MENTAL HEALTH REPORT PROMISES TO TURN THE CLOCK BACK ON HUMAN RIGHTS

In August 2010, an all party Select Committee on Mental Health and Addictions that has been working quietly across Ontario for a year to gather stories and feedback from individuals, organizations, professionals and law enforcement, on how to fix Ontario's mental health and addictions system released its final report with 23 recommendations. The report was praised in many quarters as it represented members of all three major political parties working together to produce this report, united in their experiences as they moved from town to town to hear stories from family members, a few "consumer/survivors", organizations and others on their own observations, experiences and assumptions about both mental health issues and what to do about them.

The report itself released on August 30, 2010, can be found on the site of the Ontario Legislative Assembly's Committee Reports. It is in a PDF format, which may be inaccessible for some, but there are likely sites online that may provide a copy of this public report in Word or text format. The report itself took up 63 pages, and is based on 25 days of public hearings and written submissions, and follows up an earlier version of this report, an Interim Report published in March 2010.

I downloaded both of them and read through them, keeping a supply of Tums handy in the event some of the terminology and recommendations made my stomach turn. While there are many positive recommendations, such as "removing silos" and blending services that would incorporate both mental health and addictions, and setting up a focused agency within the Ministry of Health and Long Term Care dedicated to these issues (similar to Cancer Care Ontario) makes some sense. Provision of better training to primary care physicians and nurse practitioners and others directly involved in the care of persons with mental health concerns is also a good thing. The report also recommended the obvious: funding has failed to follow the person, as he or she leaves the hospital and returns to the community. It is said the system is based on an acute care manner, whereas after the hospital stay is over, the person simply returns to whatever routine they left before they went there. Mental health has always been the "poor cousin" of other health services, taking a mere fraction of the system that claims to treat many more people than its funding assumes.

The report went into depth about the stigma of having a mental health problem or diagnosis, and what can be done about it. Frankly, I had to laugh at that section, because absolutely nothing is being done about this. This is not something that the Ministry, for example, can make a "feel good" commercial about, showing successful actors, musicians, athletes and business people, who have all experienced mental health issues, and are now recovered, thanks to the miracles of "modern medicine". The report begged for a champion, who can lead the fight against stigma against persons with mental health problems. The reason there are no takers for this position is because the mental health system, if adopted by such a champion, militates against somebody ever taking such a role. A content analysis of the verbal input into the committee hearings revealed a lot of prejudices, some of them developed by the media, and others brought to them by the "single case history" syndrome, about persons with mental health problems.

Most of the lay input into these hearings were family members, or associations representing family members, of persons with mental health issues. Their concerns are not to be disregarded. I am a family member survivor of a suicide, as well as a spouse and friend of another person who has struggled with mental health issues. I have also personally experienced some difficulties earlier in my life as well. In addition to this, I worked in mental health for ten years of my life, and currently in my practice, work with many clients that have moderate to serious problems with depression, psychosis, suicidal thinking, post-traumatic stress, and so forth. I don't relate well to what many of these family members were asking for, because there is a better way of dealing with these things than locking people up and forcing them to take treatment to which they may not recover. The Committee heard from some individuals with lived experience of mental health issues, but obviously not enough of them. I could count their numbers on my left hand.

The report only glosses over concerns about the human and civil rights of persons diagnosed with mental health conditions. This has been a recurring theme throughout, that somehow, the fact that people have rights, is somewhat detrimental to the health and well-being of the person. For example, the report notes "we are troubled that so many witnesses have experienced difficulty in obtaining care for family members who are clearly very ill, yet refuse treatment or are too quickly discharged from hospital. Many told us about their need to go through the complicated Form 1 or Form 2 process - involving the police or justice of peace - several time before their loved one was adequately treated. One family told the Select Committee that their son was not admitted to hospital until he threatened to jump from a four-story building ..." In these glimpses into the lives of these witnesses, forced treatment was good, personal freedom is bad. What was not shared with the committee were the results of this treatment and the quality of these people's lives afterward.

In the Interim Report, it was mentioned over fifty percent of the people on ODSP are receiving it for "mental health reasons", leaving one to wonder why such a huge percentage of people deemed disposable by our society are also labeled with some type of mental health diagnosis. I know when I worked in the mental health field, I did a research project, part of which included calling a random sample of employers in a random sampling of industries across Niagara, and learned that out of over 100 employers interviewed, only one had knowingly hired a person with a mental health history (and this person was their nephew). Several of them made jokes about people with mental health problems, while a few repeated certain stereotypes they felt were true about people with these experiences. A tire store told us that they were afraid that somebody like this would blow up the tires. Another said they would worry about what kind of mood the person would be in each day. Another one implied that persons with mental health issues were the same as persons with developmental disabilities. If employers think this way of persons recovering from these conditions, it is no wonder the majority of them seem to be sitting on ODSP - no matter how well educated, skilled, willing to work, etc.

About their rights, the report went on to note the following "Rights advocates cautioned the Select Committee that involuntary admission and treatment are such grave violations of autonomy that society has to accept these risks and dangers. They also warned that psychiatric drugs can have serious side effects to which many people are reluctant to expose themselves ..." This is fine until the report continues ... "the Select Committee believes, however, that the right to autonomy must be balanced with the right to be well. The Select Committee also believes that our present laws tie the hands of health care professionals and families and have contributed to the criminalization of mental illness, where individuals need to be arrested in order to receive care. While Ontario undoubtedly needs better access to community supports and hospital beds, some people will not avail themselves of such services because it is the nature of their condition to deny that they are ill ..." Grab those Tums!

So what if somebody denies they are ill. So what if somebody refuses to receive treatment they don't want or feel they need. I know of many cancer patients, diabetics near end stage renal disease or cardiac failure, etc. who have also done the same thing. They did not want yet another intervention to prolong whatever it is they consider to be ailing them. Do we force diabetics to submit to insulin treatment if they somehow refuse to take steps to control their blood sugars and dietary intake? Do we force a person with cancer, even one who is dying and who is loved immensely by her family, to accept yet one more round of chemo and radiation to hit her body with yet more poison to sully the quality of the balance of their lives? While the Committee members learned about the path many of these unfortunate souls took to get treatment or have it forced on them, the Committee has failed or neglected to explore what happened to these same people afterward. Hearing the story from a mother, a father, a brother, an uncle or an aunt, doesn't cut it for me. I have met too many people who have been through forced treatment to know that this is not the answer. One has to ask if one has to force treatment on someone, is this treatment really that beneficial?

