Decades ago, the mentally ill in the United States were often locked up in institutions, isolated from the rest of society. But, in the 1980s, overcrowding and shrinking government budgets created a movement away from mental institutions.
Still, as hospitals closed down, community based mental health services didn’t always open up. Decades later, huge numbers of America's mentally ill are trapped on the street.
David Marko is one of them. Marko is mentally ill and needs medication. He says he wants to kill himself, but just can't do it.
He's almost 60 years old and for 15 of those years, he lived under an oak tree in Knoxville, Tennessee. Then Caroline Carter, a social worker with Knoxville's Volunteer Ministry Center, found him, helped him sober up and moved him a rundown motel on the outskirts of town. He pays for his room by working odd jobs. Still, Marko’s depressed, delusional and he’s started drinking again.
Carter’s urgently trying to get Marko the medication he needs. Without it she says, like so many in his situation, he’s almost certain to end up back on the street.
Carter told me: “Once we get them in housing, if we can’t connect them with (mental health) services, I mean who knows how long they’ll last before getting evicted?”
Most homeless shelters in the US only take in people who are deemed mentally stable. Most don’t offer anything beyond basic shelter.
Housing programs that also provide psychological services are in the minority, homeless advocates told me. The harsh reality is that most homeless people living in the US who also suffer from serious illnesses like bi-polar disorder, schizophrenia and a host of other mental health disorders, are typically turned away from shelters on a nightly basis.
It's a disturbing statistic when you discover, as I did, that more than 50 percent of the people living on the streets in the US are mentally ill. Of that number, I was told, less than half are receiving any mental health treatment.
For years, Candace Wood was one of them. I met with Wood in the dining room of Knoxville’s Volunteer Ministry Center (VMC).
For years the mission has dedicated itself to ending homelessness by providing not just housing, but the mental health services that ensures its residents don’t just get off the street, but also have the ability to stay off the street.
Wood told me that before she was connected with the VMC, she was, "wandering around aimlessly."
"But, I was sick. I was sick because I didn’t take the medicine," she said.
Wood said she is bi-polar. Since she was previously not on medication and was unable to manage her symptoms. She used to break into buildings to stay warm, hoping it would also get her arrested. Wood said that in jail she knew she’d get the meals and medication she needed.
Ginny Weatherstone is a passionate advocate for Knoxville’s homeless, she’s also the CEO of Volunteer Ministry Center. She says Wood’s story is a common one among the homeless who are also mentally ill.
"Three 'hots' and a cot. You get that in jail. For them, jail is their mental health hospital. Jail is their housing," Weatherstone told me.
That kind of support is exactly what Charlie Turpin says he needed to break his own cycle of homelessness. Turpin told me he also has bi-polar disorder and his symptoms landed him in jail.
When he was released he had nowhere to go but the streets. Now, with regular counseling and medication he’s able to hold down a job. He’s even enrolled in university and hopes to complete his degree in biology in a couple of years. He says none of this would have been possible if he’d stayed at a shelter that didn’t also offer mental health supports.
"Giving food is one thing and it's great, but it needs to go further than that. That's not going to solve the problem of homelessness," Turpin told me.
It is the reason why so many like Marko will never get the care they need and still struggle. It's also the reason Carter won’t stop trying to help Marko and so many others just like him.
On the day we met however, Marko's immediate needs are more grave. He needs convincing that there's a reason to live for one more day.
He wonders aloud, "Why do people want me to stick around?"
"Because we need you Marko," says Carter.
Still, Carter knows the challenges Marko faces are daunting and the odds are against him. As long as the needs of America’s mentally ill go unmet, she understands their struggle with chronic homelessness will go on.
(Please Note: Ginny Weatherstone is referred to as Volunteer in our report. Our apologies, Ms. Weatherstone is not a volunteer, but in fact the CEO of the Volunteer Ministry Center in Knoxville, TN.)