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The National Mental Health Association identifies mental illness as "a disease that causes mild to severe disturbances in thinking, perception and behavior." Among these are anxiety disorders, mood disorders, schizophrenia, dementias, and eating disorders. A recent study by the National Institute of Mental Health found that one of every five American children is afflicted with some type of diagnosable mental illness. While severe cases may require institutionalization, children within society's mainstream can effectively mask their mental conditions with prescribed medication, regular professional monitoring, and the support of family and friends. Their symptoms regulated by psychotherapeutic treatment, children with mental disorders are able to tackle the already challenging issues of individuation and socialization common to childhood without the added encumbrance of stigmatization and ridicule by their peers. As long as their condition is stabilized, these one-of-every-five American children with mental health difficulties blend so well into their surroundings as to become virtually invisible.
Unfortunately, not all children with mental health problems belong to America's mainstream. For those caught in the emotional and psychological whirlpool of homelessness, the likelihood of mental illness increases to one of every three, 20% of these children suffering from serious mental disorders. , For most displaced children, homelessness is thrust upon them due to their parents' financial and legal problems, loss of job, loss of housing, or other such catastrophe. In some cases, their homelessness is directly related to the mental health problems of a parent. A victim of circumstances beyond his or her control, the typical homeless child is subjected to tremendous physical, emotional, and psychological trauma. Without the stability and security of familiar neighborhoods, possessions, teachers and classmates, daily routines, etc., a child disoriented by the chaos of homelessness must suddenly reevaluate his or her understanding of reality and personal identity. Fear, uncertainty, feelings of vulnerability and shame, and even misguided guilt over the family's plight are common responses to homelessness; however, these are uncommonly heavy burdens for a young mind to bear. Understandably, some cannot.
Bombarded by such stressors as lost stability and safety, hunger, transience, overcrowded living conditions, humiliation and embarrassment, disrupted education, loss of friends, exposure to violence and substance abuse, children plunged into homelessness become emotional casualties of their family's way of life. Mechanisms for coping with stress-inducing circumstances, such as rebellious behavior or emotional withdrawal, are not uncommon in the early stages of homelessness. Under ideal circumstances, such cries for help might be assuaged by a comforting hug or tender assurances if not professional treatment; but the homeless life is far from ideal, and parents-preoccupied with matters of survival and often as disoriented and fearful as their children-can become so crippled by their own emotional suffering that they cannot effectively deal with their children's fears and insecurities. Few homeless families have mental health insurance, and free clinics are seldom able to provide the long-term counseling and pharmaceutical regimen needed to repair a damaged psyche. Even if extended care were available, homeless families rarely stay in one place long enough to benefit from treatment
Unaccompanied youth-young people between 12 and 17 who live on the streets without adult supervision-represent approximately 13% of the homeless population. (See The Mailbag, March 2004, for additional characteristics of this group.) The majority are single teenage males whose socio-economic backgrounds are more advantaged than those of homeless adults. These youths typically turn to street life-or are forced into it-due to family conflict, neglect, or physical/sexual abuse. Without the support and guidance of clinicians, parents, or family members, these unaccompanied youth often respond to the psychological stressors of homelessness by turning to substance abuse, petty crimes, and promiscuity-behaviors that further contribute to poor self-esteem and emotional instability. The use of alcohol and drugs, often in combination, is high among homeless youths living on the streets, as are other disruptive and disorderly behaviors that put them at high risk for violence and for juvenile detention. Living on their own in a stratum of society that preys on the weak and defenseless, this homeless population is besieged by "anxiety disorders, depression, posttraumatic stress disorder (PTSD), suicide attempts, and other health problems that exacerbate and are complicated by emotional problems." Often undiagnosed and seldom treated by doctors or psychiatrists, their illness becomes a steadfast and oddly comforting companion.
The difficulties inherent to homelessness not only threaten a child's mental well-being, they often undermine the better life that education promises. For those who are able to attend school, loss of sleep, frequent illnesses, malnutrition, and anxiety hamper their ability to learn and retain information. Their difficulties are compounded by the shame of being homeless, poor, and academically behind due to attendance problems. The typical homeless student is beset by countless challenges unimagined by classmates with homes, family, routines, and a place to call their own. Even those who live in semi-permanent housing-staying at shelters, motels, or doubled up with other families-must overcome impossible study conditions, imposed rules and schedules, difficulty getting to and from class, lack of privacy, and numerous daily challenges to their academic success. Even if they can manage passing grades, their work may not be credited due to excessive absences: many states, including Texas, require a student to attend 90% of class meetings during the semester to receive course credit.
Remedying the tragedy of homelessness among this nation's children and restoring them to mental health is a daunting, but not impossible, challenge. The No Child Left Behind Act of 2001 demonstrates that our government recognizes the unique challenges that homeless children must overcome to enroll in and succeed at school. Similar legislation is needed that goes beyond guaranteeing the right of homeless children to attend school, however; the emotional and psychological stumbling blocks that sabotage these children's mental acuity and undermines all aspects of their life-including their education-must be removed if they are to become knowledgeable, productive, and self-sufficient citizens. Legislative reform must address issues similar to those outlined by the National Health Care for the Homeless Council :
- Provide safe, decent, and affordable housing to those in need;
- Implement universal health care that includes comprehensive pediatric health services;
- Ratify the U.N. Convention on the Rights of the Child;
- Ensure access to and accountability of mainstream systems for children, youth, and families experiencing homelessness;
- Authorize the Healthy Schools/Healthy Communities Program;
- Reauthorize the Runaway and Homeless Youth Act; and
- Appropriate resources for the following programs in FY 2004:
- Violence Against Women Act
- Maternal and Child Health Services Block Grant
- Health Care for the Homeless
- Addictions Treatment for Homeless Persons
- Projects for Assistance in Transition from Homelessness
- Education for Homeless Children and Youth
- Runaway and Homeless Youth Act
Far from the mainstream, the homeless wander in search of food, shelter, and their share of the American dream. Their inability to maintain the status quo is clearly displayed in their tattered clothes, cardboard signs, and downcast eyes. In doorways, on street corners, huddled around crude campfires, the homeless remind the rest of us how delicate life's balance can be; in today's precarious economy, even the educated, independent, and stable can suddenly plummet into homelessness. But what of the alarming number of children who, dependent on adults for protection and sustenance, are victims not of their own failures but of their family's? Fragile, naïve, and unsure of their own identity, many buckle beneath the instability and trauma of the homeless experience, their fears, anxieties, and confusion often giving way to psychological damage. Mentally unstable in unstable circumstances, these children have little hope of achieving their rightful portion of the American dream without immediate and sustained intervention. We can no longer avert our eyes, fearful that-by seeing them, by acknowledging their existence, by recognizing their suffering-we will suddenly recognize our own vulnerability or notice the glaring inequity within our socio-economic system. We the people, backed by grassroots humanitarian efforts, legislative reform, and government funding, must intervene and stop the madness. Their future-as well as ours-demands it.
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