It is often not the common side effects: "gain weight, fall asleep and experience involuntary muscle jerking" that cause people to stop taking meds.
It is that their brain feels different, not like how it should be.
Now involuntary muscle jerking has a high stigma.
It can, in the worst cases be highly visible.
The new drugs seem to stop this drawback and instead
introduces vomiting.
That would be even worse.
The worst part of the article though is the frequent reference to homeless people.
and that seems to be written by someone who has no idea of the realities.
A majority of homeless people do not have access to even basic healthcare.
There are different reasons for this, but it is true of the majority.
You dont have a look that closely to see open wounds, some infected, esp on
feet and legs. These are basic healthcare concerns.
Probably they have several other conditions that require treatment,
and deficiencies due to a lack of food period, and certain lack of food that
is nutritious and healthy.
Are the doctors just going to walk up and down the lines of homeless giving
out bottles of pills and hope the world will change?
These types of drugs should always be closely monitored by a psychiatrist.
Which is made nearly impossible with homeless people.
(not to mention the cost. It could have high co-pays but I hope there are programs
that can mitigate this.
The only way to do this is to give the person a place to live.
Ensure the person has healthy and decent food.
This will require time and treatment so build up a new sense of
safety.
Once achieved treatment for schizophrenia could start with the drug and be
closely monitored by professionals.
None of the drugs to treat mental health issues will work on all,
And some people will have strong side effects.
My read on the one reference to homelessness in the article was that a life-changing medication that can help with a disease like schizophrenia can prevent homelessness in the first place.
I have a close family member that had a psychotic episode during the pandemic. They were hospitalized but were eventually able to get effective treatment and medication and now live a mostly normal life.
Had they not had the support to get proper medication, I have a hard time seeing how they wouldn’t end up homeless.
Not saying it is or isn't overpriced, but 20k/year is actually a good price for something that can avoid homelessness. Just the cost of extra medical care and/or jail, let alone social services and lost productivity, is worth it.
$20k per year for a brand new drug that went through 15 years of development is peanuts. Welcome to healthcare in the country that leads the world in pharma research, for good and for ill.
Napkin mathing here since available data isn't great, but the US definitely doesn't lead the world in healthcare R&D spending relative to our size. We're spending something like 0.22% of GDP on healthcare R&D, putting us at about #7 globally. In comparison, Denmark spends 0.93% of GDP on healthcare R&D. And that list is missing data from other countries that probably rank above us, like Cuba.
The thing is you don't even need this new drug, from the article "Risperdal and Zyprexa" are very effective antipsychotics. Even more effective when combined with a long acting to prevent backslide from missed does.
Who cares about the TD, tremors, etc. when that patient can rejoin society? Really what needs to change is reopen US mental hospitals to get these patients treatment and end the stigma around mentally illness.
That isn't how that works. That isn't how any of this works.
21% [1] of homeless have a serious mental illness that predates their living situation, of which an even smaller chunk is schizophrenia. The major reasons for homelessness are predominantly financial (also [1]). We think that the sequence of events is mental illness/drugs → homelessness → poverty, but the true sequence is an averse financial event + lack of support → homelessness → mental illness (as a result of the homelessness) → drugs to cope.
We saw the most pronounced examples of this in Houston's homeless program, which has a 90% success rate by providing housing first [2]. For many, having a safe home is the only resource needed to get clean.
Homelessness is torture. Anyone in that situation would turn to drugs to cope. Demonizing the drugs is flying straight over the cause of the drugs themselves. If you want to fix homelessness, give homeless people homes.
Do you have a source that suggests that mental illness/drugs do not contribute to becoming homeless?
> 21% [1] of homeless have a serious mental illness that predates their living situation
This seems to suggest that mental illness does lead to homelessness. I would agree that financial strain is a major cause of homeless, but it seems likely that this is because it leads to other behaviors that then lead to homelessness. And those behaviors are probably not exclusively caused by financial strain.
Additionally, from the conclusion of your first link (my italics added for emphasis):
> SAMHSA utilizes its national surveys and grantee data to create effective programs and services to prevent and end homelessness among people with mental and substance use disorders.
Secondly, I agree that housing is an important first step for fixing homelessness because it seems like a precondition for stability.
But this:
> For many, having a safe home is the only resource needed to get clean.
seems misguided to me. "Housing First" != exclusively housing. From your second link:
> we move people into permanent housing as quickly as possible and then provide them with supportive services (like case management, health care, substance use counseling, income coaching, and more)
There definitely are people who have mental illness, which when activated or exacerbated leads to homelessness. I have family members in this boat and I've seen this cycle repeat at least a half a dozen times.
"The only way to do this is to give the person a place to live."
The people who are homeless are homeless because they, due to drugs, alcohol, or mental illness aren't safe to have around others of extreme poverty.
My friend operate several halfway houses. Almost weekly he has to kick someone out because they are a danger to staff or other clients. Generally this is at 2am, and the police are involved.
Our society has decided that institutionalizing people is inhumane. Well, if someone isn't safe enough to be in a halfway house and institutions are inhumane, the only place for them to go is the street, and, eventually, if they are lucky, prison.
> The only way to do this is to give the person a place to live. Ensure the person has healthy and decent food. This will require time and treatment so build up a new sense of safety.
> Once achieved treatment for schizophrenia could start with the drug and be closely monitored by professionals.
At least for mental illness, the US state run mental hospitals should be reopened to put the mentally ill under care, monitoring, and to get them back on medicine.
Modern psychiatric medicine could reverse the issues that used to stigmatize the mentally ill.
Improperly supervised psychiatric patients are a nightmare, if for no other reason than they often don’t take the drugs that make them not a nightmare.
That means stand-alone housing just won’t work properly.
It is often not the common side effects: "gain weight, fall asleep and experience involuntary muscle jerking" that cause people to stop taking meds. It is that their brain feels different, not like how it should be.
Now involuntary muscle jerking has a high stigma. It can, in the worst cases be highly visible. The new drugs seem to stop this drawback and instead introduces vomiting. That would be even worse.
The worst part of the article though is the frequent reference to homeless people. and that seems to be written by someone who has no idea of the realities.
A majority of homeless people do not have access to even basic healthcare. There are different reasons for this, but it is true of the majority. You dont have a look that closely to see open wounds, some infected, esp on feet and legs. These are basic healthcare concerns. Probably they have several other conditions that require treatment, and deficiencies due to a lack of food period, and certain lack of food that is nutritious and healthy.
Are the doctors just going to walk up and down the lines of homeless giving out bottles of pills and hope the world will change?
These types of drugs should always be closely monitored by a psychiatrist. Which is made nearly impossible with homeless people. (not to mention the cost. It could have high co-pays but I hope there are programs that can mitigate this.
The only way to do this is to give the person a place to live. Ensure the person has healthy and decent food. This will require time and treatment so build up a new sense of safety.
Once achieved treatment for schizophrenia could start with the drug and be closely monitored by professionals.
None of the drugs to treat mental health issues will work on all, And some people will have strong side effects.