Borderline Personality Disorder

Borderline personality disorder is a mental disorder that belongs to the group of mental illnesses called personality disorders. Therefore, like other personality disorders, it is characterized by a consistent pattern of thinking, feeling, and interacting with others and with the world that tends to cause significant problems for the sufferer. Specifically, BPD tends to be associated with a pattern of unstable ways of seeing oneself, feeling, behaving, and relating to others that markedly interferes with the individual's ability to function.

Borderline Personality Disorder had been thought to be a set of symptoms that include both mood problems  and distortions of reality psychosis, and therefore was thought to be on the borderline between mood problems and schizophrenia. However, while the symptoms of may be similar , this illness is more closely related to other personality disorders in terms of how it may develop and occur within families. Borderline Personality Disorder occurs equally in men and women in general, while primarily in women in groups of people who are receiving mental-health treatment.

While men with are more likely to also have a substance-use disorder. Borderline personality disorder is more likely to be associated with eating disorders symptoms in women. In adolescents, Borderline Personality Disorder often cooccurs with more anxious and odd personality disorders like schizotypal and passive aggressive personality disorder.

Borderline Personality Disorder is not recognized worldwide. It is diagnosed as emotionally unstable personality disorder in some parts of the world. Although there is no specific cause for Borderline personality disorder, like most mental disorders, it is probable a combination of biological vulnerabilities, ways of thinking, contribute.

It can somewhat run in families. A person is more vulnerable to have difficulty managing their emotions, particularly impulsive aggression. Their social tendencies make for great difficulty in their relationships. These people are more likely to have suffered in their childhood abuse or neglectful parenting

Adults who come from families where divorce, neglect, sexual abuse, substance abuse, or death occurred are at higher risk of developing Borderline Personality Disorder. In children, the risk for developing this disorder appears to increase when they have a learning problem or certain temperaments. Adolescents with an alcohol-use disorder are also at higher risk of compared to those who do not.

Unstable self-image, in that they may drastically and rapidly change in the way they perceive their own likes, dislikes, strengths, weaknesses, goals, and intrinsic value as a person Unstable relationships, in that individuals with this disorder rapidly, drastically, and often frequently change from seeing another person as nearly perfect, to seeing the other person as being  worthlessness; unstable emotions ,affect, in that they experience marked, rapid changes in feelings; for example, severe anger, joy, euphoria, anxiety, including panic attacks and depression that are stress related, even if the stresses may be seen as minor or negligible to others; frequent efforts to avoid being abandoned, whether the abandonment is real or imagined. Significant impulsivity, in that the person with they act before thinking to the point that it is self-damaging; sexual behaviors, spending habits, eating habits, driving behaviors, or in the use of substances ; recurring suicidal behaviors, threats, or attempts ; chronic feelings of emptiness; inappropriate, intense anger or difficulty managing their anger when it occurs Transient, stress related paranoia or severe dissociation , having  lapses in memory is often commonly found in Borderline Personality Disorder

What is a Personality Disorder

Personality disorders are long term patterns of thoughts and behaviors that cause serious problems with relationships and daily life. People with personality disorders have difficulty dealing with everyday stresses and problems. They often have difficulty with relationships with other people.

 The exact cause of personality disorders is not known but genes and childhood experiences may play a role.

Symptoms vary depending on the specific personality disorder. Treatment usually includes psychotherapy and sometimes medicine.

 Paranoid personality disorder is people who show paranoid behavior are always suspicious of others, and often become irritable and hostile. Older adults may have paranoid delusions, become very agitated, or even assault someone.

People who show schizoid behavior are not usually interested in social relationships and may behave oddly or in ways that isolates and separates them from others. Older adults with schizoid behavior may have poor, strained, and sometimes no relationships.

 In schizotypal behavior, people may have strange, unusual, or inappropriate behaviors or beliefs that may lead to conflicts with other people.

Behavior that is antisocial shows little regard or respect for standard rules and laws of society. Antisocial people often do not seem to have a conscience or care about others.