I am alive because I refused treatment when I was much younger. My spouse is alive, because I personally weaned him off three highly risky psychiatric drugs he was given, which in fact drove him to the emergency room several times until he was free of them. Others have had to experiment with different drugs in cooperation with their doctors until they found something that agreed with them. This was done on a voluntary basis, in the case where a person was given a choice. I know many who are no longer with us to tell their stories because they died of complications resulting from these drugs, or from the restraints or a combination thereof. There were numerous coroner's inquests in the 1980's, that were called as a result of "psychiatric patients" dying either in the hospital, or off grounds as a result of something treatment related. These inquests took place before the laws that exist today were passed, which are the very same laws the Select Committee is suggesting we return to.

Further on it states "we have received testimony that other jurisdictions have broadened involuntary admission criteria by expanding their definition of harm, without unduly jeopardizing autonomy (my comment: this is a very difficult tightrope they are pretending to walk). For example, these jurisdictions consider the threat of all serious harm, not merely physical harm. They also permit treatment in cases of involuntary admission. The Select Committee was particularly impressed by British Columbia's mental health legislation ..." The report goes on to state that psychological harm might also be considered as a criterion for harm. This frightens me as "Big Brother". A similar change to child protection legislation was made under Mike Harris in the late 1990's, which resulted in tripling the budgets of child protection agencies across Ontario, merely as a result of over-interpreting harm. As most child protection workers are not well trained in cultural, psychological and child-rearing differences in poor families, families of persons with disabilities and families of differing ethnic origins, these families instantaneously became a target for child protection laws in the late 1990's whereas up to 87% of all apprehensions involved children living in low income families.

One may ask if child protection laws that were more loosely defined helped save any child from harm. We can't prove it did, nor can we prove it didn't, which is the very difficulty of these types of programs as they are very rarely evaluated on their merits. They are merely funded on the basis of emotional reactions and "bad case scenarios" reported in the media. However, we have seen the results of many families that have been broken up for unwarranted reasons, former parents turning to drugs and alcohol, welfare benefits dropping leading to the loss of homes, other children, divorce, etc. The child protection agencies do not see these after effects as "their problem" as their responsibility, they say, rests solely with the child. One can find lots of personal stories about this system on other websites, such as fixcas.ca, Canada's Court Watch, and the Foster Care Council of Canada. These are not just disgruntled abusive and neglectful parents that got "caught"; many of these people were forced to sue to regain their dignity and families. Now the Select Committee on Mental Health and Addictions wants to police irritating, bothersome and offensive conduct, by criminalizing these people anyways. The Select Committee protests the idea of criminalizing so-called psych patients, then proposes a set of laws that will restrict or remove their civil liberties anyways, even if these persons committed no crimes.

My experience in working with people dictates that mental health services must be delivered in a timely, non-stigmatizing and voluntary environment, that is free of threats and influence. Many are fearful of entering the system voluntarily, fearing that somebody will later force them into another part of the system involuntarily. Others have told me they do not want to be seen entering or leaving buildings that are known to house mental health services. People in registered professions suffer in silence, fearing that if they disclose and ever end up in treatment that their capacity to carry on in their profession will be questioned. People prefer not to tell their employers about their mental health issues, even though many of them do have serious disabilities. Some use recreational drugs or alcohol to help "cover up" their disabling symptoms, fearing their employers, neighbours and others know. Doing this can lead to even worse problems, as we know. While I know that it is fact that a significant minority of people with mental health problems as serious as schizophrenia or bipolar affective disorder, do hold good jobs, the majority of these people are "hidden" - fearful of what their employer might do if they find out. Their fears are not unjustified, as in a recent case before the Human Rights Tribunal and later upheld by the Divisional Court does show how erratic an employer may react upon receiving information about an employee involving a serious mental health problem. People with mental health problems want to work just as much as anybody else, and to use the full range of their skills and education.

These facts still remain despite the fact that in cultures where persons with a serious mental health diagnosis, including schizophrenia, recover socially most of the time, when they are accepted, included and given a role or meaning in their lives. Richard Warner, a psychiatrist, studied schizophrenia in various cultures and found that in cultures where a person would return to a socially meaningful role, usually a job and a place in their community, they recover. As frequently stated by direct consumers in their testimony to the Select Committee and thereafter ignored, "a home, a job, a friend", is what they need, just like the rest of us. This concept was tested in modern western society, which with its obvious limitations and implications/stigmatization, it has been found that a model based on Sen's "capabilities-informed agenda", as opposed to today's damaged identity management, is a preferable approach.

This report not only attempts to skimp on civil liberties, but also on patient privacy as well. Later in the report, there were references to family members concerned when they approach health care providers treating their family member, and fail to obtain information over the "privacy act". This personal information, like your personal information about your diabetes, your STDs, your breast cancer, your HIV, etc. cannot be released without your consent. The same presently applies in health care for mental health clients. under the Personal Health Information Privacy Protection Act. The report lends itself to some eerie recommendations that also concern me, as it stated "... recommended that the language of the Act be amended to clarify that health information may be disclosed to reduce the risk of 'serious psychological harm', as well as physical harm. The Select Committee believes that this is a reasonable amendment ..."

The report further states that "The Select Committee was also informed that British Columbia's legislation permits the release of personal health information to health care professionals, family members, and others involved in a client's care without the client's consent for the purposes of 'continuity of care' and if it is in the best interests of the client (my comment: "best interests" as determined by whom?). In other words, you can be an inpatient of a psychiatric ward and have a sister who would love to get hold of your money, come onto the ward and be provided your health information so that she can then use this information to take over your finances. This type of information sharing is dangerous, not only in situations like this, but I have seen it alienate the person from their family entirely. Families are not always loving, caring and therapeutic, nor do they always have the best interests of one another in mind. I have seen more dysfunctional families, than functional, intact ones in my career. Would you like your family members to know all of your personal health problems, unless you deliberately permit the flow of this information? This suggestion, of course, would be only for mental health issues, and not for patients with other diseases or conditions.

