This conversation is closed.

Rather than tear down housing in Detroit, let's repurpose it to house, treat and rehab our nation's mentally ill homeless citizens.

The Reagan era dismantling of our nation's mental hospitals in favor or "community based mental health" outpatient clinics has been a disaster and needs to be re-imagined. While homelessness has decreased in most American cities, in New York and Los Angeles, homelessness has grown exponentially. Los Angeles, where I live, has been overwhelmed with an increase in the number of homeless people and the insufficiency of housing. Perhaps California might make better use of some of some of its Proposition 63 money to help Detroit build a world class treatment hub. Perhaps Hawaii, which plucks the homeless in downtown Honolulu, off the streets and gives them a one way ticket back to the mainland would show more Aloha by sending them to Detroit – where it is cold, but where our mentally ill, homeless citizens could receive a home of their own and live in a supportive therapeutic community. Or perhaps the entire nation should have a tax to fund mental health care as California now does – and a large portion would be to used to build Detroit into a world class, state of the art mental health research, drug rehab, and treatment center - not like the old mental hospitals and not like the current clinics that have no housing.
A recent study in the L.A. Times showed that giving a homeless person a place to live - even if still addicted to street drugs! - is the most cost effective way to successfully treat traumatized, dysfunctional homeless people. The concept is supportive housing where there are therapeutic staff close at hand as part of the residential plan. Yes, such therapeutic communities would require special protections for workers and residents, some sort of guards - and a trained legion of mental health workers (that w don't have to be shrinks with Ph.Ds) but a new kind of certificated therapeutic worker, trained specifically for a new model of care. That would be mean lots of good jobs for residents of Detroit and others who would move there to do this work.

Closing Statement from Tristine Rainer

The reactions to my proposal were outrage – that a plan to house and treat our homeless, mentally ill and addicted citizens by repurposing Detroit’s empty housing was equivalent to sending them to a concentration camp. People objected that this plan would ghettoize people; it would be taken over by an uncaring private-public partnership that would be run by for-profits that would further victimize the homeless, that it would isolate them from family and friends. Yet this is exactly what is going on with our current disastrous system of community mental health care, minus housing. In expensive cities such as Los Angeles and New York where homelessness has increased exponentially "wrap-around services" at homeless mental health centers too often is simply a group of professionals who hand out SSI money to the homeless or help them get food stamps, but don’t have any shelter to offer them. With the cost of housing in Los Angeles and New York, people have no choice but to live in parks, in riverbeds and under bridges from which the police regularly expel them. The dire condition of the buildings in Detroit may make my proposal unrealistic, according to many commenters, but no one had any other ideas for what could be done to improve things. My own conclusion is that nothing short of a presidential initiative to discover what models of mental health care are working in this country and in other countries, and to revamp our system accordingly, will work. Most homeless people are mentally ill or traumatized and most become drug addicts in an attempt at self-medication. In our current system we give them just enough money to eat to stay alive long enough for their addictions to slowly kill them. It is hard to not to conclude that this is what our country wants - a gentle and invisible "Final Solution" rather than visible concentration camps - or the more humane solution of reconstructing mental hospitals that were eliminated to save taxpayer money.

  • Dec 21 2013: Really I find this idea totally abhorrent, and in some way's it the real issue with people's perspective on the mentally ill, just dump them somewhere, no matter how your dress it up it comes down to.

    Out of sight, out of mind. Problem solved.

    It's the same mentality that some have had with children and school shootings, put metal detectors in schools, see no more problems. But ask yourself, does that really solve the issue for the kid, or does it add to their frustration, and so just delay the inevitable. And who cares, as if the temp fix works, that will do. Because no-one seemingly wants to get to the root of the problem and actually help the kid.

    Never mind a lot of mentally ill people actually function in society, albeit under the radar, and with a city like this, it surely would keep people from coming out or seeking pre-emptive help. As they'd be ripped from their job, their families, their life. Don't forget even the homeless have parents, and possibly children. The isolation and alienation from the world that being homeless brings, because of society's stigma towards them, might actually be a pre-cursor to mental illness, rather than the other way around.

    But back to Detroit, exactly what business, what industry, will ever invest or want to be located there? A nations dumping ground, well only those companies that are not concerned with people, but profits, and you can only too clearly see how some ceo's will see how then they can utilize the detritus of human capital to terrorize society with if you don't pay us more... we'll release them. Rather similar to toxic debt and bank bailouts, no?