 People who show borderline behavior have unstable emotions, which lead to unstable relationships. They may have emotional outbursts or injure themselves.

 People who show histrionic behavior are over emotional and want to be the center of attention. They are often disorganized and lack inhibitions.

 People who are narcissistic think that they should have and think that they are entitled to whatever they want. They often act superior, self-important, and arrogant. They do not seem to care about others.

People who show avoidant behavior are shy, inhibited, and very sensitive to rejection and how others look at them. This often leads to having not many social relationships and little support. 

People who show dependent behavior rely completely or almost completely on others to make decisions and for support.  

People who are obsessive-compulsive are constantly worried about cleanliness and keeping everything in order. They are perfectionists and do not want to compromise.

In passive-aggressive behavior, people tend to resist authority or any demands placed on them by not taking any action, procrastinating. These people often criticize and resent others.

People who show depressive behavior view life as always gloomy and miserable, with no hope of change in the future. These people often have low self-esteem and feel guilty. They often have major or clinical depression in later life.

The causes of personality disorder is both early life experiences and genetic. Severe changes in personality may develop during later life because of the stresses experienced by older adults. Many older adults become overwhelmed by losses, medical problems, and stresses that build up over time. Especially people who are not able to cope well or do not have the personal, social, or financial resources to shield them from these stresses. Being admitted to a hospital or nursing home can be a particularly stressful event, because of the loss of familiar environment, personal items, privacy, and the control over one's schedule.

Personality disorders can be diagnosed only by a psychiatrist. The diagnosis can be very difficult in older adults. It requires a detailed lifetime history. People with some types of personality disorders may be reluctant to speak openly with a psychiatrist. This means that mental health professionals often need to observe someone for a long time before being able to make a diagnosis.

Separating personality disorders from underlying medical or psychological problems is also difficult. For example, major or clinical depression, psychosis, or other psychiatric problems can distort personality features. Brain damage or tumors can also lead to dramatic changes in personality.

In personality disorder, extreme, inflexible, and difficult personality traits become a part of someone's overall personality. Many older adults who appear to have troubling personality problems do not have a personality disorder. Some people just have trouble adapting to changes. An adjustment disorder develops when a healthy and well-adjusted person suddenly shows personality changes as a result of severe stress.

Personality disorders may continue unchanged over time, or they may fluctuate in progress. Treatment for personality disorders includes many forms of psychotherapy, depending on the situation.  Medication treatments are used, including medications for depression, anxiety, and psychoses. The best treatment approach is usually a combination of psychotherapy and drug treatment.

Mood Disorders

The term Mood Disorder is the general name for illnesses where depression is a significant factor. Mood disorders are  similar to normal reactions to everyday life, except in mood disorders  the symptoms are more drastic and last for extended period, which may be as short as two weeks or as long as two years. A mood disorder is diagnosed when the symptoms interfere with normal day to day functioning or is chronic; early diagnosis is crucial for effective treatment.

The different types of mood disorders are, bipolar disorders, also called manic-depressive disorders and unipolar disorders depressive disorders without a manic phase or rarely seen mania without depression.

Bipolar Disorders are cycles of extreme mood swings. A cycle typically begins with the manic state where the individual experiences exaggerated feelings of happiness, energy, mental and physical activity, also known as highs. From there, the individual generally crashes into  depression, in some cases a period of normalcy between episodes then, usually the depressed mood appears. Normal m periods also follow a cycle of mania. In some instances the person may  cycle with depression preceding the manic phase of the illness.

Bipolar I is the classic type of the disorder and is usually diagnosed when an individual has experienced at least one episode of intense mania followed by a period of severe depression. Bipolar II disorder is diagnosed when the patient has experienced a period of depression and at least one episode of a milder form of mania, termed hypomania. Cyclothymic disorder is less severe than bipolar II, and is distinguished by the irregularity in cycles of mania and depression. Mixed bipolar state is a rare type of bipolar disorder when an individual experiences episodes of mania and depression in a short time period or a cycle which has the symptoms of mania and depression together. 

