotional or mental condition causes changes in behavior or beliefs, or if family and friends notice a difference in their behavior or attitude.”

On the subject of suicide, there are channels of attention, such as: the Suicide Prevention Line in the United States, available 24 hours a day at 800-273-8255, in English or Spanish, and during a crisis, the hearing impaired call 800-799-4889.

In Latin America and Spain, you can get help here.

When in doubt about how to select a therapist, the most important thing is to combat prejudice and ask for help, go to your family doctor, or to an insurance company that has a list of qualified professionals for this task. Schools, religious and charitable organizations, family and friends can also be of great help to those who are experiencing negative feelings and uncontrollable and undecipherable urges. It is difficult to find therapies or specialists for those who do not have insurance, and this is a chapter that needs a lot of debate to find a solution, but there are free options, which in no case should replace professional help. The Anxiety and Depression Association of America (ADAA) provides a list of mental health mobile apps.

The fragility of the mind remains a mystery for scholars, scientists and family members who, on a daily basis, deal with the loss of reason and its consequences. Attachment and detachment, sudden cuts in our habits and customs, the disappearance of loved ones, deep loneliness on the difficult path of emigration create traumatic situations that, if not addressed, can seriously threaten our health. The highly recommended, excellent autobiographical novel “Boarding Home” by writer Guillermo Rosales speaks about the fate of one of these emigrants, which begins as follows: “The house said Boarding home on the outside, but I knew it would be my tomb.” In it we can find the interior map of those who enter that territory and do not find the exit.

The question is: do we have solid personal tools to avoid mental imbalances in contemporary society?

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