Showing posts with label Mental Health. Show all posts
Showing posts with label Mental Health. Show all posts

Monday, October 29, 2018

San Francisco Housing Homeless

Originally Published April 24, 2014; Last Updated October 29, 2018; Last Republished October 29, 2018:

San Francisco has discovered that ending homelessness begins with housing1—unsurprisingly, the homeless may travel multiple pathways when participating in our civil society structures.

San Francisco may next discover that solutions to homelessness cannot be grafted onto our non-economic systems, but must be directly integrated within our economic system2.


UPDATED 12/12/2015 CRS, Chronic Homelessness: Background, Research, and Outcome (courtesy of FAS)

As we begin to understand and solve systemic homelessness it will be important to frequently remind ourselves and others that "prayer" is not a plan or substitute for allocation of necessary and sufficient resources.


UPDATED 10/29/2018 PBS, In LA, Poverty on Skid Row Defies US’ Humane Reputation and NYT, California Today: Readers Talk About Homelessness With Their Children...MAGA...

...don't forget to laugh...

UPDATED 09/16/2018 NYT, Americans Want to Believe Jobs Are the Solution to Poverty. They’re Not

UPDATED 04/24/2018 Reuters, California Does 'Poor Job' in Assisting Homeless: State Auditor and Homelessness in California, State Government and the Los Angeles Homeless Services Authority Need to Strengthen Their Efforts to Address Homelessness, Report 2017-112 (pdf) (online version)

Really!, who could have guessed that our poor are poorly served?

UPDATED 02/25/2018 LAT, Los Angeles’ Our Nation's Homelessness Crisis is a National Disgrace

UPDATED 01/07/2018 UCSF, Homelessness in Older Adults: An Emerging Crisis

San Francisco's shelter system is not now configured to address almost any requirements of a chronic and aging population. The current shelter system is not a "cheap substitute" for home, assisted, and hospice care for the city's poor and aging population.

UPDATED 10/05/2017 Department of Homelessness and Supportive Housing, Five-year Strategic Framework, Executive Summary
UPDATED 08/18/2017 SFPublic, Home Street Home
UPDATED 12/12/2016 SFExaminer, Mayor, judge clash over enforcement of quality-of-life citations

Does this represent a too long retarded and reluctant realization among some in our judiciary that they've become an aggravating part of our growing homelessness problem or simple parsimony priority during budget pressures?

As Mayor Lee's misconstrued and misapprehending response to San Francisco's Superior Court, Presiding Judge John Kennedy Stewart's refusal to issue new and dismissal of existing quality of life warrants indicates, some leaders will not easily cease attempting to coerce "solutions" to our civil society problems, however ineffective and otiose.

UPDATED 11/19/2016 SFChron, In a wealthy SF neighborhood, residents fight low-income housing

A diverse capitalist nation requires both policy and incentives. Whether prejudice leads or lags housing prices it's highly probable there is a price point set at which all or most prejudice dissipates?

UPDATED 11/14/2016 WH, The White House’s Veterans Homelessness Summit

A cloud of myths has animates our nation's many misbegotten responses to homelessness. Our President and First Lady's leadership has enabled our nation to begin to penetrate this cloud and make sure our homeless citizenry are permanently housed.

UPDATED 10/18/2016 UnivRichmond, Mapping Inequality Redlining in New Deal America, San Francisco

Too often past responses to perceived problems are prologue to solving the problems tomorrow.

UPDATED 08/09/2016 SFExaminer, Safe SROs are vital to SF’s low-income housing option and SFDPH, Draft Single Room Occupancy Hotels in San Francisco A Health Impact Assessment – Executive Summary 2016 and SFDPH, Improving theHealth of Residentsin SRO Hotels Final Power Point Slide Aug 2016  and SFDHP, Strategies to Improve Food Security Among “Single” Residents of San Francisco’s SROs Mar 2016 and SFDPH, Improving Health in SROs Health Impact Assessment 2014

UPDATED 12/21/2015 CSM, An end to homelessness: Cities take on 'impossible' challenge

UPDATED 08/29/2015 SFChron, Combatting homelessness requires making tough choices
If you're plan is to "combat" homelessness your plan has failed before it has begun.

UPDATED 07/11/2015 Atlantic, The Best Way to End Homelessness Includes links to demographic data. 

UPDATED 06/27/2015 SC, SC, Texas Dept. of Housing and Community Affairs v. Inclusive Communities Project, Inc. (slip opinion pdf)

The eventual positive impact on our civil society of this case will likely equal or exceed those of King v. Burwell or Obergefell v. Hodges , which are both currently and justifiably the focus of much celebration.

