Most people assume that everyone living on the streets is mentally unstable, drug-addicted, dangerous and inclined to violence.

This is not the case.

But it would be dishonest of me not to admit that there is a higher prevalence of individuals facing challenged mental health – be it in the form of extreme stress, addiction or mental illness – among those experiencing homelessness than one would find in the housed population.

In most situations, it can be understood as a normal response to abnormal circumstances. Those circumstances feature the severe forms of pre-street adversity – poverty, neglect, abuse, bullying, and discrimination – that are so commonly experienced by those who end up living on the streets for these reasons.

As if it’s not bad enough that individuals land up on the streets as a result of the adverse conditions mentioned above, on the streets they have to again contend with adversity for this highly marginalised group experiences victimisation, trauma, stigmatisation, poverty, poor physical health and the constant stress of day-to-day survival.

Regardless of the causes or consequences, poor mental health is a daily reality for a large number of individuals experiencing homelessness.

Many describe problems that began before they left home, and many with severe mental illness living on the streets were released there from psychiatric treatment facilities or rejected by unsympathetic families.

From those we have assessed thus far during our Everybody Counts 2023 campaign, we found that those who had been diagnosed were diagnosed mainly with major depression, bipolar disorder and post-traumatic stress disorder.

Homelessness itself is inherently traumatic, and the longer people live on the streets, the more their mental health is affected.

In terms of accessing services, most of those we spoke to with severe mental illness are not receiving any form of treatment.

Although access to these resources is difficult, even when resources are available, and many avoid them. The service providers in the sector also have no capacity to provide care for people with more severe mental illness and addictions.

Barriers to mental health care for these individuals also include a lack of a hospital card or ID documentation, no formal diagnosis, substance use, unstable housing, and long waiting lists.

This past week, I had the good fortune to hear Jesse’s remarkable story about his search to find meaning for himself and come to terms with the trauma of his family. Jesse is now 40 years old and a successful academic.

He described episodes from his youth – early memories of parental abandonment, the shattering of his nuclear family, and the love and care he received from his grandmother.

In adolescence, Jesse was having problems in school, and he turned for relief to dagga and alcohol and later went on to many other drugs as his life as a young man unravelled.

Desperate, living from one moment to the next and committing crimes to support his addiction, Jesse spent years in and out of homelessness, with temporary stays in and out of relatives’ homes, jail, rehabilitation programmes and hospitals.

While I listened to his story, it was difficult to reconcile the well-dressed, articulate and thoughtful man with the images of the youth he described.

What was it that helped Jesse turn his life around? How did the youth who struggled with intergenerational trauma, neglect, addiction, poor health, and much more transform himself into the scholar recounting this narrative today?

A major turning point in Jesse’s life was when his grandmother summoned him to her deathbed.

She asked him to promise that he would attend university one day. “Because I know you are smart,” she confided.

At that time, Jesse, in the throes of addiction, could not act on his word.

However, his grandmother’s words and her faith in him registered in his psyche and provided hope through difficult times. He eventually kept that promise and was able to realise the potential within.

* Carlos Mesquita.

** The views expressed here are not necessarily those of Independent Media.

Cape Argus

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