Agree on the underbuilding.
Agree on the underbuilding.
I don't know if we should call this inability to make basic, smart financial decisions a mental illness or not, but it's something. And these 2 people aren't/weren't even what I would consider visibly homeless. At least as long as you didn't see them living in their car behind a convenience store.
Starting with the framing that housing is just too expensive makes the problem simple. You build more housing, or you subsidize housing for these people, or somehow just inject money into services for them so they can get back on their feet. But if that's not the core issue for some or many of these people, how do you actually help these people? How does a society help people who are incapable of handling their own finances? That's where the hard questions begin.
For this subset of people, I don't see how you can help them without managing their finances for them. Even if you completely manage their finances, how do you help them if they just quit every job they get?
I never really thought about it much before them, but I think pretty often about the problem. How do you help someone who can't be helped? Even if you gave them free housing and a weekly allowance, they would still find a way to not have money for food before the next week.
Non-mentally I'll homeless people are rarely "street people". They live in a car or with friends or in a shelter. Plenty of them have jobs.
There is indeed a spectrum of homelessness from temporarily distressed to broken beyond repair. There's different actions for the different factions.
I live in the Portland OR metro and believe that the issue has spawned the Homeless Industrial Complex that thrives on extracting money to "help" but are incentivized to keep the problem going for their livelihood.
I'm not unsympathetic to their plight (I had been effectively homeless a couple times in my life). It bothers me to no end how this problem is mismanaged.
IIRC, most people who obtain "homeless" status only keep it for a short time, and don't live on the streets during that time.
You'll get very different statistics if you count transitions into (or out of) homelessness over some window, vs systematic point-in-time counts of current homeless status, vs point-in-time counts of people camping on the street, vs trying to measure QALYs.
"Requiring hospitalization more than once a month, on multiple occasions in a year".
And that number, per HUD, is 22%.
If you want to look at "untreated mental illness" in the homeless, now you're above 50%.
But "untreated mental illness" isn't the same as "mental illness that requires institutionalization" which is what the OP is saying.
Additionally, a lot of mental illnesses can be reasonably managed with proper medication, and in my mind very, very few actually require institutionalization. But we as a country can't even get behind the idea of universal healthcare for non-homeless let alone homeless people. Somehow institutionalizing them seems more feasible or reasonable than just covering their medical care?.. I don't get it.
I do think there's a Venn diagram around severely mentally ill and untreated mentally ill that might require more intensive care. There's also the complexity that drug use and abuse is a method to cope with the emotional pain of homelessness (as one of my instructors said, "if my existence was reduced to fishing rained-on food out of trash, brushing cigarette ash off of it, sleeping and shitting in alleyways, often without something to effectively wipe with, you better believe I'd be on a fast path to taking some drugs to numb that"), or for "self-medication" of said untreated mental illness.
What data have you seen which doesn't support it?