Psychiatry, Violence, and the State: California’s Systematic Failure of Its Unhoused Population

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Upon the catastrophic failure of its economic policies, California has decided to systematically restrain, incarcerate, forcibly strip, and drug its now sizable unhoused population.

Rent control, out of control zoning laws, and other red tape have plagued California’s housing economy for years, limiting housing supply despite high demand. The most vulnerable citizens have been pushed onto the streets, unable to find long-term housing options where they feel safe. Advocates push for “housing first” as a solution for the homeless to solve their problems, which allows unconditional housing as a right regardless of mental health or addiction status.

Closeup on gloved hands held up as if asking for helpThe hopelessness, isolation, paranoia, and mental breaks which often (understandably) characterize the unhoused experience are interpreted by many in the public as symptoms of “unsound mind” rather than failures of social policy. The abuse and neglect the homeless have suffered at the hands of the state and society being ignored has had a devastating impact on the social policy surrounding those affected.

Despite being a cheaper alternative to forced institutionalization, housing first doesn’t have quite the same political backing. Providing long-term shelter without strings attached does not pay dividends to Governor Newsom’s healthcare industry donors. Unfortunately for the unhoused population under his rule, their needs, as well as those of the California taxpayer, are deemed irrational.

In fact, beyond just being cheaper than forced institutionalization, housing first saves the public substantial amounts of money. Rather than allowing the homeless to descend into mental anguish, drug abuse, and occasionally crime, places that cure the issue at the source save money by reducing the need for services addressing the symptoms of the problem. Providing for the basic needs of the unhoused reduces the need for services of all kinds and promotes public safety.

However, these facts are as irrelevant to the state of California as those exposing their policies which created the homelessness crisis in the first place. The government would rather deem those most hurt by their policies as being of “unsound mind.” Thus, they can void their victims of standard inalienable rights and themselves of all responsibility.

The consequences of the concept of “unsound mind” have been harrowing, leading to innumerable human rights abuses. Historically, and currently, many psychiatrists have insinuated that no one free from the grips of “schizophrenia” could prefer to be homeless rather than incarcerated in a mental institution and put on antipsychotic drugs. This claim has been made and published in The Lancet, a well-respected journal, despite no factual basis or reasoning provided. It shows just how powerful the bias of invoking a psychiatric diagnosis to discredit critics can be.

This places psychiatry in a unique position among medical specialties in that the responsibility for unappealing services is completely displaced onto the intended target demographic, often to the point where the target demographic is forced to engage with the specialty. Then, when the long-term outcomes are predictably worse, psychiatrists then claim “services” are more needed than ever. They will then pile on more drugs and shocks, sometimes without consent, and rarely with fully informed consent. All trauma is dismissed as more disease progression and more reason to force additional “help.” (This happens across all social strata, as it so famously happened to Britney Spears. If a world-famous pop star could not defend herself from psychiatry, how could destitute outcasts possibly stand a chance?)

Furthermore, one must look at the symptoms of “schizophrenia,” the archetypal diagnostic label deeming someone of “unsound mind”: delusions, hallucinations, disorganized speech, catatonic or disorganized behavior, and diminished emotional expression. You only have to be impaired for six months and have a couple of the aforementioned symptoms for one month to get a diagnosis. Several of these are signs of fear (such as speaking unclearly and not showing emotion), and all of them make sense in the context of the mind-breakingly harsh unhoused experience, exposed constantly to hunger, irregular sleep, little support, and a potentially violent police state. Attacking their liberty would just create even more trauma than they already have.

A few months ago, I had a discussion with an unhoused man at a bus stop in California. He seemed surprised I even bothered talking to him and almost cried. He asked if I was a psychiatrist, and I said no. (I wonder now if he was afraid I was going to commit him.) We talked for hours. When the topic of psych wards came up, he believed it was inhumane to be sent against one’s will. He also told me in detail about why so many unhoused individuals were not currently sheltered, with reasons ranging from strict rules to poor conditions to only allowing short stays. In essence, the unhoused homeless are in the situation that they are because, between several unsavory options, the freedom of the street seemed best to them. (That, or they had exhausted their options.)

