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January 2011



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by Paul Linde, M.D. 

Psychiatry’s Sickest of the Sick: Abandoned by Public Health Officials

The homeless mentally ill in the city of San Francisco have been so visible for so long they’ve become almost part of the landscape to us city dwellers–essentially invisible people who, for all intents and purposes, have disappeared.

But for visitors, who flock to neighborhoods such as North Beach, the Embarcadero, South of Market, and the Haight in search of a little urban adventure, they can’t help but notice both the numbers of mentally ill and the intensity of psychiatric illness on display.

I still see these people. Time and again when I am out and about in San Francisco, I observe many of the “frequent flyers,” many of whom I know by name, that I’ve assessed in the psychiatric ER of San Francisco General Hospital, where I’ve worked as a physician and psychiatrist for more than 20 years. I’ve had to discharge many of them back out to the streets because there is no will on the part of the city or the state of California to provide appropriate care to these patients.

In my opinion, this is tantamount to discrimination.

There is no will on the part of the politicians or public health officials to provide them appropriate care. The wish is for “out-of-sight, out-of-mind.” Cut services enough and maybe they’ll leave town. These people don’t vote. They don’t donate to political campaigns. They don’t show up at meetings of the San Francisco Health Commission. They don’t live in Pacific Heights or Noe Valley.

These patients are people. Each one of them is someone’s son or sister or father or daughter or brother or mother. Nearly all have been lost to their loved ones and find themselves abandoned–swirling around the streets and the jail cells and the emergency rooms of the city, not taking their psych meds because they don’t believe they are sick and smoking marijuana and crack cocaine or drinking alcohol to deal with their psychiatric symptoms and emotional pain. Their staunchest advocates are family members who’ve lost loved ones to suicide, homicide, accidental death, victimization, homelessness, or incarceration.

Read in Full:  http://www.psychologytoday.com/blog/the-everyman-psychiatrist/201009/san-franciscos-homeless-mentally-ill-still-neglected

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