    And exactly what would be Detroit's new city slogan, "Once your in, you never get out".
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      Dec 21 2013: Steven, Perhaps the reason why you find this idea totally abhorrent is apparently you have a mind unwilling to surrender to mental illness. I can not agree with you more. Detroit is is the spiral down and will continue until it is said "enough is enough" we have to do something not the government who has helped to lead us to such a sad state! At some point we have to be willing to face ourselves as being the source of our own self created problems.

      Your new city slogan, "Once your in, you never get out". Sounds a little bit like hell doesn't it. One has to ask is Detroit and it's people worthy of being restored or am I my brothers keeper?
      • Dec 22 2013: Larry, why I find this idea totally abhorrent I hope will be clear at the end.

        I'll answer you last part first, Detroit does deserve to be restored. But in reality, one has to look and clearly understand why it got that way in the first place. Otherwise how will you ever know if you're not just setting Detroit up for yet another failure down the road.

        America, and not only her, but rather humanity as a whole goes for the shiny quick fix band aid solutions. In some ways I see those the cause of the financial issues of 2008, the quick buck with no regard for consequence ideology, which really is a contributor to the homeless issue, due to the massive amount of defaulting mortgages.

        As for mental health I think it's a hugely important issue, one that America has yet to honestly openly address. I for one have seen the actions taken by corporations regarding a severely effected person. The mindset was not to help the person by seeking medical attention, due to cost, but rather look for a reason to 'let him go', it's then "someone else's problem". I too found that abhorrent. I learned that's for the most part the reaction to mental health issues there. The implications of even admitting you have any disorder, combined with the original question implemented - I foresee - snatch squads, under the guise of helping, but really removing.

        A good learning resource is...

        I do, though I disagree, appreciate that the original poster takes the time to think about the issues, inc Detroit. I hope my comments make people think about consequences of actions before their executed, by frank discussion about all possibilities in a rational and open way.

        You see I'd rather people discuss issues first, If only because I've learned, seen, and honestly to some degree being a part of that very ideology, but now I've come to the crystal clear realization...

        It's always easy to blindly implement ideologies, when someone else has to pay the price !
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          Dec 23 2013: Steven, I watched the video in it's entirety. I was astounded at the progress made on the physical level of the brain in association with mental disease and mapping reflected areas. I am of the opinion what they are seeing is what can be called symptomatic and the panel even admits the source is unknown and there is no known cure. The value I see in the research is at least they can take some people deep in the disease process and arrest the progression. The downside is dependency on drug therapy. To gain further understanding one has to get closer to the unknown source. The same understanding can be transferable to the disease of the addict mind or the mentally disordered mind which by their nature share similar characteristics. The value of one human being helping another is that it is free and both parties receive dividends. The only way I know to be helpful is the bring clarity to a mind where it is not present as others continue to do for me.
      • Dec 23 2013: Larry, with absolutely no sense of condescension, I really am glad you watched the whole video.If your interested I hope you saw it's a part of a series.

        And in that series it really show's just how little we know, how much we have to learn, and ironically the two ladies that have issues, are probably more motivated than just about anyone else. Ain't that always the way.

        I posted it, not for the drugs, which seeming are now the only way to 'keep things in check', but how two professional people who, by the original post would have been dumped in a ghetto. Even they admit they didn't want to come forward, because it might have ruined their career.

        This is what people have to take away from this, that even though you might have something wrong with you, if you get a little help, you can go a long way.

        If those two people where not helped, but dumped, then it becomes humanities loss.

        And if we don't help, it we stigmatize, if we label, if we judge, it only reminded me of this song that was sung 40 years ago, and looking at Detroit, it's as relevant today as it ever was.....
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          Dec 23 2013: Steven, Detroit once the symbol of American industrial might! Where has our industrial might gone off to? Industrial might is our ability to produce. Simple truth is if we continue to consume more than we produce there will be nothing left. American manufacturing and production will have to come home. On the national level we must be fully self supporting or we will be dependent on foreign interest. As recognized in this debate foreign interest is currently buying Detroit on the cheap.

          The women with the issues were the voice of experience, the wisdom.

          My personal view of the disease process whether it be called by any of the psychiatric terms is fear. Behind an addict the mentally ill or homeless is a fear based thought system. It would appear to be a common denominator. An interesting question would be does chemistry produce the thought process or does the thought process produce the chemistry?

          Perhaps this will get us out of a sad song.

          Merry Christmas!
      • Dec 23 2013: Larry,

        In answer to your first paragraph, it's been co-oped out, for the sake of profits. I think it will only 'come home' if people really demand it does. And people, all of us, have the power to make that change, if we demand it.

