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Dismissing Those Who Help

This guest blog was written by Carol Smith.

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Mental illness and homelessness have a strong connection. A common misconception is that people living on the streets made a choice to be there. President Ronald Reagan once stated, “What we have found in this country, and maybe we're more aware of it now is one problem that we've had, even in the best of times, and that is the people who are sleeping on the grates, the homeless who are homeless, you might say, by choice,” (Homeless Choose to Be, Reagan Says, Williams 1984).

Studies that looked into one of Reagan's policies towards the deinstitutionalization of the mentally ill showed that, in fact, mental health services and homelessness are closely tied together. Reagan repealed a law “that essentially deinstitutionalized mentally ill patients at the federal level” (“Did Reagan’s Crazy Mental Health Policies Cause Today’s Homelessness?” Roberts 2013). Once faced with not having a place to live, and mentally no better than they were before losing their mental health accommodations, many of the deinstitutionalized had no recourse other than to wind up on the street. This brought the issue of mental health in the homeless population to center stage in the 1980s (“Ronald Reagan's shameful legacy: Violence, the homeless, mental illness,” Torrey 2013)

This finding has been found repeatedly over the years with many studies. In 2006, Markowitz found there was a direct correlation between decreasing availability of psychiatric hospital beds and the increase in crime, arrest rates, and homelessness (“250,000 mentally Ill are Homeless.140,000 seriously mentally Ill are Homeless”, Torrey, date unknown). Past studies found similar results. In Massachusetts, 27% of those discharged from state mental hospitals were reported homeless or had no known address within six months. In Ohio it was 36%, and in New York it was 38% (“250,000 mentally Ill…”).

These studies don’t appear to have found any lasting effect on mental health accessibility due to the presence of budgetary concerns.

A closer look at the state of Iowa shows that, over the past decade, citizens have had a consistent lack of appropriate access to mental health care. “Iowa ranks 47th nationally in psychiatrists per capita,” (“Iowans fall Through Gaps in Splintered Mental Health System,” Mills & Malewitz 2011). An article once stated that Iowa was named best place to live, with the state being 8th best in mental health. Meanwhile, “In 2015, the state closed two of its four mental hospitals and therefore significantly reduced the number of psychiatric beds for Iowans....A 2017 report...gave Iowa a D- grade for its mental health bed shortage...The report said in 2016, Iowa ranked last of all states in terms of psychiatric bed availability, with only 1.2 beds per 100,000 adults; this is a far cry from the national average of about 12 beds per 100,000 adults,” (Iowa Nami 2018).

Hopefully, change can still take place and those most vulnerable will be protected. There is a new bill that could further affect funding for mental health. For more information visit:

There is reason to be optimistic about the future of mental health services in Iowa as there are local groups still working in this time of uncertain legislative change. Help for those in need can be found at a number of places. Foundation2 provides emotional and housing support to youth in particular: Additionally, some local shelters provide not only a provide a place to stay, but other services as well:

· Health clinic, food, clothes, and classrooms:

· Employment program:


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