The Select Committee, while it does not make specific recommendations, through its words as cited above, would like to set up a committee of family members, health care professionals and "consumers", to come up with recommendations. My money is on picking those individuals that seem to be of like mind to the Select Committee. While there are mental health 'consumers' around that might agree to these things, most do not. People generally want to live their lives with as much autonomy as possible, and to make choices about their lives and take responsibility if they make the wrong choices. By not permitting persons with mental health problems to make the wrong choices, they are not being permitted to make any choices at all. Please be assured I was a participant in the earlier drafts of various mental health laws that we have today, such as the Weistubb Report, the Fram Report, as well as the legislative committee that preceded the Graham Report, of the 1990's. These reports were also drafted by experts, including those with lived experience, such as family members and consumers. These reports resulted in the Health Care Consent Act, the Substitute Decisions Act and the Mental Health Act amendments. I also took the Toronto Star to the Ontario Press Council in the late 1980's for their portrayal of "victims" of mental health conditions as being incompetent, helpless and suicidal, one hand or homicidal human beings, on the other, despite study after study that shows mental health diagnosis does not increase the probability of somebody being violent, and they are certainly within the same range of intelligence and skill base as the general population.

The report leaves the uneducated reader with a set of assumptions about people with mental health problems:
1. They are incapable of making decisions for themselves;
2. They have or need caregivers in their lives;
3. If they refuse treatment, it is a symptom of their illness;
4. A whole system of paid staff and institutions and programs need
to be developed to control these people; and
5. Family members should be able to dictate or control the lives of
their errant loved ones.

If I brought these assumptions to the people I presently know who are living with some type of mental health diagnosis, including the serious ones, most will say the following:
1. Let me decide how I want to live my life, but please help
support me so that I can reach these goals;
2. I don't have or need a "caregiver". I can look after myself,
thank you very much. If I need help, however, please make
sure that it is available when I need it.
3. I should have the right to accept, refuse or negotiate treatments
for all of my health conditions. I do not want decisions made for me;
4. If I want help from the system, please provide supports that I can
access readily and will not threaten me with incarceration if I
refuse some of their help, or want to do some things my way; and
5. Let me choose if I want my family involved in my life or not.


After reading this, what I find is true is a dearth of VOLUNTARY, SUPPORTIVE and HOLISTIC resources for persons in crisis. If a program was non-threatening, and promised to give the person a sense of safety, the person will go. If they feel they will be coerced into something, they will refuse. It is our human nature. We continue to spend more money on hospitals, acute care and involuntary admissions ... taking this money away from much needed community-based resources. I am constantly being told as a legal professional to "get my son some help, even if you have to help me force him to". I refuse to do so, or participate in this. When their family encounters this individual, he is stubborn, angry, delusional, confrontational and downright scary. Yet, when I meet with him, he calms down considerably. His best hope of remaining well, unfortunately must be to stay away from the source of tension - their families, at least for now. I also meet with the family separately to talk to them about how they need to take care of themselves, ensure they remain healthy and strong, and how they can be supportive if and when the person returns to them. I am always armed with resources - support groups, websites, books, articles, etc. to assist the family member to de-stress and learn to let go.

It is very hard to let go. I know it. My brother committed suicide when he was twenty years old. He was three years older than me. Prior to his death, he reached out to me, talked to me a lot, spent a lot of time with me ... for years, I felt badly, and wondered if there was anything I could have done to prevent him from doing this. Twenty years later, I finally reached the realization that there was likely nothing I could have done. I finally forgave myself for the years I dwelt on this "if only" type of thinking. This doesn't mean that suicides cannot be prevented, but it is my absolute conviction that forcing people into treatment against their will is not the answer. This may prevent the suicide for today, but will not prevent it from happening later.

In the meantime, one needs to understand the difficult time we are giving people with this type of diagnosis. If they won't even share with me what is wrong with them when they come to me to appeal a disability claim, who will they share it with? I have had young men come into my office and cry about how their knees are so bad, they can no longer work. It is only after I obtain past medicals, clinical files and medical reports, that I learn that there may have been a mental health issue. We are keeping mental health problems in the shadows by attempting to treat their bearers differently than others suffering from other medical conditions. We are disrespecting their autonomy, their privacy, their rights, and then pretending at the same time, we considered all of this, and only discover the damage done when it is too late.

I don't know when the time will be when the major stigma connected to mental health issues will ever go away, or if it ever will. However, I believe in the recovery concept or the newly developed "capabilities-informed agenda", as opposed to focusing on the deficits of these human beings. When all of us, including health and legal professionals, neighbours, employers, teachers, and others, begin to think in the same way, perhaps then, the major stigma of these conditions will go away and for once, these often beautiful and creative people will feel free to be themselves.

Your thoughts?

STIGMA AS THE ENEMY -- MENTAL HEALTH CONSUMER/SURVIVORS BEWARE

There was a major series on Mental Health in the Globe & Mail recently.

There was a lot of discussion about how painful the stigma is. Many people do not seek treatment because of stigma. They may notice issues happening within themselves, and then the TV begins to repeat stories about people like Vincent Li that stabbed Tim McLean to death, or about some other killer that ended up happening to have a diagnosis ... smaller headlines accompanying the same story try to repeat that people with mental health problems are LESS likely to be violent than people with mental health problems. So, if this is the case, why mention the mental health diagnosis at all? We certainly don't refer to people's hemorrhoids or gastritis when it comes to reporting their crimes, so why do they beat the mental health dead horse?

There were a number of panelists and presenters that told their stories or spoke about potential solutions for the mental health crisis in Canada which resulted in a report from the Senate Committee on Social Affairs, Science and Technology entitled Out of the Shadows at Last. I read the entire report. While it did highlight some important components to mental health, it did not really give a lot of answers as to what to do about the stigma, other than suggested the latter established Mental Health Commission to embark on some campaign to end it. There are some attempts out there to try to compare people with mental health problems with persons with diabetes, but unfortunately, that isn't working. If it worked, it would have worked a long time ago, and we not be faced with a continued stigma that even prevents many persons with mental health disabilities from entering the workforce, engaging in relationships or doing other "normal" things. The media images don't show mental health clients doing "normal" things -- they are always portrayed as violent or completely incapable of looking after themselves.

In Helen Henderson's regular Toronto Star column, she referred to a British study where it was shown that one in eight persons stated they did not want to knowingly live next door to a person with a mental health diagnosis. Further, this same study revealed that over one third indicated they did not believe people with mental health issues were entitled in the same way as others to a paid job. Similar studies have been done in Canada that have also revealed that many people would not knowingly engage a professional like a doctor or a lawyer if it was known that the person had a mental health diagnosis. So, what incentive is there to get help anyways?