        Interestingly, i was watch two documentaries that show the current state of play very well, the first this that financial services, credit cards, debt, et al, account for more jobs than manufacturing. Second that the foreign interest is so large in the US that in 2008 Paulson of the treasury (his memoir, “On The Brink.”) had to appeal to both Russia and China not to pull the plug on America, over the debt crisis, if they did, we wouldn't be talking today.

        Even though Russia did dump $65.6 billion stock in both Fannie and Freddie, which were seized by regulators on Sept. 6, 2008.

        After watching the whole of that series on the brain, and many others in the same ilk on other topics.

        I see that both songs are relevant, if only one shows us where we are, and one shows us were we can be. And only through understanding can we ever hope to affect meaningful and lasting change, and to also answer your other point, fear can only be overcome through knowledge and understanding, there are many a terminally ill patient that will testify to that.

        And ironically, given the season we should all realize that we all have the power of resurrection, on a personal level, on a city level, and on a country wide level, all we have to do is have, the will, the determination, no matter what the odds, not matter what the effort, to see it though. I think that too answers your question about 'why Japan?', they did.

        A very merry Christmas Larry to you and your family. Thank you for participating in the conversation, for watching the Charlie Rose special link, I hope you find the time to watch them all. Also for having a very cordial and rational discussion about the whole subject - no matter how hard and emotional the subject matter was. It was a pleasure.
  • Dec 24 2013: Steven Why, I agree with you 100% And Larry, please check yourself for unconscious stigmatizing of the mentally ill. You tried to discount my argument by saying only a crazy person could hold it. I don't think I set it forth because I'm crazy, but because I'm at the point where I think satire may be the only way to really look at our intransigent mistreatment of the homeless, the mentally ill, and the addicted in our country.
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    Dec 18 2013: Tristine, you are living in Oz. Most of those abandoned buildings are infested with fungus, rats, fleas, drug dealers, and a legion of diseases. Your solution amounts to eugenics or euthanasia on a mass scale. Even if we decided to do what you suggest the costs would crush the local government which is already bankrupt or would require donations on a scale never before seen.

    Most of the abandoned homes are not fit for human habitation any longer. If your solution could begin with a well controlled fire and followed by a massive excavation and demolition project until we had a clean flat area where we could rebuild modern care facilities and support buildings then it might work. If you could raise the funding.

    I am in total agreement with you about the scale and urgency of the issue. I have seen it first hand in several of our cities including LA, San Fran and others. And, California and other states actions in the past have been appalling. On these issues we agree. I am afraid, however, on your solution we differ sharply.
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    Dec 18 2013: Tristine,
    The spark of debate is not only meaningful but is also a practical way to ignite change. To see things differently is where it all begins. You make a great proposal and an admirable call to action in terms of taking flailing assets to deal with heartbreaking deficits.This way of seeing and potentially doing may ring emotionally true, but who knows what the actual logistics really are? To cut through the resistance that 'human nature' generates, would take an inspiring visionary, an American Mother Teresa who models heroic dedication that could forge multiple coalitions, not to mention marshaling resources to build and sustain an initiative that would certainly take many years. Who in America is even thinking like this about social problems, or acting on this level to create 'healing communities'?
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    Dec 18 2013: Would it not be more compassionate and community-spirited to provide shelter and services for unwell and poor people in the communities where they live rather than segregating them? Would they not have a better opportunity to move out of homelessness if they are served where they live in mixed-income communities?

    There would not seem to be any advantage to this population in your proposal (relative to serving them in the cities where they live), and I cannot imagine any economies of scale in providing the necessary services in such an extremely concentrated way.

    It is important to realize that many of your neighbors and co-workers likely face mental health challenges as well and, with appropriate care, function well in their settings and enjoy their neighborhoods.
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    Dec 17 2013: I vote NO!
    Not just because I live in Detroit, but it's just too easy to see an entire nation willing to shove their family members into railroad cars and intermodal cargo containers, dropshipping them to be abused, mistreated, neglected and abandoned by underpaid caregivers and greedy business people.

