Challenges double when reporting on homelessness and mental health, but a few tips can help

The closest I’ve come to understanding how terrifying and confusing mental illness can be for those caught in its grip is when I faced Jamie Hardy’s wild eyes across the table at a drop-in center for the homeless in Ventura, Calif.

It wasn’t the first time I’d talked to Hardy. I’d interviewed him a few months earlier, where he spoke a little disjointedly but coherently about his schizophrenia, drug and alcohol addiction, and how that nocuous combination fueled his slide into homelessness. Later I bumped into him again on the street. He seemed his usual, jovial self. He gave me a hug and then sauntered on.

But when I met Hardy again in July, something was different. As usual, he was more than willing to talk to me. But as we began our conversation, he seemed edgy and frightened. It was almost impossible to get an intelligible answer from him. He jumped between unrelated topics, glancing around distractedly. He told me he could hear his friend crying through my cell phone. At one point he asked suddenly if I was there to take him to the psychiatric hospital. He said voices were telling him the police were about to beat him up.

“It’s so real,” he told me.

As I witnessed Hardy’s distress, mental illness became very real to me too.

For those of us blessed with a healthy mind, it’s easy to take for granted the ability to think clearly. Our conventionally wired brains allow us to resolve problems, establish relationships, and react coherently to everyday stimuli.  But how do you do those things if your mind is invaded by voices or thoughts you can’t control? How do you function in the world if your own brain inflicts such discomfort that all you want to do is escape from yourself?

As I researched the connections between mental illness and homelessness for my California Health Journalism Fellowship project and the Ventura County Star, I came to better understand how paralyzing mental illness can be. I witnessed first hand how living on the streets exacerbates mental illness. I also saw how challenging it is for social service workers to help the homeless and mentally ill because of the very nature of their illnesses, legal restrictions surrounding forced medical treatment, and a severe lack of housing options.

The topic is important because Ventura County is grappling with how to deal with a higher-than-average chronically homeless population. Among these long-term homeless, more than a third suffer from a mental illness, according to the county’s 2015 homeless count. The number is likely higher because the count relies on self-reporting and, as I discovered, many of the homeless don’t like to admit they have a mental illness, or don’t even realize they have one.

As a journalist, both homelessness and mental illness are uniquely challenging topics to report on. When combined, the reporting challenges double, but so do the fascinating insights to be gleaned from it. I’ll admit, sometimes I wanted to tear my hair out working on this project. But at the end of it all, I felt I had grown not just as a reporter but as a human being.

For those interested in travelling this reporting path here are some tips to help you on your journey:

• Learn the lingo: Homelessness, more than any other subject I’ve written about, is a minefield of acronyms. Officials who work with the homeless frequently speak in alphabet soup. There are terms like SRO (single room occupancy), VI-SPDAT (a type of database), and 5150 (involuntary confinement of a person with a mental disorder). There are also various terms for housing types and approaches, such as rapid rehousing, transitional housing and permanent supportive housing. Familiarize yourself with these terms, either by looking at the Department of Housing and Urban Development’s website, or by asking people directly.

• Start with the experts. It can be tempting to begin by simply going out and finding some homeless people to talk to for that first-hand account. After all, they’re everywhere, especially in coastal California’s urban centers. However, particularly in reporting on mental illness, you may not easily recognize certain issues and themes unless you’ve already talked to someone (or multiple people) more familiar with this population. Start by interviewing a social worker or mental health worker about what to expect, or better yet, follow alongside them as they do their work.

• Expect mistrust. People who are homeless are often mistrustful of outsiders, they’re used to being treated badly by the public. If they are mentally ill it’s even more likely they will be on their guard because their illness can make them paranoid. I found that the best way to develop trust was by way of an introduction from someone they were already familiar with. One of the people who helped me the most was a church volunteer who hands out bus passes and body-wipes to the homeless in Ventura’s parks.

Above all, listen respectfully and with kindness to the people you talk to. What they say may sound crazy, but it is their reality.

• You will be confused. Talking to people with a mental illness can be really, really puzzling. Straightforward interview questions can turn into a maze of contradictory information and bizarre tangents. If you need concrete information, you may be able to get it from an official familiar with that person (good luck, see below). Otherwise, you might do better interviewing a person who has experienced homelessness and mental illness, but come out the other end. They will generally be much more articulate than someone in the thick of a crisis.

One reason I profiled Jamie Hardy was because he was unusually self-aware and able to explain details of his schizophrenia even as it happened to him. If you find someone able and willing to do that, keep following them.

• Beware HIPAA, and those who must abide by it. As most health journalists know, the Health Insurance Portability and Accountability Act or HIPAA (yay, another acronym!) can make it difficult to find sources or to verify personal information through a health care agency. Times that by 10 when reporting on the mentally ill. Often I had signed consent forms from a homeless person I’d interviewed, or they’d given verbal in-person consent to a therapist or caseworker that I could talk to them about their case. And yet still that official wouldn’t talk to me.

My advice: Find people in the know who are not so entrapped by health care law protocol. Police officers, park security guards, church volunteers, family members. You may not get everything you wish for, but it can go a long way to gaining a fuller picture of what’s going on with a particular person.

• Look outside your community. One of the most helpful suggestions I received from my mentor on this project, Roger Smith, was to look into Los Angeles County’s approach to helping the chronically homeless. I was amazed to discover that the county is saving $32,000 per person per year in emergency health care services by putting people in housing. That information really helped back up why homeless advocates in Ventura County are calling for local government officials to put a greater focus on finding housing solutions and not just on funding social services.

[Photo by Juan Carlo/Ventura County Star]