Unipolar disorders are types of depressive illnesses that don’t include a manic phase or a depressive phase.

Unipolar mood disorders are divided into separate illnesses including Major Depression, Atypical Depression, Psychotic Depression, and Dysthymia. They differ from bipolar states because the highs or manias that bipolar patients experience are not present. 

Major Depression is the most common form of a Unipolar mood disorder. It is the most severe type of depression. Although major depression can be caused by a traumatic event, it may also evolve over many years. In addition, some individuals develop major depression with no external cause. A single episode may last from six months to a year.

Atypical Depression is a common type of major depression. While the individual experiences the same depressive symptoms as one with clinical depression, this type of mood disorder is temporarily lifted by positive events.

Psychotic Depression is a severe mood disorder that is characterized by hallucinations and delusions. The hallucinations may be either visual or auditory. Along with hallucinations, the individual experiences the symptoms associated with other types of depression. Many individuals are aware that they are hallucinating, but unable to prevent their delusions.

Dysthymia is a primary mood disorder that may be life long. Many individuals who have dysthymia go through life dissatisfied, pessimistic, frightened, and feeling guilty without a reason. They are unaware of the lighter side of life and live with feelings of misery.

Sadness is a normal response to many life situations such as loss of a significant person in their lives or other type of stressor. When the sadness lasts for an abnormal length of time it is time to seek help.  Most people can recover from a mood disorder with treatment with medication or therapy. People with a mood disorder can find relief from the emotional rollercoaster that they find themselves on.

Bipolar Disorder and Children

Although bipolar disorder more common in young adults, it can appear in  young children. Some experts believe it is rare; others think that it occurs frequently.

If your child is diagnosed with bipolar disorder, a second opinion before starting a treatment plan is strongly recommended. Diagnosing Bipolar disorder in young children is difficult; many of the symptoms are similar to those of attention deficit hyperactivity disorder or just normal childhood behavior. The major problem is that the medication used for Attention deficit hyperactivity disorder are stimulants, which can trigger in mania in children with bipolar disorder.

Young children in a manic phase are more irritable than adults psychotic symptoms, with hallucinations can be present. During a depressive episode, the common symptom is of physical symptoms, like aches and pains.

One of the most drastic differences is that bipolar disorder in children is that they cycle much more quickly; called rapid cycling in adults. While manic and depressive periods may be separated by weeks, months, or years in adults, they can happen within a single day in child.

Bipolar disorder is an illness of brain which is also referred as manic-depressive illness. Bipolar disorder in children can be recognized by the swings in their mood which are frequent and unusual. Some times they will be in a high mood and hyperactive which is termed as mania. Some times they exhibit a mood of sadness without any reason and their performance in their regular activities are not enjoyed as usual. This situation is called depression.

Bipolar disorder in children and teens cannot be compared with the bipolar disorder in adults as both show different symptoms of the disease. Adults who suffer bipolar disorder have symptoms of mood swing episodes that are distinct and the episodes of depression and mania may last longer. The mood swings are faster and more frequent in children. Children and teens with this disease can be known by the excessive spending of money, use of alcohol or drugs.

Bipolar children are unable to acquire knowledge by the use of reasoning, intuition, or perception. They are poor performers academically. They are irregular in attending classes. Researchers are still studying Bipolar disorder in children however; effective medication and treatment has been not been determined yet.  The treatment is a team work which needs involvement of doctor, parents and the children with bipolar disorder. Often psychotherapy can relieve the bipolar disorder symptoms and the doctor may recommend the type of therapy needed. The child needs support and therapy can help them to connect with their feelings and gives them a place to communicate the emotional turmoil that they are experiencing. 

Mental Disorders in Children

The fact that mental disorders can not occur in children is a fallacy.  Children  can have a mental illness the same as adults.  The fact is that although there are different symptoms children and teens make up a large percentage of the mentally ill in the U.S.

