Progress in alleviating the plight of the homeless mentally ill has been
very slow and disappointing. After reviewing the needs of the homeless
mentally ill, the author makes recommendations for immediate action.
Extensive case management services should be implemented rather than simply
discussed. All incompetent and/or dangerous or gravely disabled homeless
mentally ill persons should be brought to hospitals, involuntarily if
necessary. Cost-effective alternatives to hospitals with varying degrees of
structure should be provided. Involuntary mechanisms such as
conservatorship and outpatient commitment should be used when needed. The
emphasis should be on timely transfer to acceptable treatment and living
situations rather than waiting for the ideal.