There are a large number of working people I know, many in the professions, that have told me in confidence that they have suffered from depression, bipolar disorder or some other diagnosis for many years, and to maintain confidentiality, they seek help from a professional in another region, as opposed to getting it here. These people are not homeless. They are not on ODSP (although a couple of them I am aware have been receiving a partial supplement from ODSP, as they work -- but they keep that to themselves too). These people are living independently and do not need "special housing" of any kind. They, like everybody else, needs a home that is affordable, with a door that locks, a roof that doesn't leak and enough space for them to enjoy their day to day living activities.

One of them was in my office the other day and we were talking about the Registered Disability Savings Program and he wanted to know how to get it. I advised him that he would need to qualify for the Disability Tax Credit first, then I explained what happens once they become eligible for the program. It is actually not a bad program for people with serious physical disabilities, as they do not need to stigmatize themselves by applying. However, for somebody with a mental health problem, they need to show that 90% or more of the time, they have a marked restriction in thinking, perceiving and/or remembering, which would reflect more of a neurological condition, although the examiners for the purposes of qualifying people would accept arguments involving problem solving, capacity to live independently, etc. as part of their evaluation for eligibility for mental health disability.

The problem with this is that if one values their status as a professional, a student or perhaps, even an executive or manager of an organization, accepting this definition of themselves would render them unemployable, which is something most of my professional friends do not want. They do not want to face a Fitness to Practice committee of the Teacher's College or other professional regulator that would somehow question one's capacity to carry out their profession, if they allegedly have "marked restrictions" in these areas. Of course, as soon as my friend went through my literature on the topic, the whole question of the RDSP became moot. The one gentleman who receives a partial ODSP now knew this would not work well for him, thus forcing him to live within the restricted means of that benefit.

People with mental health problems CAN get the Disability Tax Credit. I have appealed many cases successfully in the past; however, in not one of these cases, was the subject able to work. In fact, even in these cases we had to prove severity. These folks had problems managing their money, handling their personal hygiene, using public transportation independently, as well as being unable to handle stress - thus, the problem-solving issue. Some of these people were relatively high functioning, such as the case with Buchanan v Attorney General of Canada, but in the end, his case was proven but he was not able to work, and had to be cared for by his wife. The new 'mental health consumer/survivor' as they call themselves today wants to be independent, competent and functioning as a human being to the extent possible, and in most cases - if analyzed at the surface, they certainly wouldn't be eligible unless they met the criteria of my successful appellants in the matter.

If somebody were injured in a car accident, for example, and ended up in a wheelchair, or if they had only 20% of their hearing and required sign language or other adaptations, then the stigma of applying for and receiving something like this isn't there. The examples given in the Canada Revenue Agency guide appear to favour physical disability over mental disability and this is post-review of the criteria, despite what some progressive mental health organizations might like to pretend they have accomplished on people's behalf. To me, this should be based exclusively on additional costs - direct or indirect - as a result of having the disability. This was in fact the original purpose of the credit. However, a high functioning consumer/survivor that is working, but needs to pay out of pocket for psychological counseling services isn't eligible. A high functioning professional with epilepsy that cannot drive due to seizures is not eligible. This can be a very long list indeed, as we can all cull out examples from our own experience.

One of the other issues faced by consumer/survivors is that they are too often chronically unemployed or under-employed regardless of their educational attainment. In a study cited by the Global Business Roundtable on Mental Health, employers tend to under-estimate the number of people they have working for them that could possibly be consumer/survivors. In this study, the figure estimated was almost always under 5% - when the general figure given is that one in five persons at one time or other experience a mental health problem, according to the Canadian Mental Health Association. When they do have problems, they are not usually accommodated, but instead sent on disability leave. If the employee is fortunate enough to have a long-term disability insurance plan, they will at least not be forced into poverty, like so many thousands of others. The loss of productivity is shameful and dispiriting.

Some consumer/survivors think it is a good idea to get consumer/survivors to work in a consumer/survivor-run business. To most of my friends I spoke of earlier, this is NOT a good idea, as one is permanently labeling themselves and later restricting their employment options, as research and experience has shown that society has not yet progress far enough to recognize the skills and talents of people without the label first. However, for those consumer/survivors who may never work again in a "normal" job, it may be an option for them. If they can be taken off or substantially off disability benefits, that is even a better thing over the long run.

So, it seems that people still do not want to accept people who directly experienced the services of the mental health system. How does one go about resolving that? This is an age-old question.
I, for one, do not like the term "mental illness", not only for its logical inconsistency, but it does contribute to the stereotype of incapacity. Moreover, there is no actual peer-reviewed research that definitively ties mental health diagnosis with a specific physiological cause. This is not to say there is no value in the use of medication, as many consumer/survivors are helped by the different medications prescribed for their condition. Because a medication may "work", it does not mean it corrects a physiological condition, but may provide symptom relief in other ways, such as a person suffering from a major headache taking an Advil. Again, as always, one needs to be informed about their medications and ensure they try different ones before they settle on a cocktail that may eventually be proven to be most effective over time.

But not all so-called "mentally ill" respond to medication or need it. Medication is just one part of an array of services, or weapons, against the problems of the condition. Alternative therapies help many consumer/survivors, as does some forms of psychotherapy. When given a wide range of choices, understanding the benefits and drawbacks to each, a consumer/survivor will eventually find their way. But, to label them "mentally ill" automatically generates a picture of somebody who is "mentally defective" or "mentally incapable", whereas the focus is on what the person cannot do, as opposed to what they can. Advocates attempting to "educate" on mental health issues and to eradicate stigma should take this issue into account.

Nor are persons with "mental illness" likely to be homeless as a direct consequence of their condition either. Unfortunately, the media and even many social workers tend to paint this picture of their clients, as people who are not capable of caring for themselves. Earlier, I referred to the Out of the Shadows at Last report from the Senate. Various deponents slated the percentage of persons with mental health disabilities as unemployed or underemployed as 75 - 90%, which also explains a lot. When you are unemployed, especially chronically so and without access to long-term disability under a private plan, you are forced to impoverish yourself in order to be eligible for the remaining programs, Ontario Works and Ontario Disability Support Program. Neither program pays well and a single person, even on ODSP is several thousands of dollars below the poverty line.