There are many physical factors  heredity and brain chemistry that might be involved in the development of a mental disorder.  Many mental disorders can be effectively treated with medication, psychotherapy  or a combination of both.

Diagnosis of mental disorders in children is difficult for normal medical health care providers. Children differ from adults in that they experience many physical, mental, and emotional changes as they progress through they development and are often seen as growing pains. They also are in the process of learning how to cope with, adapt, and relate to others and the world around them. Each child matures at their own pace, and there is a range ofwhat is considered normal for children is a varity of behavior and abilities. A diagnosis of a mental disorder depends on how well a child functions at home, within the family, at school, and with peers, as well as  age and symptoms.

There are several different types of mental disorders that can affect children and adolescents. Children with anxiety disorders respond to certain things or situations with fear and dread, as well as with physical signs of anxiety nervousness;  rapid heartbeat and sweating.  Children with Attention deficient disorder generally have problems paying attention or concentrating; can't seem to follow directions; they are easily bored and/frustrated with tasks. They also tend to move constantly and are impulsive  and are hyperactive. Children with these disorders tend to defy rules and often are disruptive in structured environments, such as school.

 Development disorders in children and they are often confused in their thinking and generally have problems understanding the world around them. Eating disorders involve intense emotions and attitudes, as well as unusual behaviors associated with weight. Disorders that affect behavior related to using the bathroom.

Children with learning disorders have problems remembering and using the information learned and their thoughts and ideas. Mood disorders are persistent feelings of sadness and/ rapidly changing moods, and include depression and bipolar disorder.  Schizophrenia is a  disorder involves distorted perceptions and thoughts.  Tics, these disorders cause a person to perform repeated, sudden, involuntary and often meaningless movements and sounds, called tics.

Some of these disorders, such as anxiety disorders, eating disorders, mood disorders and schizophrenia, can occur in adults as well as children. Others begin in childhood only, although they can continue into adulthood..

Symptoms vary depending on the type of mental illness, but some of the general symptoms are the abuse of drugs/or alcohol; inability to cope with daily problems and activities; changes in sleeping/or eating habits; excessive complaints of physical ailments; defying authority, skipping school, stealing or damaging property; fear of gaining weight; lasting negative moods, often accompanied by poor appetite and thoughts of death; outbursts of anger; changes in school  poor grades despite strong effort; loss of interest in friends and activities they usually enjoyed; an

increase in time spent alone; excessive worrying or anxiety; hyperactivity;  nightmares or night terrors; disobedience or aggressive behavior; abnormal temper tantrums; hearing voices or seeing things that are not there hallucinations.

The exact cause of most mental disorders is not known, but research suggests that a combination of factors, including heredity, biology, psychological trauma and environmental stress may be involved.

Genetics have a part in mental illnesses and tend to run in families, which means the risk of developing a mental disorder may be passed on from parents to their children. Some mental disorders have been linked to chemicals in the brain called neurotransmitters. Neurotransmitters help nerve cells in the brain.  If these chemicals are out of balance, messages in the brain may not connect, leading to symptoms. Defects in or injury to certain areas of the brain also have been linked to some mental illnesses.

 Some mental illnesses may be triggered by psychological trauma; severe emotional, physical or sexual abuse; the loss of a parent. Stressful or traumatic events can trigger a mental illness in a person with who is vulnerable, and can cause a mental disorder.

Mental illnesses are not limited to adults. Children can also be afflicted and often the symptoms are overlooked or mistaken for other problems.  The aid of a qualified doctor is the only way to find out the nature of the problem.

