[Vision2020] Drunks, drugs, and the empathy factor

[Andreas Schou]

> One more thing:  I don't mean to attack addiction, but I find it absolutely
> REPUGNANT that there are more resources out there for folks suffering from
> addiction than there are for people suffering from neurobiological disorders
> over which they never had any control.  

As someone who works with both people suffering from neurobiological
disorders and addicts, I can tell you that the resources for those
suffering from schizophrenia, clinical depression, and severe anxiety
disorders far exceed the resources available to addicts. In those
areas where addiction resources are more readily available, it's
because addicts themselves have organized twelve-step programs.

Of particular note are the people at Adult Mental Health at Latah
County Health and Welfare (shout-out to Doug Salata) and Disability
Action Center (shout-out to Janesta). Between the two, I've had very
few problems getting people with Axis I disorders the help they need
to get out on their own, with a consistent income (often SSI/SSDI) and
a place to stay. In fact, Sojourners' Alliance has higher success rate
with the severely mentally ill than with the homeless population as a
whole. 80% of our schizophrenic clients this year (we've had five)
have graduated to subsidized housing.

Where the problem really lies is in getting dual-diagnosed (mental
health/substance abuse issues) clients the help they need. Often, the
substance abuse providers will diagnose mental health as their
"primary" issue -- because they have little experience dealing with
mentally ill clients -- and the mental health providers will diagnose
substance abuse as their "primary issue." So you'll see a client
that's both mentally ill and a methamphetamine user get a diagnosis
like this: Bipolar II secondary to borderline personality disorder
with methamphetamine abuse. And, whammo, all of the sudden a client
who clearly needs help (but who may not want it) has a diagnosis with
which they can't get any help, whether or not they might someday
realize that they need it.

> Of course, I'm a bleeding heart
> liberal who wants to help all those who want it, and that includes addicts.
> BUT, when employers start limiting health benefits (in part) because of the
> high costs of treating addiction, then I think we have an obligation to make
> sure those who have illnesses/disorders/diseases over which they have no
> control DON'T wind up with the short end of the stick.  

Addicts are often hard to work with. Often, the addiction has covered
for poor coping skills for years. The costs of not treating addiction
are, however, much greater than the costs of treating addiction. If
addicts don't receive the help they need (and since addiction, unlike
many psychiatric disorders, can't be treated with a pill, the costs in
terms of staff time are greater), they end up meeting either myself or
the criminal justice system. The costs of providing effective
outpatient treatment to addicts are far lower than the costs of
providing a room here at Sojourners' or a bunk in state prison ... or,
failing either of those, having the person burglarize your business to
steal money to buy meth.

-- ACS