I spoke to a homeless gentleman named John, here in the city. He supposedly had a mental health "history", but he chose homelessness over starvation, because he knew he could not afford both housing and other basic needs on ODSP. As such, most times when I seen him, he was enjoying a meal of sorts. To me, it's the consequent poverty that often arises out of discrimination and stress from the job market that leads to homelessness, not the other way around. Can you live on $572 a month and cover housing, groceries, clothing, transportation and other needs with that? My suspect is that most of the homeless are like John. The only ones where I actually feel their disability itself may have played a part are those that are addicted, as many would "blow their rent money on drugs". For those folks, we simply dry them out and get them treated and housed, but for somebody with only a mental health problem, get them enough money to live on or housing they could afford - period.

One of the consequences of linking so-called "mental illness" itself to homelessness is the danger of it translating into social policy, whereby one's liberties are once again at stake. Proponents of this "model" tend to favour forcing people into mental health treatment -wanted or not - effective or not - on such persons and keeping them under some kind of prison-like condition in the community. They would be under curfew, forced to share their accommodation with others, often with worse problems than their own, and forced to take medication at the risk of being evicted if they don't. While this policy may keep some people on their medication, it does not necessarily "cure" them, nor does it help them progress to citizenship status that we all take for granted. You need to ask yourself if YOU want that kind of quality of life FIRST, before you suggest imposing it on others. Nevertheless, liberalizing mental health incarcerations and follow-up supervision has NOT reduced the homeless numbers one bit.

Instead of attacking people for what they are labeled as, one needs to view all people for who they are. People sharing the same diagnosis are two very different people with different needs, interests and abilities. But nevertheless, they are people first. It is high time we start to demand treatment from mental health professionals and their advocates that assume they can eradicate the stigma by telling everybody how poor John is crazy, hopeless, incapable and delusional, so he becomes homeless ... How does this advocacy make John look like a person, other than distance his problems from those of yours and mine? Instead we need to stop the labeling and let John speak for himself. We might learn something.

Your thoughts?

DISABILITY - WHY IS IT THE PROBLEM OF THOSE WITH DISABILITIES?

Our society's progress on the rights of persons with disabilities is likely akin to what the rights of African-Americans were before Rosa Parks did her famous stand down on the city bus and refused to move to the back, as they were required then. African-Americans received a major boost with the election of President Barack Obama. I am not saying things are now perfect for this group, as still there is far too much poverty, too much racism and too much violence in this population. However, they are many steps away from the rights of persons who are differently abled?

In Hamilton, Ontario, a 22-year old man was lured to an address in a run-down neighbourhood in that city by four males, then subsequently locked up in the attic and beaten within a mere inch of his life. There are reports that he'd been raped, forced to eat his own feces and starved. It turned out this man was someone with various disabilities. An informant in my community told me he suffered from major epilepsy and mild intellectual disabilities. He grew up in several foster homes and of course, when he aged out of that system, they left him on his own. I am not sure of the background of this situation, how well the offenders knew this man and if they were aware of his vulnerability. Nevertheless, they certainly took advantage.

When I was younger, I used to do enumerating for the elections (yes, I am old enough to remember when actual humans used to go knocking on doors). One building on my route housed a number of adults with mental and intellectual disabilities. After I knocked, the woman who answered attempted to push me away by telling me that none of "these people" voted. I phoned the Returning Officer at that time, who then advised me that the owner of a residence like this cannot turn away enumerators, so we returned and pushed ourselves in and interviewed a number of people, many of whom wondered why the manager tried to chase us away.

Nevertheless, a few months after that, a man who happened to live in that home came to a club I was running at the time, complaining that he was fed only one meal a day which consisted of bologna sandwiches and tomato soup, sometimes weiners. When I stirred the pot on the issue (as I never go without stirring pots when I have the chance), some social worker came to my building to try to discourage me from acting further ... I hated social workers since, even though it is one of the professions I worked in for a time.

In another situation, another group home reached the news with workers on strike over what they found were appalling circumstances they found their resident clients living in. They brought attention to the media about spreading a single can of tuna over fifteen sandwiches and handing a man a bus ticket to get to the hospital when he was suffering from chest pains. This man was quickly diagnosed as having a heart attack, but it was too late. He died before anything could have been done for him.

Some of these incidents and many others sparked an enquiry led by Prof. Ernie Lightman, of the University of Toronto, who led the Enquiry on Unregulated Residential Accommodations. I did some work with this enquiry at the local level, interviewed many people who lived in these types of "homes" across the city and made policy recommendations. Steps were taken towards the implementation of a Resident's Rights Act and later under a subsequent government, board and care homes were given some protection under the then Tenant Protection Act.

While these incidents apart from the incident in Hamilton took place in the early 1990's, nothing has changed at all for persons with disabilities. People with disabilities are still viewed as being "less than", "less skilled" and "less valued". This dangerous thinking that preceded the Holocaust whereby hundreds of thousands of persons with various degrees of disabilities were experimented upon, then disposed of (well before the Jewish community was targeted) ... still exists in its most mildest forms. It remains in our laws. It remains in our government programs designed to "help" people with disabilities. It remains in how people with disabilities continue to be viewed by the "able-bodied public" that believe they pay taxes to people that don't want to work and use "disability" as an excuse, or at worst, they campaign for the re-institutionalization of many persons with certain types of disabilities, such as mental health.

Before we can truly address prejudice and discrimination against people with disabilities, we need to address our cultural assumptions. We need to address the pictures that come into our minds when we hear the term "persons with disabilities". For the able-bodied, most see the wheelchair, the walker or perhaps, even the white cane. They believe we should make sure people get access to buildings, restaurants and other destinations so they can go where able-bodied people go. This is the enlightened view. However, even among the enlightened, we fail to see how these same people, as well as many other persons with other types of disabilities that may prevent them from driving, as an example, can get to many of these places in the first place, even if such destinations represented the epitome of accessibility.

Able-bodied people take a lot for granted. They trust that when their brain directs their legs to move and to pick themselves up, they will be able to walk across the room, climb those stairs and read from a regular book or magazine with ease. It is when we lose some of this ability do we realize what we had, how precious, for example, our eyesight, mobility, agility and other physical attributes represent with respect to ensuring we have a quality of life. If this happened to you, I am willing to bet that you would want support services, assistive devices and other systems to "kick in" to allow you to take part in your favourite activities. If our home is no longer useable for us, we want somebody to help us set it up so that we can continue to live there. We don't want to be shunted off to some nursing home.

