Schizophrenia and homelessness: lonesome twins

A friend of mine has a homeless brother with schizophrenia who refuses offers of shelter and housing. He also rejects gifts of clothing and supplies from family members and rebuffs their efforts to stay in touch with him. Why? Because in his paranoia he’s struggling to control everything in his life.

For a person with schizophrenia, accepting a gift opens a pathway that givers can use to travel right inside his head. When he’s not worrying about being invaded, he has to worry about how he’ll use the thing that was given. Things get out of hand. So do people, and schizophrenia adds an invisible crowd of noisy, unpredictable company to the sufferer’s mind, confusing everyday events and filling them with menace.

Possessions and companions – for many people with schizophrenia, both must be kept to the barest minimum. So they typically spend their time alone and tend to lose things or throw them away.

According to available statistics half of the people who are homeless have a chronic mental illness. Schizophrenia in particular drives many homeless people to seemingly “choose” a life outdoors despite physical misery and danger. Of course, they’re not really choosing a homeless existence. The gang of thugs that took over their minds monitors their every move, and their invisible inner voices may be warning them that if they live or work inside a building, their neighbors (or their stuff) will corner them and pounce.

In lucid moments my friend’s brother wants a girlfriend, wants to finish his college degree, wants to be able to work and make a good life – basically, he wants the same kinds of things we “normies” want. But his family can’t help him get there. As one of the residents at the National Alliance on Mental Illness (NAMI) Greater Seattle’s Hofmann House, an innovative, self-governing residence for people in treatment for chronic mental illness, once told a parent, “You can’t help your kid. He has to get so miserable that he accepts his disease and takes meds. All that his mom and dad can do is wait.”

Some of you already know first-hand and the rest of you can probably imagine what sheer hell it is for family members who must wait (hopefully!??) for loved ones to become so miserable they see no way out, and then (if they survive such misery) for them to decide they need medical help in the face of relentless inner tyrants who tell them they’re not sick.

Choose one person sharing our public spaces who is socially isolated by mental illness or homelessness to meet at a cafe' once a week.

In this free country of ours, people are free to be as wretched as their mental illnesses can make them – unless they’re standing on the Aurora Bridge ready to jump, or threatening  someone else. Harming others is the less likely event. Statistics say people with mental illness threaten other people only a tiny fraction more often than do the mentally well. When they do harm, it’s usually to themselves.

Knowing this, one of my small defenses against helpless despair about my friend’s brother is to go out for coffee once a week with a person who is isolated because of a chronic psychiatric disorder or who has been fenced into the social ghetto called “the homeless.”

True, some people with schizophrenia reject offers of companionship. If they’re not taking meds, their voices may already be more company of a certain kind than they can stand. But the great majority of those in treatment appreciate having a weekly social hour with someone who isn’t a caregiver or a fellow client. A beneficial side effect of this companionship is that it will help them believe in the value of continuing to take their meds, even if the subject never comes up between you. This is a great gift to people in treatment as well as to the families that love them.

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