I have had strong opinions about the origin of homelessness for a long time. In 1962, I spent a summer working in the VA psych hospital in West Los Angeles. It was one of the more interesting experiences of my life. The professor and chief of the service was George Harrington, one of the most colorful and impressive people I have met in medicine. At that time, psychiatry was dominated by the psychoanalysts and schizophrenia treatment was just starting to use anti-psychotic drugs like Thorazine. Harrington had been trained as an analyst but had a funny story about how he had learned as a medical student that analysis just didn’t work. He was convinced, he told me, that psychosis, particularly schizophrenia which constitutes the vast majority of cases, was an organic disease, possibly even an unknown vitamin deficiency. Time has proved him correct and present-day treatment is with drugs that target specific receptors for neurotransmitters like GABA and serotonin. There are theories of the cause that may be startling to those who have not spent time reading the literature. For example:

Schizophrenia and prehistory: the price we pay for language?
Robert Kaplan
Graduate School of Medicine
Wollongong, Australia
The defining characteristic of humans is language: the expression of the capacity to handle abstract symbols. A growing body of evidence shows that the essential hu-man features did not occur in a ‘big bang’ in Europe around 50Ka, but developed over a 100-200Ka period in Africa.

Schizophrenia, the most severe psychiatric illness, is remarkably consistent in all populations – average 2% – regardless of climate, geography and industrial conditions. As the Australian Aboriginals, who have the same incidence of schizophrenia, were separated by rising seas from early humans, it is clear the illness is genetic and arose sometime between 137,000 and 60,000 years ago..
The other unique feature of the schizophrenia is that it occurs during the reproductive age; despite the obvious disadvantage, it remains prevalent. This suggests that there is a balancing factor which overcomes the reduced reproductive capacity of patients.

Crow, a leading schizophrenia researcher, has put forward the provocative hypothesis that schizophrenia is a disturbance of language, resulting from problems in development of brain asymmetry. A gene on the short limb of the X chromosome has been identified as the possible site that leads to brain asymmetry, an essential development for language. As a result, the speech centre is located in the dominant [left] hemisphere, eliminating the delay from sending a signal across the commissure.

In view of the earlier onset in males, Crow has postulated homologous X and Y genes.
The ‘psychosis’ gene may be a consequence of the development of language: is schizophrenia the price we pay for language? Recent discoveries at MSA sites in Southern Africa coastal regions – such as the cross-hatched ochre from Blombos – give rise to hopes that further evidence of first human capacity to utilise symbols will be found in this region.

Anyway, treatment was severely disrupted about 40 years ago when the politics of mental illness trumped medicine and the state mental hospitals were emptied onto the street. Some of the sad story is described here. The “homeless problem” arose from this action and has persisted since then, garnished with Maxist rhetoric and vapid social theories. Now sense may slowly be returning.

The homeless population continues to decline, by an estimated 12% per year between 2005 and 2007, according to a new report released Tuesday.

Why ?

Homelessness is one of the few corners of public policy in which traditional liberal ideas have gone largely unchallenged. But Mangano believes that many professional activists, though well intentioned, have given up on ending homelessness. They have accepted the problem as intractable and fallen back on social work and handouts as a way to make broken lives more bearable. In doing so, he says, they have allowed “a certain amount of institutionalism” to take root. The Bush Administration proposes to solve the problem by beginning with the hardest cases: the 10 percent who are severe addicts or mentally ill, and consume half of all resources devoted to homeless shelters. Mangano believes that by moving these chronic cases into “supportive housing”—a private room or apartment where they would receive support services and psychotropic medications—the government could actually save money, and free up tens of thousands of shelter beds. The Bush Administration, spotting an opportunity to increase the return on its investment, is seeking to end chronic homelessness within ten years.

It seems to be working. What is unknown is what the next president will do with this program. This is a subtle way of returning to the institution care of severely psychotic individuals and that may be too much like sense for Obama’s liberal theology

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