Friday, March 13, 2015

ADHD May be One of the Largest Causes of Homelessness

Undiagnosed ADHD may be one of the largest causes of homelessness.  This may seem like a stretch of logic to you, but lets consider ADHD and ADD for a second. NIMH says that ADHD has been shown to be a developmental condition in which the brain maturation is delayed (link).  The delay is most pronounced in brain regions involved in thinking, paying attention, and planning.

Essentially, Johnny doesn't do his homework.  He signs up for the course, amazes people in the classroom with his thoughtful and creative ideas, and becomes a class favourite, but he fails the course-- why? Because 60% of the course mark is based on weekly assignments, and he has missed 80% of the deadlines.  He has also been late or absent for more than 40% of the classes.That's because Johnny doesn't track time very well, and he always figures he has a bit more time.
Planning is a frontal lobe activity, and it is what some argue separates us from animals.  We see the deadline approach, and we prepare, using intellectual analysis of environmental factors to make a prediction about what will happen.  If we time it right, we do exactly what is expected at exactly the right time.
This mental ballet elludes the ADHD brain.  People with ADHD may say that they understand when the deadline is- you can look them in the eye and ask them if they understand what is expected of them, and they will assure you that they will be there.  When it comes time to rely on them, however, you may be disappointed with the result.

ADD is an invisible disability.  As a person struggling with this invisible demon, I frequently find myself in awful situations with no real good reason why.  I am articulate, thoughtful, and I care SO much about others, but success eludes me, because I dont seem to follow through when it matters.  If I talk about this with others, they simply say things like "do better," or "yeah, Im lazy too sometimes, but I learned to pull my socks up and get things done."  Its as though my disability doesn't exist... Im just lazy, or manipulative.

Today, everything is tracked. Every late payment you make for a bill goes into some database that will affect your ability to aquire resources down the road.  A poor attendance record is one of the worst things you can have on your profile, and it's possible that I am damning my ability to ever get a job again by publicly stating that I have struggled with attendance my entire life.

Yet I want us to talk about this, because I am having some success with my brain these days, but I am struck by how many homeless I have worked with who share my experiences.  In order to apply for welfare in my city, an applicant must first go online, and register.  Then they have to show up for a phone interview at the office, in which they will be given a list of documents they will have to supply to gain eligibility(a 60 day bank statement, income tax assessment, identification, etc).  They are given a second appointment, the social assistance worker reviews the material and books an "Intake interview."

Anybody with ADHD is probably laughing (or crying) as they read this, because they realize that us folks have a very slim chance of even having current ID and a current tax assessment, let alone being able to show up on time to three appointments in a row.  Most of us ADHD folks will put off gathering the required docs until the last day, thinking it will be easy.  Then we will stress ourselves out trying to get banks and tax centers to give us the info in too little time.  We will stay up the night before, trying to cover up our delayed response-- only to miss the first appointment because we slept in (got distracted by a phone call and forgot to set the alarm).

I have so many people on my caseload who play this scenario out over and over again.  They cant rent anywhere, because when the landlord checks references, the old landlords always mention how the rent was late, etc.  People with ADHD or ADD can be brilliant, but their attendance record stops them from gaining entrance to most school programs.

Have you ever seen an employment job description that did NOT include "careful attention to details?" I haven't.  We are all expected to plan, to show up, to "take our time and do it right."  It is like a fundamental pillar of our society, and on all of it, we ADHD people fall down.  Over the years, I have found myself hated for what Ive done (or not done).  People react with disgust, anger, frustration, and thus, as Dr Gabor Mate points out, the most frequent phrase used by people with ADHD is "Im sorry."

For many of us, homelessness is the only way to find peace from the relentless demands of systems and institutions.  Some of us end up in jail, because its actually a crime to not show up for court.  We will house a homeless person who is dependable, who shows up to group therapy on time, who is predictable in behaviour, but who can help the guy who "made his own bed?"  Most programs which help the homeless are merit-based, and ADD folks will never make the cut when so many others are competing for resources.

So how am I coping?  I have a pretty awesome career, am widely respected, and I show up when it seems to matter.  While my ADHD is fairly mild compared to some, I use a number of techniques to get by.  I surround myself with people who remind me where to be and when, I medicate occasionally (ADHD meds are usually stimulants that wake the brain up so I can focus at crucial times), and I talk openly about my condition with people I care about, so they know that when I show up late, its not personal, or out of a lack of concern.  When I set an appointment, I usually set up frequent email and text reminders leading up to the event, and I tell friends if I need their help to remember.  It actually takes me three times the effort to show up on time, but it can be done.

To help homeless people with ADHD, I have one strategy: I do it all for them.  I cannot count on them to be there, so I focus on getting them to sign consent forms so I can show up in their place if need be.  Oddly enough, I seldom drop balls with my homeless clients, though I drop balls in my own life like crazy.  As it turns out, outreach worker is a fabulous job for people like me, because the diversity and depth of the work works well with a creative mind. 

Ok world, decide: is the ability to plan, show up on time, and stay focused required to gain access to basic human resources like housing, food, and love?


TJ Laverty said...

Hi there,

I've worked raising awareness of the impact of ADHD on individuals and the consequent increase of risk of homelessness. I've done specific work with homeless charities, and there's a lot of anecdotal evidence out there for what you're saying.

Maybe it's time for a study?

Derek M Book said...

Yes, it is worth studying, though ADHD is often underfunded. Thanks for your comment 😊