Investigative reporting shows the homeless are fleeing forced treatment. Given the option, I would prefer to be on the street too; there is at least more freedom there. I would be surprised if anyone who has researched, investigated, or been to most of these places from the viewpoint of the user disagreed. Having lived in California myself, and known plenty of people who went to the wards or were committed to them, I’ve never heard a single positive experience. Their mental health unanimously either remained unimproved or got worse. (Of course, there are nice treatment centers; but the homeless and most of those in crisis don’t have access to those kinds of facilities. That’s a large part of why they aren’t going voluntarily.)

The paranoia characterizing many of those labeled with “unsound mind” can, and has been, addressed with great success by addressing the root causes, like housing and employment. Furthermore, more consensual services minimizing drug use while maximizing human connection could vastly improve outcomes. Forcing hospitalization on those who don’t want it is more expensive, more traumatizing, and creates worse outcomes than housing first, in addition to potentially increasing the risk of suicide. It goes against the principle to do no harm for professionals to advocate such invasive, inhumane, drastic measures, especially when the bare minimum has not even been tried.

Another issue in forced hospitalization is that resources are diverted from voluntary patients, straining the staff and creating a worse scenario for everyone involved except those profiting at the top. I once had a conversation with a woman who recounted her depths of despair wherein she was turned away because the beds were full. She told me she almost committed suicide that night because she felt so emotionally out of control. She had already had multiple suicide attempts on her record, and the doctor did not care. With estimates showing that many if not most patients experience coercion in admission, and that this worsens outcomes, it is a miscarriage of justice that she was not allowed a bed in favor of locking up people who likely didn’t even want to be there.

Everyone in crisis deserves an environment where they feel safe. California has not been providing this, from the policies targeting the most vulnerable to the notoriously corrupt Los Angeles Police Department. Resources are diverted away from policies that are free to enact, save tax money, reduce crime, and create a more compassionate society, and into more incarceration, whether in jails or in mental institutions. The result is less of everything to go around and a crueler, harsher world for those most affected.

What the state of California is doing is a form of DARVO. The state denies its wrongdoing towards its people and then institutionalizes them, framing the ones suffering the most at their hands as a root cause of social ills. With the recent legislation, psychiatry has gotten its big win by being handed an even bigger role in coercive social control than it already had. It is becoming further cemented in its historical and current role as an arm of the state, exploiting its power over the most disempowered people in society. (While they claim to be well-regulated, the insides of these institutions tell a different story entirely; the letter of the law doesn’t apply when those being abused are disempowered in every possible way from fighting back.)

The most logical, cheapest, and most humane solutions are being ignored by legislators in favor of a violent gaslighting of the state’s most economically vulnerable. Despite having produced this crisis, California politicians walk free while tossing their victims into asylums.

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Crystal Nelson
Crystal is a student of clinical mental health counseling at West Coast University. Her undergraduate background was in physics at the University of Washington, but she realized over time that her greater passion is in mental health advocacy. Upon learning about the corruption in the American mental health system and some of its nonprofit fronts, she took to digging deeper. She began connecting with survivors and other advocates to pursue positive patient outcomes over profits.

26 COMMENTS

  1. A superb analysis of the interplay between emotional crises (NOT so-called mental illnesses) and the cruel, oppressive, unjust conditions engendered by a corrupt economic and political system enabled by the venal psychiatric guild, among many other stakeholders.

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    • I agree that this article is a well thought out and strong analysis about how psychiatry is used against homeless people. I think our psychiatric survivor movement ought to pay more attention to this problem. We need to revive our movement so we can take up issues like this.

      And as Canadian journalist Rob Wipond has written in his excellent new book “Your Consent Is Not Required,” about the massive power grab by psychiatry, we had better start fighting back before it is too late.

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      • Psychiatry/Institutionalization has long been used to dispose of people who the state no longer wants to deal with-see how the Soviet Union and its satellite states locked up and drugged up dissidents in their psychiatric hospitals.

        I definitely agree, we need a MASSIVE revitalization of the psychiatric survivors’ movement, this time centered around/amplifying the voices of those specifically unhoused/formerly unhoused psychiatric survivors who have been subjected to psychiatric violence.

