Culture, Medicine and Psychiatry

, Volume 16, Issue 1, pp 1–22 | Cite as

Through a different lens: An anthropological perspective on the homeless mentally ill

  • Paul Koegel
Article

Abstract

Recent attempts to understand the emergence of a growing population of homeless mentally ill individuals have almost exclusively relied on epidemiological and clinical approaches, the result being an incomplete and even distorted perception of these people and their behavior. This paper describes gaps that currently exist in our understanding of the homeless mentally ill, focusing on the dearth of rich qualitative descriptions of lives in process, the overwhelming preoccupation with pathology and disaffiliation, the failure to view homeless mentally ill individuals in the broader socio-economic and situational contexts of their daily lives, the absence of a longitudinal perspective, and an over-reliance on self-report as a source of data. Data are offered from an ethnographic examination of the ongoing adaptation of 50 chronically mentally ill homeless adults in the downtown area of Los Angeles to suggest how research utilizing an anthropological perspective can fill some of these gaps. This discussion indicates by extension that anthropological research can provide policy-relevant insights in this critical area and that the study of homelessness and mental illness presents opportunities for anthropologists to pursue a variety of issues relevant to the field.

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References

  1. Access 1989 NIMH Awards $3.1M to Study Homeless Mentally Ill. Access 1:1–3.Google Scholar
  2. Agar, Michael H. 1973 Ripping and Running: A Formal Ethnography of Urban Heroin Addicts. New York: Seminar Press.Google Scholar
  3. Bahr, Howard, and K. Houts 1971 Can you Trust a Homeless Man? A Comparison of Official Records and Interview Responses by Bowery Men. Public Opinion Quarterly 35:374–382.Google Scholar
  4. Baxter, Ellen, and Kim Hopper 1981 Private Lives, Public Spaces: Homeless Adults on the Streets of New York City. New York: Community Service Society.Google Scholar
  5. Becker, Howard S, and Blanche Geer 1970 Participant-observation and Interviewing: A Rejoinder. In Qualitative Methodology. Firsthand Involvement in the Social World. W.J. Filstead, ed. Chicago: Markham Books.Google Scholar
  6. Blasi, Gary 1988 Litigation Strategies for Addressing Bureaucratic Disentitlement. New York University Review of Law and Social Change 16:591–603.Google Scholar
  7. Burnam, M. Audrey, and Paul Koegel 1988 Methodology for Obtaining a Representative Sample of Homeless Persons: The Los Angeles Skid Row Study. Evaluation Review 12:117–152.Google Scholar
  8. Chrisman, Noel J., and Thomas M. Johnson 1990 Clinically Applied Anthropology. In Medical Anthropology: Contemporary Theory and Method. T.M. Johnson and C.F. Sargent, eds. New York: Praeger.Google Scholar
  9. Chrisman, Noel J., and Thomas W. Maretzki 1982 Anthropology in Health Science Settings. In Clinically Applied Anthropology: Anthropologists in Health Science Settings. N.J. Chrisman and T.W. Maretzki, eds. Dordrecht: D. Reidel.Google Scholar
  10. Circourel, Aaron V. 1972 Cognitive Sociology. New York: Free Press.Google Scholar
  11. Dear, Michael, and Jennifer R. Wolch 1987 Landscapes of Despair: From Deinstitutionalization to Homelessness. Princeton: Princeton University Press.Google Scholar
  12. Dennis, Deborah, Kostas Gounis, and Joseph P. Morrisey 1987 Housing and the Homeless Mentally Ill. New York State Office of Mental Health Research Notes 2:5.Google Scholar