    This is not a well thought out idea.
    You haven't accounted for human nature.
  • Dec 21 2013: The reason for Detroit's decay is that the city simply didn't manage the financial problems well, so that they had to borrow money to maintain the operating expenses of the city. Then as the municipal debt built up, the city became even less capable of maintaining the city's maintenance because of the additional repayment for the debt and interest on it. So the city had to increase the taxes on the city residents, especially the businesses and the people with high income. Actually maybe that the business employees move out first because if they had the proper skill, there would be better job offering in other cities, then why would they stay in Detroit with very high taxes. Of course, this applies to the businesses too, so the net result is both the businesses and their employees moved out. The net result is that majority of the businesses and the people with good jobs left the city, because you couldn't survive by one component without the other.
    therefore to reverse this, we have to lure them back into the city. And the reversal has to start with the businesses. Moreover, only moderately sized business/industry could attract an inflow of employees, as well as the electricians, plumbers, remodeling firms and small shops of food and clothing and hardware stores, etc. to make up a booming city.
    In summary, you can't simply move the homeless people to Detroit, if there are insufficient support of day-to-day life needs of the above mentioned small supporting businesses and technical people available there. Another problem is that it can't be a "home for the mentally-inadequate" by connecting a few small houses. It has to be a large hotel or a condo or an abandoned office bldg to be converted into a convalescing home, so the remodeling expenses could be very high if these bldgs have been abandoned for a long time. Even such expenses are paid by outside contributions, this isolated facility won't be viable when there are no support maintenance and other nearby vendors..
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    Dec 20 2013: I am uncertain what the answers is. I have heard "The best way to be a winner is to follow a winner". Forget politics and look at the images in the link below of Hiroshima, Nagasaki and Detroit and ask how can this be? I'm not suggesting nuking Detroit that would be a step up. All Japan had to do was rebuild materially, Detroit needs to rebuild spiritually. Detroit is in decay from the inside out. We all have a big problem at hand, our only saving grace is for every problem there is a solution. If we as people do not wake up we'll all be living in a Detroit as well as those that come behind us.

    An idea that comes to mind is tough love, if you desire a better life it will require your participation and effort. This can be applied on the level of homelessness, addiction and mental illness. The stand of, I can't do it for you but I am willing to show you how to do for yourself. I am not for giving them anything other than if you want something you are going to have to work for it on some level the best you can. Giving a clear message that your life is your responsibility.
    • Dec 22 2013: I have no problem Larry, with your life is your responsibility, to a large degree I am a subscriber of that.

      But, look at the word...responsibility, response & ability. It was directly mentioned in the declaration of independence, more eloquently worked than I shall state here, if you have ability and can respond then it should be your duty to. Your duty to your country, your fellow man.

      I'd also quote Kennedy who rephrased that part of the declaration very well, "My fellow Americans, ask not what your country can do for you, ask what you can do for your country."

      That's were to me the government, of the people, by the people, has recently and unequivocally let the people down.

      That's why Detroit is in a mess, and is not easily getting out, I don't believe it can't, but I believe the will, of the people, by the people, and with politicians who without the sense of what's in it for me, is just not there (yet!).

      That defining moment of American history where the brightest and best reach literally for the stars and got there, by actively taking responsibility, by working together for a common goal, has with great sadness, at least in my heart, seemingly just faded away. Maybe, just maybe that loss is Detroit loss too.

      So maybe Detroit is the true reflection of just that, what government policies have become, what wall st has done, and what America may well become (although I hope not), and no-one want's to look at the ugly reflection that shows the consequences of actions over the last few decades, they'd but rather just turn away.

      And that is NOT a solution, from the many people I saw, and the many years I lived and worked there, I think that is NOT what, I believe, the heart and soul of true Americans honestly desire.

      But in some ways until the elected officials truly and honestly, without lobbyists, reflect THAT America, the one of the people, by the people, Detroit may well be just a symptom of a city reflecting that loss.
  • Dec 18 2013: Thank-you, Fritzie, for the link to SAMSHA. I have in the past checked out their activities in L.A. There was a conference downtown for professionals in the field where the ticket price started at $179. I imagined a room full of professionals lobbying for funding for their particular community based mental health center. Am I wrong?

    The agency supposedly serving my daughter does not want her to leave her current location, even though it is where she became addicted to meth, and anyone knows you have to get out of the environment where using in order to overcome such a serious addiction. She begged to be sent to rehab, but she only has Medicare and Medical, and while the new affordable health act demands parity for mental health and substance abuse treatment from private insurers - Medicare and Medical are exempted. Those few rehab facilities in Los Angeles that will accept Medical have waiting lists of 6 to 9 months. Medicare is not accepted for rehab.

    I see a lack of will on the part of her "housing" agency ( that has no housing) to let go of her - because she brings in income for them each year her FSP status is renewed.