Violence and the Mentally Ill

Much of the discrimination and stigma associated with the mentally ill is because of the myth that the mentally ill are violent in the minds of the general public. The belief that persons with mental illness are dangerous has developed into a stigma and the result is discrimination. The effects of stigma and discrimination are profound. Stigma leads others to avoid living; socializing; and working with; renting to; and hiring people with mental disorders especially those with severe disorders. It leads to low self-esteem, isolation, and hopelessness. It prevents the public from seeking and wanting to pay for the necessary care. People with mental illnesses become so embarrassed and ashamed that they often try to conceal symptoms and refuse to seek treatment.

This stigma is reinforced by the entertainment and news media. For example, actors and actresses in prime time television; persons with a mental illness are portrayed as the dangerous and involved in crime or violence. Most news accounts describe people with mental illness as dangerous.   The majority of news stories on mental illness focus on negative characteristics related to people with a disorder or receive mental health treatments. The positive stories that illustrate the recovery of many persons with even the most serious of mental illnesses are often not revealed. Inaccurate and stereotypes of the mental ill still exists in other mass media; films; music; and novels.

Most citizens believe persons with mental illnesses are violent. The majority of Americans believe that persons with mental illnesses are a threat for violence to others and themselves.

 Americans are cautious when interacting with people who have mental illnesses. Often they are unwilling to be friends with someone having mental health difficulties.

People have little reason for these fears.  There may be a link between mental illnesses and violence,  but the percentage of the violence committed is small, People with mental illnesses with violent behavior is  more common when there is the presence of other factors substance abuse or dependence; a history of violence ; physical abuse; and recent stressors.

The risk of violence among the mentally ill as is still very small; only a small percentage of the violence in our society are committed by persons who are mentally ill.

People with psychiatric disabilities are more often victims rather than the person who commit the acts of violence

People with mental illnesses can and do recover. People with mental illnesses can recover or manage their conditions and go on to lead happy, healthy, productive lives. They can contribute to society. People can often benefit from medication, rehabilitation, therapy, or a combination of treatment.

Most people who suffer from a mental disorder are not violent there is no need to fear them. They are normal human beings with difficulties, they need be treated with an open mind, caring, and helpful support. The discrimination is just a unfair as avoiding a person with a medical disorder, like cancer, because you  fear catching the disease. People with a mental illness are a part of our society and are entitled to their basic human rights as are all of us citizens.

The Problem of Discrimination Against the Mentally Ill

Mental illness can happen to anyone.  Each  year, more than 54 million Americans are affected by one or more mental disorders.

 Although medical science has advanced doctors and researchers are continuously working at solving unidentified working of the brain.  No one fully understands how the brain works or why it malfunctions. Researchers believe that many mental illnesses are probably the result of chemical   unbalance in the brain. These unbalances may be inherited, or may develop because of excessive stress or substance abuse. People with mental illnesses have many types of behaviors such as extreme sadness and irritability, and in more severe cases, they may also suffer from hallucinations and total withdrawal.  The general public has no empathy or understanding, people with mental illnesses often encounter hostility, discrimination and stigma.

The media is responsible for many of the misunderstandings which persist about people with mental illnesses.  Newspapers often stress a history of mental illness in the backgrounds of people who commit crimes of violence. Television news programs frequently dramatize crimes when persons with mental illnesses are involved. The media is one of the ways that stigma can be eradicated through education and influencing public opinion.

A mental illness is a disease that causes mild to severe disturbances in thinking, perception and behavior.  These disturbances can significantly impair a person’s ability to cope with life’s ordinary demands and routines; proper treatment is needed by a doctor. With the care and treatment of a mental illness, a person can recover and resume normal activities. Many mental illnesses are believed to have biological causes, like cancer, diabetes and heart disease, but some mental disorders are caused by a person’s environment and experiences.

 Some common misconceptions about mental illness are: young people and children don’t suffer from mental disorders; it is estimated that more than 6 million young people in America suffer from a mental health disorder that severely disrupts their ability to function at home, in school, or in their community. People who need psychiatric care should be locked away in institutions; most people can lead productive lives within their communities with a support, programs, and medications. A person who has had a mental illness can never be normal; people with mental illnesses can recover and resume normal activities.  The mentally ill are dangerous; the majority of people with mental illnesses are not violent. In the cases when violence does occur, the incidence usually results from a feeling being threatened or excessive use of alcohol and/or drugs. People with mental illnesses can work low-level jobs but aren’t suited for really important or responsible positions;  people with mental illnesses, like everyone else, have the potential to work at any level depending on their own abilities, experience and motivation.