If your problem is mental health related, and yes -- one in five of us do experience mental health issues at some point or other in our lives. Of that one in five, 10% suffer from what one might identify as a "severe mental health problem", whether it be named schizophrenia, bipolar mood disorder, generalized anxiety disorder, post-traumatic stress disorder, etc. If you have never experienced the serious side of things here, it is too easy to believe the stereotypes ... those being that people with serious mental health problems are either violent and unpredictable, or they are bumbling idiots who are unable to care for themselves. These two are the predominant themes that describe people with mental health issues in the media.

In the 1990's, I managed a local mental health agency, then later moved to work in the policy area. Very few of the affected that came through my door were either violent or bumbling idiots. However, in many cases, their medications often made them look different, or their self-esteem was so low that they did not feel they were capable of ever working again. In my life, there are many examples of people I met even with the most severe of mental health problems who have picked themselves up and made themselves into community leaders. Bill McPhee, publisher of Schizophrenia Digest, and recently a publisher of another magazine geared to people with mood disorders, is not shy about talking about his beginnings ... as a man who was diagnosed as schizophrenia himself. While I may not necessarily take a pro-medical approach, as many of the articles in his magazine depict, he also includes lifestyle issues, advocacy issues as well as spiritual commentary. He has been a public speaker at numerous events before a wide variety of audiences.

Bill Wilkerson, previously an insurance executive, co-founded the Roundtable on Mental Health and the Economy. Former federal Finance Minister Michael Wilson was also part of this initiative. Michael Wilson's interest in the initiative was personal. His son Cameron was reported to have committed suicide at such a tender age when he became frustrated at not being able to find work, despite his education and skills ... he was apparently diagnosed as having a bipolar mood disorder. Bill Wilkerson engaged many others in his initiative and together with other coalitions, the federal government eventually set up the Mental Health Commission, which is designed to help educate, research and train people in this delicate area.

However, in a recent article in the Globe & Mail, Wilkerson began to disclose his own personal interest, a long-term diagnosis of depression, something he kept well-hidden from the media until he believed it to be the right time to disclose. If somebody like Wilkerson, who has been at the top of the business echilon, and with obvious skills to bring this Round Table together, was unable to disclose his personal interest earlier in this project's progress, one can only imagine how others without these significant personal resources would do it.

There are barriers to disclosure. There are too many Vincent Li's out there that commit heinous crimes that are well-publicized (e.g. Li was the man that viciously murdered and dismembered Tim McLean on a Greyhound bus last summer), and to make matters worse ... it becomes well-publicized that he is declaring to "hear voices from God" that apparently directed him to kill McLean. Whether this was true or not, this does nothing for mental health advocates who are attempting to work with those others so labeled to even get them to the door to get help ... we never hear of stories that counter these conclusions, such as how Bill McPhee overcame his disability to become a spokesperson and advocate for the cause, or Bill Wilkerson, who only recently disclosed his own interest in the issue, or Michael Wilson's recount of his son's suicide ... these latter cases are stories we need to hear more about and the Vincent Li's of the world, we need to hear less about.

In a recent edition of Mother Jones magazine, a section was devoted to photos taken of mental hospitals around the world (and yes ... these are hospitals that operate in 2009). In the words of the publisher, it seems that once one is labeled, many people think they can do whatever they want to persons with mental health issues, whether this be experimentation with dangerous therapies, such as ECT or insulin shock, or drugs with questionable benefits, such as haliperidol, lithium and thorazine. I'm not saying that there is no place for medications in the treatment and amelioration of mental and emotional distress. I am saying that the process or dynamic that leads to the labeling of such persons, and how such treatments often become drilled down, are in fact, done to as opposed to done with the person in mind. Often times, people can become further disabled by the treatments themselves.

Culturally, people with disabilities, including people with mental health issues, are not looked upon as credible people in their own right. As a result, many members of the public misunderstand who these people are and assume they either have no skills, or are incapable of learning new ones. Sadly, when I report my own personal knowledge of people in various professions who have had mental health diagnosis, people don't believe me ... and I shield their names, as these folks do not want it to be popularly known that they suffer. One lawyer friend of mine told me he wanted the "secret" sealed, as he feared public knowledge of his "condition" would lead to questions about his ability to practice. While many of these fears may be unfounded, they are realistic enough to know that members of the public may see it differently - that they'd rather not be treated by a doctor they know has been treated for mental health issues or to have a lawyer handle their civil case who was hospitalized a few years ago for a bout of depression ... there are surveys that prove that public opinion is real.

Another lawyer I know has a severe physical disability; shortly after he passed the bar, many of his colleagues challenged his ability to work as a professional, simply because they saw the wheelchair and the breathing apparatus, but not the man. Some people say we need a champion, but nobody wants to be the first one. Nevertheless, the prejudice and stereotypical ideas about persons with disabilities continue.

Even when it is known what education and skills a person with a disability has, employment workers can often be their worst enemy when they attempt to work with them at their career development or transition (in the case of an injured worker, for example). Telemarketing and call centre work seems to be the most sophisticated work a person like this is referred to, as the worker believes the person with the disability wouldn't handle the "stress" of a more advanced position. Well, did they ask? Likely not. This is so analogous with the scene where a person in a wheelchair and a temporarily able-bodied friend are in a restaurant together and the waiter approaches their table, only to ask the able-bodied person what the friend in the wheelchair wants ... something like this happened when I brought a friend of mine who was severely visually impaired, guide dog and all, into a restaurant and the waiter attempted to make me her interpreter ... I just told her, "Why don't you ask her what she wants?". Yet this kind of scene is repeated everyday in the social work and employment agency world when it comes to persons with disabilities ... they don't know what to do with those that know exactly what they want, nor do they know how to deal with employers that seem to deliberately screen people with disabilities out of jobs they can otherwise do quite well. To me, I always wonder why they have these jobs if they are doing nothing to connect the persons with the disability with the employer, but then again, I must be naive.

One person I know that uses a wheelchair felt that those with invisible disabilities had nothing to worry about, but after I gave him a little history of how people with mental health problems, intellectual issues, even autism, were treated, he was shocked ... and realized the importance of working in a cross-disability alliance. All people with disabilities experience discrimination, humiliation, stereotyping and marginalization, although different disabilities may attract different kinds of prejudice. Persons with mental health issues are believed to be stupid and irresponsible at best, or violent and unpredictable at worst. Persons with physical disabilities are sometimes seen as demanding, when they ask for accommodations, when in fact providing them with the same actually puts them on a level playing field with the able-bodied. Scary.