UPDATED 04/04/2015 SFExaminer, Jailing the Homeless Perpetuates Problem

It not only perpetuates the problem, it exacerbates and demonstrates a gross ignorance of the problem.

Eventually, our nation will ensure every citizen-resident is habitabily housed, regardless of their inability to pay or reason for homelessness, but evidently not until we've tried every other alternative, regardless of how inefficient, ineffective, inane, or inhumane!

UPDATED 01/15/2015 SFExaminer, Ed Lee to put focus on housing in State of the City address

Ensuring each citizen-resident has continuous access to habitable housing is not a "below market" exercise—it's an "all market" exercise.

The idea that any of our citizenry is homeless because they queue on an arbitrarily "below market" segment of an arbitrary housing market gradient seems absurd, at best.

Any homeless citizen-resident is a housing market failure—calling it a "below market" housing failure does not eliminate or excuse that failure.

UPDATED 12/27/2014 OutbreakToday, San Francisco Reports Spike in Shigella Infection, Homeless Hit Especially Hard

Just another reason, from a developing long list of reasons to ensure each and every one of our citizen-residents has continuous access to sustainable shelter, healthcare, nutrition, and education.

It's shocking that we have so long tolerated and many times proudly praise economic schemes4 incapable of ensuring each and every one of our citizen-residents has continuous access to sustainable shelter, healthcare, nutrition, and education.

UPDATED 12/18/2014 SFExaminer, Nonprofit Offers Expanded Shelter Resources to Homeless Families during Winter

A waiting list for any "emergency shelter" or service is by definition not an "emergency shelter" or service. At best is a non-responsive system to a fundamental need and requirement of our citizens and residents—at worst it is a grossly negligent and indifferent system to all their fundamental needs and requirements.

Unfortunately, it has become fashionable to publish "homelessness stories" during our holiday season then return to business as usual for the remainder of the year, which generally includes enormous "waiting lists" and "queues" for sporadic access to even the most basic and fundamental of human needs such as shelter, healthcare, nutrition, and education.

Our civil society objectives should not be to make access to these basic human services so ineffective, inefficient, painful, miserly or minimal that collecting bottles, aluminum cans and coding to arbitrage or auction public parking become or qualify as career or growth opportunities, by comparison!

UPDATED 11/17/2014 UPI, President Obama wants to end homelessness by the year 2020 and NCFH, Child Homelessness:America’s Youngest Outcasts (report pdf)

It will take until 2020 just to eliminate all the myths successive governments and some citizens perpetuate about homelessness, typically in an effort to do little or nothing to eradicate it.

Perhaps our President intends to ignore all the mythology, proceeding directly to eradicate the homelessness scourge from our nation—one-fourth of the minimum required of any “exceptional” nation (the other three-fourths being citizenry’s continuous access to nutrition, healthcare and education)!

UPDATED 04/24/2014  KQED Forum, Is San Francisco Effectively Fighting Homelessness?

It's fantastic that discussions on homelessness are beginning to occur more frequently.

Instead of directly integrating homelessness into our economic system, homelessness is treated as an unexpected aberration or defect that surprises and shocks our economic system.3

Homelessness is then grafted onto a hodge-podge of non-economic systems where ephemeral strategies are abundant and solutions more rare than winning a lottery.

SFGate Blog,  No longer homeless, but they act that way


1. Before saying "duh" consider that most American cities are decades away from making this discovery, if they ever do—it's difficult to discover solutions to a problem you're busy hiding, denying, ignoring or shifting. The logic is deceptively simple and incorrect; homelessness is inconsistent with the expectations of our economic system.

2. Typically, many putative solutions to homelessness have presumed an individual has some moral defect (why else would they be homeless) that requires correction before that individual is redeemed and partially "reintegrated" into civil society. Unsurprisingly religion and churches have played a primary and dominant, if ineffective role in "reintegrating" our homeless.

Integrating solutions to homelessness directly within our economic system does not presume any moral defect or depend on any religion or church. Of course some individuals' pathway may involve religions and churches, but their participation in our civil society structures must not be constrained by any religion or church.

3. It seems bizarre that an advanced economy would depend on the luck of lottery or arbitrary self interested generosity to ensure all their citizenry have continuous and unconditional access to basic nutrition, shelter, healthcare and education.

