I met with a new patient today at the psychiatric hospital he's staying in. This is the fancy hospital in a ritzy suburb that prefers housewives with depression to, well, OUR patients. This is not to minimize the problems of depressed housewives. I've BEEN a depressed housewife and it sucks rocks and can interfere profoundly with parenting. But our patients are usually psychotic and have often self mutilated or overdosed or have experienced other things that typical mentally ill people don't. We are the bottom of the barrel. Our patients are the people left behind by the traditional psychiatric and disability systems. They are often homeless, needing foster care or stuck in the worst pits of housing projects with predatory landlords and neighbors. Sometimes they are too ill to bathe or change clothes and they just smell really bad. They are people that the typical suburban person would cross the street to avoid on most occasions. They seldom have any income, and when they do it is often only $200 a month. Not enough to get even the most basic housing in a residential motel or boarding house, let alone pay for food and medicine. Some of our most vulnerable patients are forced into homelessness because adult foster care is not paid by the state like child foster care. Instead, a person has to have about $800 a month to get into one. It used to be less but now people with SSI or SSDI have premiums of around a hundred dollers taken out of their checks for medicare premiums. Plenty of people in foster care are left homeless once the qualify for medicare, unless they have a very proactive human services worker. But those workers have caseloads of 600 people or more. They usually don't return phone calls from clients, let alone do anything that will help them. They're just too overwhelmed. But they do better than the general public and legislators. Nobody cares about the suffering of our patients. They don't acknowledge their existence mostly. It can get very frustrating. What am I saying? Not frustrating - heart breaking.