One of these days, I will write about the dangers of ODSP income support and how in itself, it acts to marginalize and isolate persons with disabilities, as well as perhaps, even shorten their lives. As an advocate for persons with disabilities, I am often a lightning rod for comments, as I always try to get people to understand there is always more to every story than meets the eye. I hear all the time from members of the so-called able-bodied public about how people with disabilities can just do "desk work" or they often exaggerate their conditions to get welfare and then not lift a finger to "help themselves". I hear from some people who outrightly say that "at least half of those on ODSP" are not really entitled. I always ask them how they know this -- are they a doctor? Do they know everything about the people of whom they speak? The most interesting thing, however, is when something happens to them and they reach out to our dwindling welfare state to find help to keep them from sinking, they seem to change their minds relatively quickly about what they used to say about so-called "disability people".

The only thing we can do is to iterate the facts, which I will attempt to do in another post later on, so that the reading public can understand what hardships people on ODSP really do endure and how unintended (or intended?) consequences are killing their spirit.

Thoughts?

The STIGMA in Mental Health is STILL the Same

Did you ever wonder why a student at Virginia Tech would suddenly blow a gasket, take a gun and go around shooting up his school?

How about another fellow who deliberately drank a twelve pack of beer, then walked into a Florida bar with a gun and shot up the establishment?

Of course, you are thinking ... these people have got to be mentally ill. Nobody in their "right mind" would dare to do something like shoot up a school, a bar or a former employer. That is insane!

On the more subtle side, we hear from "experts" that a disproportionate number of people that live on the streets are mentally ill. The implication of course is that such persons cannot stay in housing because they can't manage their money, they say. How about the man that was found in a Toronto apartment building surrounded by pigeons and other wild species - to a point that it got so bad, that the police shuttled him off to a mental health facility and the animal rescue people were called in to get the animals out of there.

Were these people "mentally ill" or is somebody just giving them a label because of their attitudes, behaviour and ideas? Who determined these people were "mentally ill"? Are you "mentally ill" simply because you spent a night in a mental health facility? Nobody knows "Pigeon Man's" mental health history, but they shuttled him off to a mental health facility anyways, so therefore, because he was sent to a mental health facility - everybody now believes that "Pigeon Man" was mentally ill.

How about the rest of the 99.999999% of people who apparently suffer from some type of "mental illness", whether that be anxiety, depression, schizophrenia or obsessive compulsive disorder or a whole whack of other "conditions" that continuously seem to be added year over year to the psychiatric Bible, known as the Diagnostics and Statistical Manual of Mental Disorders, the short term being the DSM-IV? Are all these people like the "Pigeon Man", living among the homeless, or are they like Cho, the infamous Virginia Tech school shooter?

Let me tell you one thing. In a recent report of the Canadian Senate, it was cited that approximately 90% of those who have been diagnosed with serious "mental illness" are unemployed. Whenever somebody with a known "mental illness" wants to move to any neighbourhood, the picket signs go up and the stigma goes full tilt. People scream about the Chos, the Pigeon Men, the bar shooters and all the other horrific characters that are simply part of the 21st Century ... to no avail. People who are open about having a "mental health" history are as good as dead even in 2007.

What is the truth? First, there is NO evidence that people who have been diagnosed with a "mental illness" are any more dangerous than you or me. Second, there is no evidence that people with "mental illness" are any more likely to do stupid, outrageous things than you or me. You point to the "Pigeon Man". I point to Criss Angel, the Mind Freak, who has his own show on A & E, where he has done a string of stupid things, ranging from from lying in the path of a mega-SUV, had himself buried alive in a coffin under a ton of dirt, as well as pretended to walk on water over a swimming pool - all on national TV! We are entertained by Criss Angel, yet nobody carts him off to a mental health facility!

You tell me that people with "mental illness" should be supervised with their money. I point out that I know many well-paid professionals that go to the casino all the time and owe hundreds of thousands of dollars, often resulting in the break-up of their marriages and the loss of their homes. I also know of many individuals who are like you and me who buy a new car every two years, put everything on credit cards, and live the life of envy of most and beyond their means, but yet never get labelled "mentally ill" or told that somebody has to manage their money for them.

What about the homeless, you say? Okay, let's make this one simple and straight forward. Can you manage to pay for a place to live, food to eat and other necessities with a sum total of $536 a month? In most places, this is even becoming difficult to do with an ODSP cheque of almost $1,000 a month. Yes, some of these people may be "mentally ill", but many of them are also physically disabled, blind, suffer from migraine headaches, or not suffer from any conditions at all. Let's be honest about this one. This is an income problem first. Once we resolve the income issue, then we can look at everything else -- too many people with a direct and financial interest in the outcomes of these issues want to put the cart before the horse and receive money for what they do, instead of allowing the people who need it the most to use it to pay for their own needs.

In my line of work, I handle appeals for various kinds of disability benefits among other things. In particular, the appeals I handle for people seeking ODSP benefits are difficult because roughly half of my appellants end up having at least one spell of homelessness while waiting for the government to get their act together. The people that end up homeless have all kinds of disabilities, e.g. very bad backs, multiple sclerosis, arthritis, Parkinson's disease, deaf or hard of hearing, spinal stenosis, cancer, etc. as well as a few that have a so-called "mental illness". In fact, most of my homeless appellants have not had a history of "mental illness". They just have a hard time convincing the peons of government bureaucracy they have a legitimate disability and they cannot compete adequately in today's labour market to sufficiently earn enough money to support themselves on a persistent basis. This has also happened to several of my worker's compensation appellants ... people who held legitimate jobs, but sustained injuries while working that disabled them. The proof is in the pudding. Welfare rates are grossly insufficient for people to live on, let alone maintain a home. Because we often have to fight uphill battles to obtain just about anything else on behalf of these folks, welfare becomes the income of first resort - not last resort - and because this income is grossly insufficient, many fall behind in rent payments and get evicted or lose their homes to forclosure. Some may be able to keep their homes, but end up in a serious debt crisis. I am working with a man who has put well over $75,000 on his credit card in order to prevent what is often inevitable if he were to turn to the welfare system.

