Maybe you’ve seen the looks a homeless man on the corner gets as he converses animatedly with the voices in his head. Or witnessed stares and nervous laughter on a city bus when a woman won’t stop yelling about the government’s plot to take away her millions.

The behaviors that accompany serious mental illness don’t phase me much because I’ve known and worked with plenty of mentally ill people — or as I sometimes like to call them, people.

My mom is a retired social worker who worked to keep elderly adults, many of whom suffered from mental illness, independent and in their own homes. The office was casual, so my mom was able to bring her kids to work with her or have us visit her there fairly often. For me, it was an invaluable education.

From the time I was 8 or 9 years old, I had interactions with hoarders and people with bipolar disorder, schizophrenia, personality disorders, and those who were too depressed even to lift their heads to look at me.

I can’t say I was never intimidated or afraid, but the people I met all had one very important thing in common: they were human beings. And they were hurting.

Shortly after graduate school, I landed a job as a case manager and worked with mentally ill adults full time. I went into some of the most crime-ridden, dangerous areas in the city on a daily basis. When I started working with the agency, I admit I was terrified — no, not of my clients, but of their environment.

What would I do if threatened? How would I protect myself?

By the time I left (largely unscathed), I was still terrified, but for one very different reason:

Mental healthcare for those who live in poverty is abysmal.

In seeking mental healthcare for myself, I’ve been both privileged and lucky.

At the age of twenty, I saw a psychiatrist for the first time. I had just been diagnosed with obsessive-compulsive disorder and I was petrified. I feared that my psychiatrist and my therapist would judge me. I thought they would declare that I was crazy and lock me away, which, at the time, was about the worst outcome I could imagine.

Instead, my psychiatrist treated me like a person. She treated me with respect and compassion and kindness. All of these things helped me to heal and realize that I was not a monster — just a very sick young woman in need of treatment.

By contrast, the doctors who treated my mentally ill clients (who, in all fairness, were spread thinner than a drop of honey on a loaf of bread) behaved as if they were running a pharmaceutical racetrack.

Stop here. Get your meds. No time to talk about how you’re doing with life. Off you go and call this number if you’re feeling suicidal. (By the way, that number was me or one of my coworkers as we took turns being on call.)

I received no training to deal with suicidal ideation. I had a master’s degree in psychology, which provided me with a little more knowledge and training than many of my coworkers, but I still felt sick to my stomach and panicky when talking to a suicidal client over the phone.

I white-knuckled my way through those conversations, praying that I wouldn’t say the wrong thing before the police finally showed up.

I fully acknowledge that much of what I have said is anecdotal, but consider these facts:

• An estimated 26% of homeless adults staying in shelters live with serious mental illness and an estimated 46% live with severe mental illness and/or substance use disorders.
• African Americans and Hispanic Americans each use mental health services at about one-half the rate of Caucasian Americans and Asian Americans at about one-third the rate.
• 70% of youth in juvenile justice systems have at least one mental health condition and at least 20% live with a serious mental illness
• And there just aren’t enough mental health providers to meet the growing need.

The relationship between poverty, social factors, mental illness, and substance abuse is complex, but one thing is clear:

Poverty doesn’t improve any of it.

So what can any one person do?

How to Help

If you want to help, check out these resources for opportunities to volunteer and/or donate.

• The National Alliance on Mental Illness (NAMI) is one of the biggest organizations to support, educate, advocate for, and help individuals suffering from mental illness and their loved ones.
• The National Institute for Mental Health (NIMH) is the largest funder or research on mental disorders in the world. They also collaborate with mental health research stakeholders, such as consumer, family, and health care professional organizations.
• The Substance Abuse and Mental Health Services Administration (SAMHSA) offers a number of programs and services. SAMHSA’s programs and campaigns “offer information, training, and technical assistance to improve the quality and delivery of behavioral health services across the nation”.
• Another option that many people may not think of is to participate in a clinical trial. You may be leery, or shy away from being a “lab rat” but clinical trials are how new treatments are found and developed, which benefits us all.

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