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I recently found myself disagreeing with one of GMC’s doctors. She talked about the impact of poverty in homelessness. “Wait a minute” I stammered, “homelessness is all about mental illness and disability” and I began talking in circles. Although I feel strongly that most of the people I see on the street are homeless because of faulty mental processes and therefore are unable to fit successfully into society, I didn’t have much evidence other than the anecdotes of my work over the last 30 years.

It is important to remember that we work with a unique subset of people who are homeless: people who live on the street. And many of the people we work with have been on the street for years. We almost never see families.

There is a shortage of good literature on the prevalence of mental illness among people who are homeless. Good data and good research involving mental illness starts with definition. What is mental illness? Do you include personality disorders? Traumatic brain injuries and developmental disabilities such as autism? These are all realities for the people we see.

The second problem is diagnosis. Even well-trained professionals disagree on diagnoses. It takes a long time to do an effective evaluation and even then many people don’t want to share their behavioral flaws for many different and complicated reasons. Additionally, while much of psychiatry has been systematized in a way that gives good guidance to diagnosticians, it is still very complicated.

Often people have more than one set of symptoms or have symptoms that change from day to day – as in borderline personality disorder. Also symptoms of bipolar disorder can mimic the psychosis of depression or schizophrenia.

The third problem is that half of all people with serious mental illness don’t think they have a brain disorder. They have a condition known as anosognosia which blocks insight into their own dysfunction. They deny symptoms and avoid mental health practitioners.

In the end, it is my observation that most of the people I see on the street have conditions that limit their ability to function in society. Sometimes the symptoms are obvious such as yelling at nobody in particular as they walk down the middle of the street. For most it is not so evident, even to the trained observer. It might take months of interactions before the observer notices an unusual preoccupation with “the Church,” for instance, or an unwillingness to enter buildings of any type.

We also hear about substance abuse as a leading cause of homelessness, but again from my observations over the years (except during the crack epidemic), I rarely meet a substance abuser in which I don’t find an underlying brain disorder. In fact, research has shown that people with certain disorders of the brain are much more likely to abuse substances.

Many people experience substance abuse and brain disorders without becoming homeless. However, most homeless people are on the street because of an untreated or poorly treated (sometimes untreatable) disorder of thought and a lack of supportive services. We can do better. I have no doubt that poverty contributes to homelessness, but I don’t think that poverty, in itself, is a significant cause of urban homelessness as we know it in the United States.

―Gunther Stern

$50/month provides 10 GMC guests with access to our two psychiatrists and general practitioner each year. By serving clients who do not have access to basic medical care and psychiatric treatment, we help them address the underlying issues that may cause their homelessness. Find out more about how you can help!

“We found her.”

Gunther sounded tired, but his voice carried a quiet note of victory as he entered the office one Tuesday afternoon. Three hours earlier, he’d set out, accompanied by Adriana, an outreach worker from Miriam’s Kitchen, with a seemingly simple mission: find Ellen. (The names of our guests have been changed to protect their identities.) Ellen is likely eligible to receive supplemental security income (SSI). When combined with other forms of assistance, supplemental income can make a big difference in helping our guests get off the streets and into housing.

The only challenge? Ellen had to agree to the arrangement and sign paperwork. First, they had to find her. However, Ellen has a reputation – “almost legendary,” according to Gunther – for being reclusive.

The search began at 27th and K streets, where Gunther last saw Ellen. She wasn’t around, but a homeless man there confirmed he recently saw her. The next stop was Arlington, one of her usual spots. Crossing the Key Bridge, a woman Gunther knew pointed to the place where Ellen often sleeps: “But I haven’t seen her in awhile.” And so it went for the next several encounters: “Yeah,” a homeless person would affirm, “I sometimes see her around here. But she hasn’t been around in awhile.”

A visit to a homeless services center in Arlington didn’t turn up any more substantive leads, so it was back across the bridge and up the hill to the Georgetown Library. There, finally, the stalwart outreach team had a stroke of luck. When Gunther told two regulars, Mike and John, who he was looking for, John implored: “Gunther, you gotta do something for Ellen.” Gunther gave them his phone number, and continued searching. It wasn’t long before the phone rang. John was on the line: “She’s in Rose Park.”