Nevertheless, once I do get the appellants on disability and they receive their retroactive back pay, they *are* able to find and secure housing on their own. This includes those with "mental illness", if you must call it that. I don't know of any of my appellants subsequently losing their housing, except for one or two -- one I do recall had an addiction to crack and his behaviour when he was using it caused him to lose one apartment, but nevertheless, he got help (at my urging) and is now housed and has been for the past five years. Yes, these people can and do get housing - however, as I often write in these columns, eating is quite a different matter. This is why a *substantial* increase in social benefits are in immediate order. Third world style malnutrition is not difficult to find among many recipients of social benefits; it's either that or substantially increased health care costs. I know of people who have been forcibly incarcerated in nursing homes because they were unable to afford proper nutrition for themselves and their health suffered the consequences. As a society, we need to consider if we could afford to continue allowing this to happen.

One person once tried to convince me of the alleged inherent stupidity in these folks by telling me that many people on ODSP have to use the direct pay system for their landlords, so that is why they don't lose their housing. That system is actually in place *because* many landlords, upon learning that you are on social assistance, actually demand it. It has nothing to do with the recipient's own ability to manage their funds. I know this because I represented landlords before the Landlord and Tenant Board, which have made arrangements upon the recipient moving in, or as a condition of them staying, to receive direct pay. Some of my ODSP clients also offer this to prospective landlords to make themselves more desirable to rent to ... many landlords still do not like renting to people on any form of public assistance. To add a tidbit to this discussion, the vast majority of people who I helped landlords evict are tenants with jobs, some of whom were making good money. They just don't like to pay rent.

However, in spite of all this, we continue to hear the bells tolling by the so-called mental health sector that want people with "mental illness" to live in segregated housing or to work in jobs created just for them. Despite their goodwill gestures here, this actually adds stigma to the vast majority of people with mental health issues who can and will manage their lives well despite their problems. Many just can't get jobs because people believe the Hollywood images of psychos, or listen too much to the so-called "experts" who have pre-diagnosed people like Pigeon Man and thousands of others through the media before they can turn their lives around. Those people with serious mental health issues that DO get jobs LIE about their histories so they can be hired on the basis of their qualifications only, nor do they DARE ask for accommodations fearing their prospective or existing employers will treat them differently upon learning they have the red scarlet letter on their forehead of "mental illness".

There are other stigma producers, such as those who believe people with "mental illness" all want to live with others who also have"mental illness" or work with them. They create housing that is specifically made for "them", even though none of these people if asked likely will demand this kind of "support" and suffocating lifestyle these set-ups entail. Those in these types of housing are mandated to take their medications, attend counseling sessions and have "life skills" training in areas they likely already do well in. Some of these programs will actually evict someone if the resident chooses to stop taking their medications, for example. To me, this is not a "home". They may as well remain in the hospital with regards to the choices they are given under these circumstances. If one desires supports, they should NEVER be connected to the home they live in and only be delivered by whomever one chooses and in the manner and to whatever extent is desired by the person. This would be no different than somebody who - for example - requires assistance with bathing three times a week and help with light housekeeping, but can manage most other aspects of their lives. These other supports are provided to people because they request them, not because somebody else says they need them.

People with mental health conditions often get sent to work in settings that are disproportionately within the five "f's" - food, filth, filing, fetching and flowers, regardless of the person's own education, training and career aspirations. Some of these settings are non-profit groups ironically set up by other consumer/survivors, as they call themselves today, that will hire people for a few hours a week in these jobs that also smack of stigma. Only a handful of people who work in these places actually hold higher-paid, full-time management positions, while the vast majority remain on their disability pensions, which these organizations ultimately leave out of the picture when they make their calculations of costs for the purposes of marketing their programs, what their actual costs are versus what subsidies they actually get. To me, ODSP subsidizes these programs just as much as any other government funding it receives if people are not likely to get off their pensions or reduce their reliance substantially in a dignified manner. Further, if you or I have a disability and run our own businesses, why are WE not *also* entitled to the same government subsidies these people get?

The real clincher is if somebody worked for one of these places for a number of years and wants to move on, despite any valuable skills and experience they may have gained, they are forced by identifying the name of the employer to disclose to *all* prospective employers that they were diagnosed with a "mental illness". I continue to advise my clients NOT to disclose to employers their mental health history and ONLY disclose this fact AFTER they get hired and ONLY IF they feel they require certain accommodations under the Human Rights Code. In circumstances where job seekers are moving on from these "special programs", they are not given the dignity of this choice. Wearing the scarlet letter almost guarantees a lifetime of unemployment, particularly for those who were not in management or supervisory positions (who may otherwise try to hide behind that fact, because many employers don't think "mentally ill" people are capable of working in higher level jobs anyways).

The chance that a person with a known mental health condition getting hired in a supervisory or management position is slim because when people believe the stigma that people with "mental illness" are unable to manage their own money, how can they handle the money of somebody else or that of an employer? Even those who have been trained and established in a profession have difficulty finding work for employers that would hire somebody in that profession, because again - people cannot envision the possibility that somebody with a "mental illness" is capable of working in a profession, let alone holding a low level job. Remember, they are all homeless, cannot manage a budget, babble to themselves as they walk down the street and don't know any better, right? That is why I am so emphatic about HOW people - including many advocates - express themselves about the circumstances of persons with mental health issues.

As long as the media continues to publish stories about people like "Pigeon Man", the legions of homeless get diagnosed long distance via the media as being "mentally ill", and people like Cho who shoot up schools get labeled as crazy, people with "mental illness" will never be thought of in any other other way. Even those who put forth so called "positive stories", such as a non-profit cleaning company for example that hires only "mentally ill" consumer/survivors, can also plant ideas in people's minds that folks who have been through experiences that society deems to be "mental illness" can only do jobs that fall within the five f's - food, filth, filing, fetching and flowers, and forget ever hiring them to do anything in management or other positions that might actually get them OFF disability and securely housed, let alone actually *own* a home for Christ's sake. Scary.

As a result, society relies on its non-existent social safety net to support these individuals, as nobody seems to want to hire them. Those who are not lucky enough to get on ODSP must survive on a total of $536 a month ... try getting even a hole in the wall for that amount of money almost anywhere. If they get on disability, they usually spend at least 70% of their cheques on shelter, leaving very little left over for food, transportation and personal care. Then, if they have trouble keeping their housing because their income is so low, then we blame them for being poor money managers. If any "middle class" person had to survive on what they get, I am sure they'd have lots of trouble too. But instead, because we want to keep the possibility of homelessness and destitution as far away from our own lives as possible, we try to convince ourselves that the homeless are different people than what we are. So different, that we are willing to shame those who are different into believing their differences is what causes them to suffer their misfortunes - and while doing so, we are only further denying the problems that we and the governments we elect have created. Shame, shame.