Susan Fox was in her mid-30s before she began to deal with the anxiety and depression that had haunted her all her life. By outward appearances, she was a happy, successful young professional “with a condo, an expense account and a nice car.” Privately, she was hooked on cocaine and booze.
After years of trying to control her addiction, a new job triggered the familiar cycle of stress and relapse. She lost 30 pounds in three weeks and wrestled with insomnia before finally seeing a doctor. Diagnosis: anxiety. Though that was only half the equation. When she moved to Seattle from Washington DC in 1990, the pressure bore down on her again and Fox began to see her symptoms for what they were: depression.
“I remember thinking, ‘I don’t want to be mentally ill,’” she says. “I had this biochemical condition in my body that was probably genetic, and that alcoholism probably exacerbated, and when the alcohol was gone and the cocaine was gone, I was left with this biochemistry and no self-confidence or sense of myself.”
Now Fox spends her days sharing her story in her role as the Executive Director of Peace for the Streets by Kids from the Streets (PSKS), a shelter which offers support programs for homeless youth in the Seattle area. Fox was never homeless, though she came close — bouncing between family members’ couches in her darker moments — and she is well aware of the numbers of homeless youth who have experiences similar to hers.
Homelessness and mental illness have long been linked. Mental illness is especially challenging to treat when it afflicts homeless youth who are ill equipped to recognize or cope with its symptoms. One-half of all cases of chronic mental illness begin by age 14; three-quarters by age 24. Homeless youth exhibit psychiatric disorders at a rate six times higher than the general youth population, according to a 2009 study from shelters in Denver.
“The majority of young people we see do have mental health issues or mental health concerns,” says Charlotte Sanders (left), Director of Neighborcare’s 45th Street Youth Clinic, which provides services for young people, aged 12 to 23, who have been homeless or in unstable housing in the last year. “Whether they’ve been diagnosed or not, a lot of young people carry with them diagnoses they’ve at some point heard.”
The results of early-onset mental illness can be devastating. Consider, for instance, that the National Alliance for Mental Illness (NAMI) reports 70 percent of young people in juvenile detention have been diagnosed with at least one mental health condition. Twenty percent have a serious mental illness.
Their mental illness could be the result of a chronic condition presenting itself, or a ripple effect of childhood trauma. Either way, for teens already struggling to navigate young adulthood, a diagnosis can send them spiraling into an identity crisis, unsure where their selves begin and their conditions end.
PSKS is unique in that it was founded and is organized by the very young people who use its services. At the heart of operations is a governing body of homeless and at-risk youth who help structure the organization’s goals and mission statement. Fox emphasizes that PSKS is not a mental health treatment facility. Like many youth clinics and shelters, it relies on a small volunteer staff to tackle an issue (mental illness) that is gargantuan. How do you help a young person who may not know where his or her next meal is coming from? How do you provide a continuum of care despite the chaotic nature of life on the streets? How do you shield someone from the very triggers that homelessness perpetuates?
Fox says psychological issues are both catalysts for and consequences of homelessness. Young people who live on the streets are more likely to be victims of sexual assault and are often exposed to high rates of violence. They may also be dealing with childhood trauma or depression. Many more street youth show some signs of Post-Traumatic Stress Disorder (PTSD).
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