Stigma can disappear with education, understanding, and compassion. Share your experience with mental illness.  Convey to others that having a mental illness is nothing to be embarrassed about. Help people with mental illness reenter society.  Supporting their efforts to obtain housing and jobs is vital. Clarify the false statements about mental illness or people with mental illnesses.  Many people have wrong and damaging ideas. Facts and information can help change both their ideas and actions.

The Problem the IMD Law

The Problem the IMD Exclusion

Medicaid for some are not available the alcohol and drug addiction residential treatment facilities for services provided to individuals between the ages of 22 and 64. A law in existence restricts Medicaid reimbursements to Institutes for mental disorders. 

Substance abuse treatment services are not distinguished from mental health services in statute or regulation.  Medicaid and Medicare Services have been linked; substance abuse with mental health. Addictive disorders are now mental disorders.  Institutions in the IMD statute to include community substance abuse non hospital residential treatment are considered institutions. The move to deinstitutionalize mental health patients restricts the resources to community based services. .The exclusion us a bars citizens receiving community based care through therapeutic communities. Therapeutic communities are located mostly in the neighborhoods and communities in which their clients live and work. The Medicaid exclusion jeopardizes the services to the clients.

The IMD exclusion is a barrier to many who need substance abuse treatment. Those with substance abuse disorders must have treatment options available to them, including the services of therapeutic communities. The IMD exclusion blocks the clients to the choice and access to care that is effective. The exclusion limits Medicaid eligible citizens from receiving either no care at all, or less effective care for their addiction.

 If the IMD Exclusion were corrected, many American citizens in the public health, social service, and criminal justice systems could be treated for their disease. 

 Medicaid eligible clients receiving substance abuse treatment in an IMD are not eligible for any medical benefits even emergency care, despite the fact that if the client were not in an IMD, they would be eligible for their Medicaid benefits

About 2 million people who suffer from severe brain disorders are not receiving treatment.  A major reason why so many are not being treated is that, because of the effects of the illness, they lack awareness of their illness. Studies have shown that approximately half of all patients suffering from schizophrenia and bipolar disorder have impaired awareness of their illness. These individuals will refuse to take medication because they do not believe they are sick.

Persons with severe brain disorders are reduced to being homeless persons.  It is estimated that as many as 200,000 are in jail or prison, which means that prisons have become treatment institutes.

The majority of long term and a large number short term hospitals for severe brain disorders in state psychiatric hospitals are without services and treatment.  This is an effective deinstitutionalization. The number of state psychiatric hospital beds has continued to decrease.

With  community services, the majority of persons with severe mental illnesses do not require long term hospitalization, however, a small group still requires the long term care and supervision of a psychiatric hospital but in some areas  they are faced with waiting lists for admission to many of the state psychiatric hospitals.

Deinstitutionalization is a good c idea. Many persons with severe brain disorders who are not currently receiving care can be cared for in community residences as in a group home.

A percentage of individuals with severe mental illness are unable to use community treatment. These people require long term care in an institution.  Those with the most severe, disabling and chronic forms of severe mental illness have had their needs are overlooked in the mass closure of state hospitals unavailable community services.

One major reason leading the states to close their psychiatric hospitals is the Medicaid reimbursement law which is known as the IMD Exclusion. This exclusion prevents a state psychiatric hospital from receiving federal Medicaid funds for its patients. Patients hospitalized on the psychiatric ward of a general hospital or treated in a community setting are eligible for funds. Without federal funds, state hospitals close. The result is the discharging of patients and then closing the state hospitals and states save state money. If a patient then needs to be hospitalized, it is to a general hospital that is not equipped to handle long term psychiatric care. The quality of care is generally not as good as in private or state psychiatric hospitals.