4. Until the economic schemes unwind and all prior praise morphs in to vociferous condemnation amid protestations that the schema was too complex to understand. It's unclear why schema, which are too complex to understand are not simultaneously too complex to proceed?

Thursday, December 21, 2017

Mental Illness - Frontline - The Medicated Child

Originally published January 09, 2008; Last Updated December 21, 2017; Last Republished December 21, 2017:
Kudos to Frontline for again focusing our attention on mental illness! The program The Medicated Child is excellent and I hope more like it follow.

I cannot recall a child speaking more horrifying words than those spoken, during the program, by the little sixth grade girl, saying of her medication:

"it makes me more like I'm suppose to be"

Who authorized these people to treat our children like defects off some manufacturing assembly line whose manufacturing process they do not understand, but nevertheless use crude pharmaceuticals, they do not understand, to sledge hammer our children into "certified" conforming commodities?

I'm sure her doctors and parents think they are helping, but their actions differ little from those performing the barbaric lobotomies of our recent past and may be worse!

UPDATED 12/20/2010 ProPublica, Med Schools Flunk at Keeping Faculty Off Pharma Speaking Circuit. Article part of the excellent Dollars for Docs series. 


UPDATED 12/21/2017
STAT, College Can be Brutal for Students with Serious Mental Health Conditions. Here, They Find Support Their Schools Can’t Provide and BostonUniv, Niteo 

Kudos to BU, Niteo and the young pioneering participants.

UPDATED 12/30/2016 SA, Is Mental Health Declining in the U.S.?
UPDATED 09/30/2016 WH, Making Health Care Better Series on Suicide Prevention

Access to mental healthcare remains a rhetorical illusion, which policymakers deploy while we grapple to understand and solve the causes of our national mental health crisis (plague).

UPDATED 06/25/2016 SA, To Diagnose Mental Illness, Read the Brain
UPDATED 06/07/2016 WH, Making Health Care Better Series on Mental Health
UPDATED 05/22/2016 SA, The Hidden Harms of Antidepressants
UPDATED 04/22/2016 CDC, Suicide Rates for Females and Males by Race and Ethnicity: United States, 1999 and 2014

"The age-adjusted suicide rate in the United States was 24% higher in 2014 than in 1999, and increases were observed for both females and males in all age groups under 75 (1)."

UPDATED 10/04/2013 WTimes, Reports: Woman in Capitol chase had history of mental illness and UPI, Woman killed after Washington chase reportedly on medication and ThomsonReuters, Woman killed in Washington car chase had post-partum depression, family says

How is it that an erratically mentally ill driver ends up shot to death on our city streets by platoons of paramilitary police? Have we become so accustom (some might say addicted) to solving problems with force and violence that deploying platoons of paramilitary police on our city streets to chase down an erratic driver, with guns blazing seems normal and routine?

If deploying platoons of paramilitary police on our city streets to chase down an erratic driver, with guns blazing isn't indicia of mental illness, it should be!

As an aside, if our nation charged every American that showed up at or near the White House believing they had an appointment with the President we could reduce dent our debt. If our nation charged every American that showed up at or near the White House believing they had an appointment with "God" we could eliminate reduce our debt.

UPDATED 08/21/2013 MedicalxPress, Antipsychotic drug use in children for mood, behavior disorders increases type 2 diabetes risk
UPDATED 06/04/2013 Reuters, Obama urges greater openness in dealing with mental illness and Remarks by the President at National Conference on Mental Health

Kudos to our President for encouraging a national conversation on the tough, but important topic of mental health! Our continuous conversation must be accompanied by allocation of public research, resources and responsiveness1—personal prayer IS NOT a substitute or complement to the allocation of public research, resources and responsiveness1.

UPDATED 05/05/2013 NYT Magazine, The Problem With How We Treat Bipolar Disorder

Kudos to the author for sharing her atypical mental fluctuations and the behaviors they induced.

Sadly, the article quotes a professional as saying that patients experiencing behaviors induced by atypical mental fluctuations find it difficult “to reconcile those behaviors with their self as they have come to know it.”

Unfortunately, this statement implicitly acknowledges the lack of any standard model for understanding, developing and maintaining individual mental health—our professionals are shifting the responsibility for reconciling behaviors induced by atypical mental fluctuations to our patients!

Imagine arriving at the doctor's office with appendicitis where you're informed that you're responsible for reconciling your previous healthy self with your current painful self, including the removal of your own appendix, if necessary!
UPDATED 03/13/2013 ProPublica, Dollars for Docs Mints a Millionaire
UPDATED 04/23/2012 Post-Prozac Nation 

UPDATED 10/13/2010 Reuters, Pfizer depression drug ineffective, may be harmful: study. Reboxetine (aka Edronax), a selective serotonin re-uptake inhibitor (SSRI) is ineffective as a treatment for depression and may have harmful side effects, according to German researchers. 

