Shirah Vollmer MD

The Musings of Dr. Vollmer

Homeless Bureacracy

Posted by Dr. Vollmer on August 1, 2016

Rory Gallegos, left, and Axel Cortes



“Gallegos was caught in a historic transition in housing policy as the federal government  wrestled with how to parcel out inadequate resources to the most needy. It’s a shift away from waiting lists toward what is essentially a homelessness grading system.”


The most vulnerable population gets hurt over and over again. Without advocacy, the mentally ill are often falling through the proverbial crack. In my experience, those well enough to “work the system” often get tremendous benefits, but those who have little insight into how a city distributes funding, or those who do not have loved ones who can help them,  suffer the most. Systems can be “gamed” and those savvy enough to understand that get to the top of the line. Cynical, you say? Maybe, but maybe also true. The issue with mental illness is that, by definition, the illness impairs their ability to navigate systems of care and as such, they often lack the mental tools necessary to deal with changing rules, and as such, homelessness often results. The homeless mentally ill, by and large, do not vote, and as such they lack political power. Having said that, there are wonderful advocacy groups such as NAMI, which make a large impact on helping the helpless. Still, there is work to be done. This LA Times story of Rory brought tears to my eyes. How he could fall down on the list because the rules changed on him is simply tragic. This new system is based on a paper and pencil test, which more insightful folks, will fill  out to gain priority, rather than honestly answering the questions, thereby tilting the program to the less-needy.

We know that “Housing First” programs work. . The lower the threshold to get housing, the faster people, including people with mental illness, will function independently. If we know that, why don’t we act on that? The answer is that there a huge housing shortage in LA County. Too many developers are gaining from building new apartments and homes for paying customers. They often create low-income housing along with new housing, but not enough to meet the growing need to house this population. Government must intervene to care for our most needy. As a psychiatrist, I want to shout about it. It is a baby step.



2 Responses to “Homeless Bureacracy”

  1. Shelly said

    So when you say, “Government must intervene to care for our most needy,” who specifically do you mean? How can the government assess who is the most needy in a most expedient, convenient, cost-effective manner? Do you mean to leave it to the Social Welfare system? I don’t believe the mentally ill participate in that system. Via the psychiatrist? Those who pay for private psychiatrists probably don’t need public housing. Public clinics’ psychiatrists? That would take years to fix. So what are you proposing, precisely?

    • In WLA there are good community mental health clinics in which needy patients could immediately qualify for housing assistance and thereby go through much less red tape. Psychiatrists such as myself are very willing to volunteer to expedite this process, if asked. It is plausible, but politics gets in the way. Thanks.

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