Thursday, November 21, 2013

Unwrapping A Moral Impulse

People assume that I readily recommend calling 911 regarding panhandlers because I got so fed up with the issue during my now concluded career in community economic development but let me tell you why they are wrong.

About 6.7% of the U.S. adult population experiences major depression, meaning it lasts two weeks or more.  But 2% have what is called severe depression.  The percentage is higher among young people, women and whites, lower among blacks, but only half get treatment and for 1-in-5, the treatment is minimally adequate according to researchers.

About 16.5% of Americans experience major depression during a their lifetimes or about 1-in-6 people.  When severe, it is also known as clinical depression.  Sports Illustrated featured a touching interview with Andre Dawkins, a Duke Basketball player who was forced to miss an entire season for treatment for severe depression.

Dawkins had an incredible support network including his parents, but to his credit, he also sought professional help, and Duke has some of the best in the world.  He could have ended up homeless or worse.  It happens to many who are mentally ill.

People struggle to distinguish panhandling from being homeless.

Surveys show that while more than 80% of panhandlers are homeless, only 19% of the the homeless resort to panhandling.  The proportion of panhandlers suffering depression is six times the general population.

However, 30% don’t have a disability, 15% work and 4% admit to participating in panhandling rings (most likely underreported because of pressure not to.)  More than enough public services are available so that no one has an excuse to panhandle.

In Durham, North Carolina where I live, several hundred city and university police officers, deputy sheriffs, firefighters and EMS personnel have undergone special schooling to be part of a Crisis Intervention Team to assess mental illness and other issues.

More are being trained each year.  The training is sufficient for CIT members to be available wherever needed to de-escalate situations, make an assessment similar to triage, and get people where they need to go for help, be it substance abuse treatment, mental health or social services.

The concept originated in Memphis Tennessee in 1988 but today the FBI reports that CIT teams exist in 2500 law enforcement and related agencies nationwide.  Unfortunately their work is impeded by members of the general public who won’t cooperate and worse, enable panhandling.

According to Dr. Dan Gilbert, a researcher at Harvard, “we are hard-wired with a strong and intuitive moral impulse – an urge to help others that is every bit as basic as the selfish urges that get all the press.”

In my experience though, far too many fail to inform this impulse with facts and realities about panhandling.  Mental illness is not a crime but in my experience it can greatly impair good judgment.

CIT assessments will quickly separate panhandlers involved in theft from those unaware of the many services available, and from those in serious need for intervention related to mental illness or substance abuse.

Handing over money or a turkey leg to panhandlers in the end is not the answer and only perpetuates the problem while delaying the solution.

For many of us though, having learned the complexity and ambiguity of the true panhandling narrative and knowing the CIT is better equipped to handle these situations, we call 911 rather than risk being robbed of our humanity.

In his blog, Gilbert describes being ripped off by a thief masquerading as a panhandler in 1997.  He compares it to being vandalized or burglarized which taught him “to be better” and more careful, while the thief masquerading as a panhandler “had taken advantage of [his] helpfulness and taught [him] to be worse.”

A promise of the Affordable Care Act is better treatment for mental illness including variations suffered by nearly 7-in-10 panhandlers.  It may mean a better rehabilitation for the nearly 17% in prisons who suffer from serious mental illnesses.

A 2010 study found that currently we have more mentally ill people in prisons than we do in hospitals, approaching the levels in 1840 before mental health reformers such as Dorothea Dix changed the paradigm.  As long ago as 1939, researchers postulated that the population of psychiatric hospitals and prisons were inversely correlated.

As one decreases, the other increases, a lesson we have relearned the hard way over the last fifty years and as recently as the attempted murder-suicide of a U.S. Senator.

Note: For my resource on panhandling vs. homelessness I have relied on a survey conducted a few years ago in Clark County, Nevada.

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