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        • Thank you Spencer! That’s so true. People think coercive psychiatry is now “help” and not social control, but social control is all it’s ever been.

          I hope Britney Spears can rile people up against coercive psychiatry, though it seems she wants something of a break from thinking about everything (understandably so). I wonder if someday, maybe a few years down the line, she can lead an APA protest? That would be cool if she were interested.

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      • Thank you Ted! Wipond’s book is great. I tell people about it often, and his book compiles a lot of information useful to my research. It’s linked in, iirc, both articles I’ve written so far. I also plan to conduct more studies on forced “treatment”, specifically in ways relevant to the USA/CA. Civil commitment is a crime against humanity! (Also see you soon! Hopefully my survivor uncle can come too.)

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  2. Thanks for this Crystal. You should look up the legacy of Mitch Snyder and The Community for Creative Non-violence in Washington DC. One of the problems there in the early 2980’s late 1970’s was folks sleeping on grates . Even if it was a source of heat some folks died. The problem was safety and the big warehouses for shelters just not safe. There used to be SRO’s back in the day. And age and past life also affect how folks deal with severe adverse housing circumstances. Lots of retirees in certain cities just get literally pushed out. Also so do much more stringent policies and security. Some homeless once could pass and end up at events with a meal or two of free food. Some just were well known entities. In my area there was a man who would just show up everywhere and dance.
    Another was a respected poet in the community. This is so important and thanks agin. There was a book put out by The Community for Non-violence . I passed my on to a friend but perhaps if you can find a copy worth a look. And each city vastly different ways of handling homelessness and start up funds but always no guarantee even if the program works the funds will continue. I think of the convents and seminaries and schools that are soon to be vacant or are vacant and think what a waste because the need is great and so many people could be helped.

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    • Thank you Mary!

      It’s so awful how the unhoused have been and are still being treated in so many parts of the United States today. The funds for programs which are actually helpful are hard to come by. Things like independent, non-traditional peer houses struggle for funding versus things like stringent shelters and locked psychiatric wards. Thank you for the resources as well. 🙂

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  3. Absolutely correct and, dare I say, perfect article. Literally everything it says is disturbingly true. I am definitely sharing this article on my social media accounts.

    As a currently three-time impatient psychiatric survivor myself, albeit one who has very fortunately never been unhoused or experienced homelessness, I’ve been meaning to write about my own experiences in forced impatient psychiatric treatment for years now, especially since they happened both pre-COVID (my Feb 2019 stay) and during the COVID shutdowns here in California (my April 2021 and August 2022 stays), but I have let other things get in the way of writing out the important full details of my story.

    Honestly, I think finishing my memoirs about my experiences in psychiatric incarcerationand spreading them everywhere I can are going to be my big goals of 2024.

    It’s been a long enough while since someone who’s actually had their entire life put in the hands of the “behavioral health” system has been able to make any real splash with the general public who often consigns them to such a fate, and that’s a crying shame.

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    • Thank you Spencer! Sharing your story would be very brave. I think after Britney’s book, we need a wave of more psychiatric survivors to come forward. It can be hard, for sure, but there are possibly over 10 million in the U.S. alone who have been exposed to coercive psychiatry. People just fear talking about it until someone else speaks up.

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    • Thank you for well done artical. You have touched on almost all points don’t forget malpractice victims and those without money for medical and discrimination as victims in police help like employment landlord societal crime against the innocent even more on the street..I’m writing from Canada same here sane motives of politicians to make an entire group persona non grata and denied political voice of resolutions thank you glory glory psychotherapy glory glory now we can be free by Melanie…let’s stop them once snd for all by the word of our testimonies and the blood of the lamb.

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  4. 100% agree. My life didn’t really start until I stopped all mood stabilizers and anti depressants which was wreaking havoc with my health and mind. I learnt to cope with my own behavior and applied it successfully. Psychiatrists induced fear and made me dependent on drugs and even blamed me when it doesn’t work. None of it ever worked until I took control myself.

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  5. Thank you, Crystal, for bringing up this important societal issue. Bad banking laws, led to predatory lending, led to “trillions in houses stolen,” led to a large homeless problem. Gee, who is to blame for the homeless problem?

