Mental health services for homeless "innundated," advocates say

By Steffi Broski

Carol Carlile’s days start early. She usually gets up by 6 a.m. She smokes a cigarette, gets dressed, tears down her tent, rolls up her sleeping bag. She gets on her bike and rides to a local charity called Loaves and Fishes. There, she gets hot tea and breakfast. Most days she spends at the park, reading. After lunch she takes a shower on the grounds of the charity. Around 3 p.m., she heads back to the campsite.

Carlile has lived on the streets for three years. She lost her job and couldn’t pay the rent.

“It can be really hard. A lot of people, when they first become homeless, aren’t streetwise,” she explained.

Homeless advocates estimate that there are about 1,200 homeless people in Sacramento who don’t have a bed at night. Carlile said the more accurate number for Sacramento’s homeless population is 4,000.

“It’s definitely higher than 1,200 people,” said Vince Gallo, a counselor at Genesis, a free mental health program of the local charity Loaves and Fishes. “I think we serve something like 500 to 800 lunches a day to homeless people here at Loaves and Fishes. And those are just the people that eat lunches.”

Carlile spent decades in abusive relationships, starting when she dropped out of school, got pregnant and married at 17. Carlile has never received counseling, but said a church in Humboldt County helped her deal with some of her demons.

A social services counselor diagnosed Carlile with depression, agoraphobia and post-traumatic distress disorder, stemming from years of physical and mental abuse.

“I haven’t allowed a man to beat me in 25 years,” she said.

Genesis provides mental health counseling services to about 200 people a month. Gallo said they see a consistent number of new “visitors” each week. Three full-time counselors and three volunteers handle hundreds of visits per month. PTSD and depression are common disorders among the homeless people who come to Genesis.

“Of course PTSD stems from severe trauma,” said Gallo. “We hear a lot about sexual abuse, lots of physical abuse. This absolutely goes for women, but also for men.”

If she wanted to get help for her disorders, Carlile said she could.

“It’s about getting people to go get help. But a lot of people have had bad experiences with counselors,” she explained. “Or they’re not getting the help they really need, and it is hard for people to get the right medication.”

But Gallo said mental health treatment programs for the homeless are inundated.

“It’s not that there’s a bunch of resources that aren’t being used,” he said.

While Genesis only offers counseling, people come every day to ask for medication. He can refer them to Sacramento County’s Guest House, which provides psychiatric medication evaluation and treatment and, among other things, referrals for housing and ongoing services. But the waiting lines are long, and people are advised to come almost two hours before the doors open. And it takes a month before they can see a psychiatrist.

“They are doing the best they can,” said Gallo.

Guest House only accepts people with certain diagnoses, including severe depressive disorder, Asperger’s syndrome, schizophrenia and a few others, but not PTSD. Recently, the Sacramento County Mental Health Treatment Center was forced to cut half of its 100 psychiatric beds and temporarily close its crisis unit. If Genesis now issues a “5150,” which refers to Section 5150 of the state’s Welfare and Institutions Code -and means a person is greatly disabled, or a danger to themselves or others- Gallo said “the police have to be creative.”

“They may take them to an emergency room or psychiatric hospital, but there’s less and less to choose from,” he added.

Patricia Pavone is the president of the board of directors for the National Alliance on Mental Illness in Sacramento.

“Emergency rooms aren’t necessarily set up for someone in a serious psychiatric state, and the police have to stay with the person. Sometimes the police have to drive around until they find an ER that takes them,” she said.