Dying on the Streets

Excerpt

Andrew Jackson once commented that the health of a society can best be measured not by how those at the top are doing, but by the welfare of those at the bottom. The United States is among the wealthiest nations in the world; those at the top of society are doing well. But the gap between the “haves” and “have-nots” in the United States is growing, and no one has less than the homeless. For healthcare professionals and students wondering why they should get involved in politics and health care policy, there are few better examples of the impact of policy on society and on individuals than the plight of the homeless. In 1963, Congress passed, and John Kennedy signed, the Community Mental Health Act. This well-intended act was designed to create and expand community mental health centers to provide community-based care as an alternative to institutionalization. Many states took advantage of the opportunity to close expensive state mental health facilities and released institutionalized patients into communities without the facilities or expertise to treat them. The consequence was an upsurge in the rate of homeless not seen in the United States since the Great Depression. …