Other groups like Catholic Charities of the Archdiocese of Washington, D.C. are actively ministering to this population, providing case management and long-term psychiatric treatment for inmates and those who have been released from the justice system.
Kianna Richardson, a correctional support specialist with Catholic Charities of the Archdiocese of Washington, D.C., sees clients with arrest records, most of whom are "non-violent offenders."
She provides 60-day case management for those "with severe and persistent mental health diagnoses who are returning from Charles County detention center back to the community." She insisted that "it's crucial for them" to receive treatment.
"Hopefully that will help them avoid being incarcerated in the future," she said, and "reduce their recidivism rate."
Housing and employment are the biggest challenges for this population, she insisted. If they have untreated mental health problems and an arrest record, they have a much lower chance of getting a job and holding it down. If they have no job, they can't pay for a place to live.
Also, in the county where she works – Charles County, Md. – the temporary shelter stays open only during the winter months, meaning that the homeless may have no options from April through September.
Washington, D.C. is one of the highest cost-of-living metropolitan areas in the U.S., and this poses a unique challenge to the city's homeless population, said Karen Ostlie of Catholic Charities, D.C., who has worked in mental health in the district for 20 years.
"There's a lack of affordable housing," she said. "That can be very difficult, when somebody doesn't have a stable place to live, to stabilize that person, for them to follow through with their mental health treatment."
Catholic Charities provides psychiatric treatment, and the ACT (Assertive Community Treatment) team "works with about 120 of our consumers," Ostlie explained, including "some of the most disengaged" and "seriously ill consumers."
They also work with other clients who had long-term hospitalizations at St. Elizabeth's, a psychiatric facility in Southeast D.C.
The ACT team will find and meet the homeless where they are, seeking to engage them in treatment, she said. But there are challenges – even if they receive prescription medication upon being discharged from mental hospitals, if they have no stable home, it is harder for them to keep the medication and take it as ordered.
The goal is to get the patients to engage in treatment with a psychiatrist, Ostlie said. They also work to get benefits for the patients and to help them apply for the appropriate housing, such as a single occupancy room or a group home.
"With some of our most seriously ill consumers, part of the difficulty with finding housing, other than the cost of apartments, is that they can't manage in a shared group home situation, or their behaviors are so challenging that the folks that run the group homes won't accept them or they leave or they don't want to deal with the rules."
Drug abuse is another significant challenge among this population, she said. Not only can it make mental illness worse, but even if patients go through treatment for it, they can easily fall back into addiction by returning to their former place on the streets.
"The key is to change the way we think about these things," Leifman said at the panel, insisting that there must be a greater national focus on improving mental health in communities rather than just incarcerating the perpetrators of crimes. "So much of our money is now going into correctional cost."
"There is no other illness in this world that is permissible to send people out into homelessness in the middle of the night," he said, but when it comes to mental illness, "people don't bat an eye."
This article was originally published on CNA Feb. 21, 2017.