  13. Dennis, Deborah, Joseph P. Morrisey, Kostas Gounis, and Susan Barrow 1987 Sheltering the Homeless Mentally Ill. New York State Office of Mental Health Research Notes 2:5.Google Scholar
  14. Deutscher, Isaac 1970 Words and Deeds: Social Science and Social Policy. In Qualitative Methodology. Firsthand Involvement in the Social World. W.J. Filstead, ed. Chicago: Markham Books.Google Scholar
  15. Edgerton, Robert B. 1967 The Cloak of Competence. Berkeley: University of California Press.Google Scholar
  16. Edgerton, Robert B., and L.L. Langness 1974 Methods and Styles in the Study of Culture. San Francisco, Chandler & Sharp.Google Scholar
  17. , and 1978 Observing Mentally Retarded Persons in Community Settings: An Anthropological Perspective. In Observing Behavior, Volume 1. Theory and Applications in Mental Retardation. G.P. Sackett, ed. Baltimore: University Park Press.Google Scholar
  18. Estroff, Sue E. 1981 Making It Crazy: An Ethnography of Psychiatric Clients in an American Community. Berkeley: University of California Press.Google Scholar
  19. Feldman, Douglas 1990 Culture and AIDS. New York: Praeger.Google Scholar
  20. First, Richard J., Beverly G. Toomey, and John C. Rife 1990 Rural Homelessness in Ohio. Columbus: Ohio State University College of Social Work.Google Scholar
  21. Geertz, Clifford 1973 The Interpretation of Cultures. New York: Basic Books.Google Scholar
  22. Goldfinger, Stephen M., and Linda Chafetz 1984 Designing a Better Service System for the Homeless Mentally 111. In The Homeless Mentally Ill: A Task Force Report of the American Psychiatric Association. H.R. Lamb, ed. Washington DC: American Psychiatric Association Press.Google Scholar
  23. Hopper, Kim 1988 More Than Passing Strange: Homelessness and Mental Illness in New York City. American Ethnologist 15:155–167.Google Scholar
  24. 1991 Pitfalls and Potential Liabilities of Ethnography in the Study of Homelessness and Mental Illness. Comments presented at the NIMH-sponsored FY 1990 McKinney Research Demonstration Projects for Homeless Mentally Ill Adults Meeting, Crystal City, January 16–17.Google Scholar
  25. n.d. A Poor Apart: The Distancing of Homeless Men in New York's History. Social Research, in press.Google Scholar
  26. Hopper, Kim, and Jill Hamberg 1986 The Making of America's Homeless: From Skid Row to New Poor, 1945–1984. In Critical Perspectives on Housing. R.G. Bratt, C. Hartman, and A. Meyerson, eds. Philadelphia: Temple University Press.Google Scholar
  27. Johnson, Alice K. 1989 Measurement and Methodological Issues in Research on Homelessness. Paper presented at the 8th annual meeting of the Homelessness Study Group, Committee on Health Services Research, Medical Care Section, American Public Health Assocation, Chicago, October 21.Google Scholar
  28. Kaplan, Abraham 1964 The Conduct of Inquiry. New York: Chandler. Koegel, PaulGoogle Scholar
  29. Koegel, Paul 1990 Ethnographic Views on the Homeless Mentally 111. Paper presented at the 143rd annual meeting of the American Psychiatric Association, New York, May 12–17.Google Scholar
  30. 1990 Micro-level Views of Macro-level Processes: The Case of the Homeless Mentally 111. Paper presented at the 89th annual meeting of the American Anthropological Association, New Orleans, November 28–December 2. n.d. Understanding Homelessness: An Ethnographic Approach. In Homelessness: A Prevention-Oriented Approach. R.I. Jahiel, ed. Baltimore: Johns Hopkins Press, in press.Google Scholar
  31. Koegel, Paul, and Daniel Sherman n.d. Assessing and Treating Homeless Mentally III Adults. In Delivering Health Care to Homeless Persons: A Guide to the Diagnosis and Management of Medical and Mental Health Conditions. D. Wood, ed. New York: Springer Publishing, in press.Google Scholar
