Reckoning With Homelessness (Anglais) Broché – 5 décembre 2002
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As introductions to homelessness go, mine as a newly arrived graduate student in New York in 1972 was hardly traumatic. Lire la première page
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Consider the case of the policy and practice known as Housing First. In theory, auxiliary services like psychiatric care are not required for the former homeless to participate in Housing First. In practice, that typically is not the case. Typically, psychiatric care costs skyrocket with Housing First. And this despite that one of the reasons--maybe the most important reason--given for Housing First is to diminish costs.
In Los Angeles alone, for example, there was an over 200% rise in psychiatric costs the first year of a recent Housing First initiative. Some would say that this is because the need for care had been previously undiagnosed. However, there is just as strong an argument to be pursued that goes along the lines of what Robert Whitaker suggests in Anatomy of an Epidemic.
In that book, Whitaker charts the rise of pharmaceutical-based psychiatry together with the rise of mental illness disability claims. Based on a sociology of the professions perspective, one could marshal the evidence in Whitaker's book and elsewhere to argue that psychiatry established its legitimacy away from the couch and on toward the pharmacy, at least in part, by establishing itself as the arbiter of who is disabled on the basis of mental illness. Right now that means, as far as Housing First is concerned, the homeless and many formerly homeless.
Hopper's approach does not make room for a critical assessment of Housing First or of the role of psychiatry in "treating" homelessness as a medical rather than a social problem. It should.