Once at Rose Park, Gunther spotted her on a bench at the far end of the park. “What you have to know about Ellen,” Gunther shared later, “is how reclusive she can be. Everyone who knows her knows you won’t get more than a couple of words out of her.” So he was pleasantly surprised when she was willing to engage with Adriana and sign the SSI paperwork. At the end of the day Gunther checked his phone to see how far he’d walked that day. Including a trip downtown for a mental health advocacy meeting, he’d traveled 11.5 miles by foot. He estimates that 8 of those miles were dedicated to searching for Ellen.

From the perspective of moving people into permanent housing, signing SSI paperwork might look like a small win. But from the standpoint of an individual for whom personal connections and relationships are a challenge, such a hurdle represents an enormous victory. It takes years of relationship building, hours of conversation, and sometimes miles of walking in a day to get there. For Ellen, it took a network of people willing to speak out for her and a level of personal resilience and courage to take these steps. For all of us at GMC, the journey to small successes can be a long one. But whether it’s 10 miles or 10 years, no journey happens without the first step. What next step can you take to walk with our guests on their journeys home?

―David Finnegan-Hosey

Want to take the next step with us? Find out how you can help!

While temperatures in the sixties made it hard for us to believe it was time for the winter shelter to open, about two dozen staff, volunteers, and shelter residents packed into GMC’s day center on November 4 for a shelter training session. After an afternoon of safety training, the group shared a meal, reviewed important policies, and prepared for a successful winter shelter season.

GMC staff emphasized the importance not only of shelter but of building community and an environment of mutual respect. GMC’s Case Manager, Sabrina Burrell, asked everyone to share their name and something they liked about themselves. We heard about one resident’s guitar skills and another’s love of learning.

The opening of the shelter itself took place at Christ Church Georgetown on November 6. With help from GMC staff, our residents set up cots and checked in with each other. This year marks the 26th year of the program, in cooperation with Georgetown congregations who open their doors to provide safe, warm shelter for 10 residents from November through March. Residents, staff, and volunteers shared a delicious and hearty meal, made by Christ Church youth. Conversation flowed over pasta carbonara, salad, bread, and fresh-baked brownies. After dinner, our residents settled in for the night. The Winter Shelter is officially open, and residents, volunteers, and staff have already begun the deeper work of forming a community.

Interested in helping? Contact Sabrina Burrell. We’re thrilled to have new volunteers to prepare meals, eat with guests, or spend the night.

Happy Thanksgiving!

We are thankful for you and the rest of our community of supporters. A group of our Day Center guests, volunteers, and staff have a special message for you:

This morning, we all awoke to the news that the nation has elected Donald Trump as our next president. This has been the most contentious and divisive election in most people’s memories. Over the last two years, we at GMC have seen so much progress in meeting the needs of the population we serve. Now, let’s come together and make sure the people GMC supports are not forgotten.

Here are some suggestions we have for our next president:

• One of the reasons there has been so much progress is that housing has been a priority for both the federal and local government. Since the summer of 2015, with the commitment of federal resources, 30 of our guests have moved into permanent housing, with 10 more guests “at the door” of housing and 8 guests whose journey to housing is in progress. Let’s continue this commitment.
• Many of our guests struggle with chronic, severe mental health issues. This summer, the House of Representatives passed the Helping Families in Mental Health Crisis Act with bipartisan support. Let’s keep moving forward on mental health policy.
• Many of our guests also have a variety of other sorts of disabling conditions, including developmental and neurological disabilities. We hope the new president will prioritize their needs as well.
• Many of our guests suffer needlessly because of barriers to treatment in cases of severe mental illness. We at GMC embrace the recommendations of the Treatment Advocacy Center for fixing our mental health care system so it better serves those members of our society who are marginalized by profound brain disorders.

We hope Mr. Trump, with his many policy priorities, does not forget the people who most need our help: those who live on the street and who depend on the rest of society for care and support.