  32. LaGory, Mark, F.J. Ritchey, and J. Mullis 1990 Depression Among the Homeless. Journal of Health and Social Behavior 31:87–101.Google Scholar
  33. Lang, Michael H. 1989 Homelessness Amid Affluence: Structure and Paradox in the American Political Economy. New York: Praeger.Google Scholar
  34. LaPiere Richard T. 1934 Attitudes vs. Actions. Social Forces 13:230–237.Google Scholar
  35. Liebow, Elliot 1967 Tally's Corner. Boston: Little, Brown.Google Scholar
  36. Lincoln, Yolanda S., and Egon G. Guba 1985 Naturalistic Inquiry. Newbury Park CA: Sage.Google Scholar
  37. Lovell, Anne M., Susan Makiesky Barrow, and Elmer L. Struening n.d. Between Relevance and Rigor: Methodological Issues in Studying Mental Health and Homelessness. In Homelessness: A Prevention-Oriented Approach. R.I. Jahiel, ed. Baltimore: Johns Hopkins Press, in press.Google Scholar
  38. Messerschmidt, Donald A. 1981 Anthropologists at Home in North America: Methods and Issues in the Study of One's Own Society. Cambridge: Cambridge University Press, 1981.Google Scholar
  39. Peacock, James L. 1986 The Anthropological Lens: Harsh Light, Soft Focus. Cambridge: Cambridge University Press.Google Scholar
  40. Piven, Frances Fox, and Richard A. Cloward 1971 Regulating the Poor: The Functions of Public Welfare. New York: Vintage Books.Google Scholar
  41. Reich, Robert, and Lloyd Siegel 1978 The Emergence of the Bowery as a Psychiatric Dumping Ground. Psychiatric Quarterly 50:191–201.Google Scholar
  42. Robertson, Marjorie J. n.d. Mental Disorder, Homelessness, and Barriers to Services: A Review of the Empirical Literature. In Homelessness: A Prevention-Oriented Approach. R.I. Jahiel, ed. Baltimore: Johns Hopkins Press, in press.Google Scholar
  43. Segal, Steven P., Jim Baumohl, and Elsie Johnson 1977 Falling Through the Cracks: Mental Disorder and Social Margin in a Young Vagrant Population. Social Problems 24:387–400.Google Scholar
  44. Shimkin, Demitri, and Peggy Golde 1983 Clinical Anthropology: A New Approach to American Health Problems? Lanham MD: University Press of America.Google Scholar
  45. Snow, David A., and Leon Anderson 1987 Identity Work Among the Homeless: The Verbal Construction and Avowal of Personal Identities. American Journal of Sociology 92:1336–1371.Google Scholar
  46. Sosin, Michael, Irving Piliavin, and Herb Westerfelt 1990 Toward a Longitudinal Analysis of Homelessness. Journal of Social Issues 46:157–174.Google Scholar
  47. Susser, Ezra, Sarah Conover, and Elmer L. Struening 1990 Mental Illness in the Homeless: Problems of Epidemiologic Method in Surveys of the 1980s. Community Mental Health Journal 26:391–414.Google Scholar
  48. Susser, Ezra, Stephen M. Goldfinger, and Andrea White 1990 Some Clinical Approaches to the Homeless Mentally Ill. Community Mental Health Journal 26:463–480.Google Scholar
  49. Weitzman, Beth C., James R. Knickmam, and Marybeth Shinn 1990 Pathways to Homelessness Among New York City Families. Journal of Social Issues 46:125–140.Google Scholar
  50. Williams, Terry M., and William Kornblum 1985 Growing Up Poor. Lexington, Mass.: Lexington Books.Google Scholar
  51. Wiseman, Jacqueline P. 1970 Stations of the Lost. Englewood Cliffs, NJ: Prentice-Hall International, Inc.Google Scholar

Copyright information

© Kluwer Academic Publishers 1992

Authors and Affiliations

  • Paul Koegel
    • 1
  1. 1.Social Policy Department RANDSanta MonicaU.S.A.

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