UPDATED 06/02/2010 UPI, Depression therapy, drugs similar results (note: the study is based on older individuals which may not extrapolate to children "talk therapy"). Wonder to what extent "talk therapy" is not regularly used, even though capable of delivering similar or superior results, because it:
* requires significant time and resources; and 
* does not always progress linearly from understanding to understanding; stated differently, understanding will often take you place where you did not think you wanted to go! 
* aims at producing a unique, if not conforming individual; and 
* may conflict with the nominal objectives and goals of an existing social structure.
The objectives of "drug therapy" beyond short-term stabilization and drug industry profits are unclear and often rarely articulated, poorly defined, or subjected to rigorous objective testing for effectiveness.

UPDATED 05/21/2010 UPI, Preschool depression may look different. If a society is medicating a significant number (some might say any) of its preschoolers for depression unconnected with any physical diagnosis it's an indication that major structural changes are required to that society. Medicating our preschool children so they can participate in any social structure is beyond bizarre and absurd.

UPDATED 01/05/2010 NYT, Popular Drugs May Help Only Severe Depression.

UPDATED 12/13/2009 NYT, Poor Children Likelier to Get Antipsychotics. This article is disturbing and shocking. More probing and investigation is required to determine whether and to what extent our mental health professionals may be directly or indirectly treating the condition(s) of "poor" as a mental illness or disorder.

The distinctions may be subtle and complex.

Additionally, parents of poor children and poor children themselves may not question or seek second and third opinions. It would not be overreacting to begin providing our children (especially our poor children) with their own personal disinterested professional advocates. Research into methods of accurately and objectively assessing the delivery of mental health services is no doubt challenging, but will benefit patients, doctors, and our society.

UPDATED 11/11/2009 ProPublica, Drugmaker Paid Psychiatrist Nearly $500,000 to Promote Antipsychotic, Despite Doubts About Research. At a minimum our doctors must disclose when they are prescribing a medicine or procedure or test or course of treatment in which they have a financial interest.

If a doctor is also conducting sham or shoddy research into a medicine or procedure or test or course of treatment in which they also have a financial interest that must be investigated as well as disclosed.

If a doctor is providing patients with inaccurate information about a medicine or procedure or test or course of treatment the doctor should be reported to applicable state medical licensing board and possibly sued for malpractice.

UPDATED 10/27/2009 ScienceNews, Psychiatric Meds Can Bring On Rapid Weight Gain In Kids. Some children gained as much as 19 pounds—the control group, one pound. "Drugs that alleviate severe mental disorders can also result in troubling metabolic changes."

Other Incidents of Pharma Influence:

UPDATED 08/18/2009 NYT, Senator Moves to Stop Scientific Ghostwriting. Article talks about Wyeth''s ghostwriting. 

UPDATED 08/18/2009 UPI, Medical groups paid for vaccine promotion. Once again it's Merck purchasing the influence to promote Gardasil: 

"Merck acknowledged it paid a total of $750,000 to the American College Health Association, the Society of Gynecologic Oncologists and the American Society for Colposcopy and Cervical Pathology,"--UPI referring to Washington Post Reporting--
Hopefully we''ll hear from the three journals on how they plan on preserving their credibility and independence?

UPDATED 09/24/2008 AFP, US kids three times likelier to be medicated than in Europe: study.
UPDATED 04/15/2008 NYT, Merck Wrote Drug Studies for Doctors. Merck ghostwrote medical research studies, which prestigious doctors then signed for publication in academic journals—gives new meaning to the term "blowback". Some are questioning the validity of all Merck's research reporting. 

UPDATED 11/02/2009 UPI, Feds side with investors in Vioxx suit

UPDATED 01/31/2008 Lilly Considers $1 Billion Fine to Settle Case. Eli Lilly is being investigated and sued for mis-marketing its antipsychotic Zyprexa® for non-approved purposes, which is believed to have caused harm.

UPDATED 01/17/2008 Antidepressant Studies Unpublished. Manufacturers withheld data misleading doctors and consumers about pharmaceuticals' effectiveness!


1. Public responsiveness is the antithesis of shoehorning our citizenry into preexisting and preconceived public paradigms—mental health is not so easily achieved or maintained.