    What is needed is a national commitment from the top, as Kennedy shot for the moon, as Nixon announced a War on Cancer, as Bush pushed AIDS treatment for South Africans. Regionally it is everyone fighting for their own turf.
  • Dec 18 2013: Wow Jim, this is valuable information. I have not been inside the buildings you describe in Detroit, but I have been inside the buildings in Los Angeles where my adopted, now 32 year old daughter, has stayed sporadically since she has been homeless, both before and after and receiving community services in Los Angeles. The places she stays and tries to make livable are "infested with fungus, rats, fleas, drug dealers, and a legion of diseases", and bedbugs. And Fritzie, I would rather fly to visit my mentally disabled, traumatized daughter in her own hovel in Detroit than to see her spend another cold winter in the riverbed or next to the freeway with her tent and sleeping bag and all her possessions and I.D. stolen from her - and further traumatized by her dog being killed and being beaten up herself .
    The solution is not just more money for the private/public partnerships that have become the community mental health industry. The County of Los Angeles gives enough money every year - just for my mentally disabled daughter - to pay rent for her to live in L.A., but instead of paying for her rent that public money goes to a privately own agency that pays it to mostly uncaring employees to sit in their offices and dispense her SSI check. What every homeless person needs first of all is a home - no matter how humble. The agency owns no homes and every list for supportive housing in L.A. is closed. The question is how to provide such homes - rather than letting them be bought up by the Chinese - while there is housing in the U.S. that is still cheap.

    Also please consider that many homeless people are capable of the physical work of cleaning up a place to make it livable if guided what to do, how to do it, and re-enforced and rewarded.

    What is missing is the will and the way. I don't have it, either. But I cannot stay silent after hearing my daughter's voice on a cellphone, "Please don't let me die on the street, Mom."
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      Dec 18 2013: Why not in her own place in LA where you and others would not need to fly to go see them and where she would have the chance, with support, to re-integrate herself into the normal life of a diverse city? Some in your position could not afford to fly to go see their loved ones were they shipped off to the East Coast.

      There seems a real opportunity for advocacy to show the County of Los Angeles how, for the same resources, they could accommodate the homeless with greater safety and compassion.

      It seems you have some facts in hand and a position that large numbers of people would support- that resources can be used more effectively to solve a problem everyone recognizes as important.

      Which are the advocacy organizations for the homeless in Los Angeles?

      Here is a valuable resource on best practices in meeting the housing and support needs of the homeless:
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    Dec 18 2013: I happened to see a piece of news online:

    Maybe Chinese can help you to rebuild it.
  • Dec 18 2013: I concede your point that bigger is not necessarily cheaper or more efficient. I was visualizing planned communities in locations scattered throughout Detroit where presently there are mostly abandoned buildings. I also grant you that the costs of being dislocated from family and from what is familiar would adversely effect already traumatized people. But many, actually most, homeless people are already dislocated from family, and their communities are built around the necessities of living in a tent city in a riverbed or on sharing drugs of choice. I suspect there are some healing communities that have been built around community health care services and classes, and I think it would be valuable to know where there positive communities of common interest are thriving and why. But for the vast majority of homeless people who are preyed upon by those outside and inside their current communities it could be a positive change to be protected in a new compassionate and structured community..
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      Dec 18 2013: Have you had the opportunity yet to work with homeless people for any length of time so as to have a ground level view? I think compassionate communities can be scattered where people happen to live and that life would likely be more comfortable for the homeless of temperate Los Angeles were they able to stay nearby rather than being sent thousands of miles away to a harsher climate probably far from where they have ever lived.

      I think also that sending poor people to a place with a high rate of unemployment and concentrating large numbers of health and resource-disadvantaged people there is not as compassionate and as conducive to their increasing participation in normal community life and economy as providing for them in a more dispersed way.

      .Funding needs to be secured for whichever model is pursued. You may be right, sadly, that people would be more likely to open their wallet to send their homeless far away than to care for them locally.
  • Dec 18 2013: Yes, it would be better to serve the homeless and addicted mentally ill in their neighborhoods. That is the present model of community based mental health care. But it is not working because it was underfunded and now, as Ullysses quite legitimately and eloquently stated, minus the railroad cars and cargo containers, so that the consumers are "abused, mistreated, neglected and abandoned by underpaid caregivers and greedy business people." It's time for a new model that incorporates what some very smart people have learned about treating trauma and addiction. It should be based on observation of models that are working in the United States and around the world. Community organizations need to be part of the discussion. But just as the present dire situation was partly caused by defunding mental hospitals - to reverse things, we again need a radical re-imagining. And that re-imagining needs to include a huge repurposing of housing. Building and repurposing housing in neighborhoods is a great idea, but it won't happen fast enough. Centralizing gives you all kinds of economies of scale.
    Yes, my proposal is somewhat like Jonathan Swift's recommendation that the Irish solve hunger by eating babies, but perhaps worth thinking through to address all the things that could go wrong and building a structure that minimizes that.
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      Dec 18 2013: I question whether there would be significant economies of scale at all relative to a more decentralized model.

      It isn't as if bigger is always or even typically more efficient after a point, and the costs of other kinds to the target population are significant.