The IMD Exclusion was forced deinstitutionalization as states saved their own funds by closing state hospitals, the funds were reassigned to the Federal Government. Many of the patients should not have been discharged and were not receiving follow up care was disregarded by the states. No changes were made to care for those affected by deinstitutionalization and American citizens are still denied their basic rights, and forced to receive inadequate care.

Chemcal Dependence and the Mentally Ill

When substance abuse and a mental disorder such as depression, bipolar disorder, or anxiety occur together it is called a co-occurring disorder or dual diagnosis. Having a substance abuse, alcoholism, or drug addiction is often difficult to treat, but there are treatments that can help.

With proper treatment, support, and self-help techniques it is possible to overcome both the alcohol abuse or drug addiction, relieve the symptoms of depression or anxiety and begin to live your life more fully.

Co-occurring disorders are complicated. In a dual diagnosis, both the mental health problems and the drug or alcohol abuse have different symptoms that cause your ability to function, contend with the stressors of daily life and the ability to relate with others. The situation is more complicated, the co-occurring disorders often impede recovery unless they are both treated together.  When a mental health problem goes untreated, the substance abuse problem becomes worse; and when alcohol or drug abuse increases, mental health problems increase.

 Chemical dependence is common in people with mental disorders. But although substance abuse and mental health disorders like depression and anxiety are linked, one does not directly cause the other.

Alcohol or drugs are often used to self-medicate the symptoms of depression or anxiety. Unfortunately, substance abuse side effects causes the symptoms they were used to relieve the pain of the mental disorder are exacerbated.

Alcohol and drug abuse can increase the risk for a mental disorder. Mental disorders are caused by many factor genetics; environmental triggers; and other stressors. If you are at risk for a mental disorder, drug or alcohol abuse may mask the mental disorder making the diagnosis more complex.

Alcohol and drug abuse can cause a mental disorder worse. Substance abuse may increase the symptoms of mental illness or trigger new symptoms. Alcohol and drug abuse also interact with medications such and make them less effective.

Addiction is common in people with mental disorders.  Doctors and therapists are challenged every day with cases of co-occurring disorders.  The problem facing them is often the dilemma of which came first and combining treating for both concerns.  Without the active participation of the patient the prognosis is grim.

The Whys of Mentally Ill Homelessness

The Whys of the Homeless Mentally Ill

Why are so many severely mentally still homeless. Community mental health centers are inadequate, underfunded, and are often the victims budget-cutting.

Mentally ill homeless people have special problems for health care workers. They may not be as cooperative and motivated; because of their limited or nonexistence of resources, they may have difficulty getting transportation to treatment centers; they frequently forget to show up for appointments or take medications.  Among people with severe mental disorders, those at greatest risk of homelessness are both the most severely ill and the most difficult to help. Many of the homeless mentally ill lack the insight, and do not realize they are sick and they are in need of regular treatment. Others have given up, believing that the system cannot or will not help them. 

Most homeless people when asked what their greatest needs were, they listed affordable housing, safety, education, transportation, medical and dental treatment, and job placement. Mental health and substance abuse services were regarded as unimportant.

Solving the problem of the mentally ill homeless cannot be done without resolving the problem of homelessness totally. State institutions for the mentally ill are no longer available by law to help them.  The mass closure of state hospitals has caused more homelessness. Food and shelter the basic needs of life versus mental health needs, the homeless and those trying to care for them choose the basic needs.

Many cities in taking action against homeless crisis have criminalized homelessness, which shifts the problem to the over-filled jails. Religious institutions provide shelter and food, and basic needs without addressing the reason why the person is homeless.

A national effort is needed to eliminate homelessness; the problem is get ting worse, particularly in these economic times. The mentally ill homeless have no place to go, no way to provide for themselves and have little hope in the present situation.