    Provide housing for the homeless, US, not psychiatric “torture” and defamation of character. And bring back rational banking regulation.

    I did hear that there was a person in my local area who was making “little homes” for the homeless. I thought that sounded like a nice idea. And the US government owns a lot of land, so they could set up campground like rest room and shower facilities, maybe even dining facilities, for formerly homeless “little home” dwellers? I don’t know if that’s what the guy is doing, but it could be a possible solution?

    Or is that too similar of a bad idea, to the US government’s inner city housing project debacle, like the now nonexistent Cabrini Green? I think if you keep “little home” communities relatively small, and set within nature, it might work? And people can work remotely these days, so being in the city is no longer so important.

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    • Thank you! You are right that it’s the oligarchs to blame, not “mental illness,” whatever the system of the day means by that. Overwhelmingly, people struggle with mental crises and drug abuse after becoming homeless, rather than before, though that does happen sometimes.
      >”Provide housing for the homeless, US, not psychiatric ‘torture’ and defamation of character.”
      Amen!
      >”And the US government owns a lot of land, so they could set up campground like rest room and shower facilities, maybe even dining facilities, for formerly homeless ‘little home’ dwellers? I don’t know if that’s what the guy is doing, but it could be a possible solution? Or is that too similar of a bad idea, to the US government’s inner city housing project debacle, like the now nonexistent Cabrini Green? I think if you keep ‘little home’ communities relatively small, and set within nature, it might work? And people can work remotely these days, so being in the city is no longer so important.”
      I am not an expert on the logistics, but keeping the communities small and spread out seems ideal for integration with the rest of society. I think remote work isn’t a realistic option for your average person on the street, though I am open to being proven wrong. Getting a head start towards getting a job and potentially disability pay, though, can be possible online, as can getting certain certifications like those for alcohol and food service.

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    • Hi Joy, I believe I did mention drug use, though that wasn’t the focus of the article:
      > “In fact, beyond just being cheaper than forced institutionalization, housing first saves the public substantial amounts of money. Rather than allowing the homeless to descend into mental anguish, drug abuse, and occasionally crime, places that cure the issue at the source save money by reducing the need for services addressing the symptoms of the problem. Providing for the basic needs of the unhoused reduces the need for services of all kinds and promotes public safety. … Furthermore, more consensual services minimizing drug use while maximizing human connection could vastly improve outcomes.”
      Drug abuse can be addressed a lot of the time by providing housing. There are still people who will continue to suffer after, but starting with unconditional housing creates a safe environment where people are less likely to turn to drugs as a coping mechanism. Oftentimes, these issues start or worsen after the sufferer is on the street, and were either not present or not so bad before.

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    • I don’t know that it is true that the majority of homeless people are addicts. Whether it is true or not, living on the street is going to lead people to have a lot of emotional issues. In other words, homelessness is going to CAUSE addiction, not the other way around. If you had no place to live, wouldn’t YOU be upset? That would be understandable.

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    • What is your concrete evidence that the “vast majority” of the homeless (60%, 80%, 95%??) have addiction issues?
      And even if this is the case, their addictions are often an understandable response to the brutal exploitation of human labor, financial hardship, lack of affordable housing and medical care, family tensions, racism, and other social ills resulting from this corrupt corporate fascist system masquerading as a free-market democracy. THAT is the whole truth.

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  6. Newsom’s forced psychiatry scheme will collapse under the weight of its own dysfunction. Its cost, the number of people it seeks to persecute, and the visibility of the tyranny cannot be contained. I read an article a few days ago that revealed the number of people – 15 – processed by “CARE Court” during its first month of operation. That’s 15 people *processed*. It includes people whose cases will eventually be dropped, people who will flee the area, and people who will “agree” to treatment in the real world and quit later on, when the legal heat is off them. There’s only one way to help unhoused people: permanent housing with no strings attached.

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    • Thank you J! I really hope that the number will continue to be as close to zero as possible as far as “CARE” court goes. What a human rights disaster that is! I hope it will get overturned. Psych survivors need to go bring the state of California to court over its egregious policies as far as commitment goes.
      >”There’s only one way to help unhoused people: permanent housing with no strings attached.”
      I 100% agree.

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