Not sick enough for hospitalization but unable to cope alone, many of the homeless with mental illnesses are the stepchildren of the mental health care system.
Services to provide shelter for these people falls short, despite the fact that almost half of the homeless population have some sort of mental illness.
"These people aren't strong voting blocks," Monte Fast, executive director of Friends in Service Helping said.
Carson-Tahoe Hospital's Behavioral Health Center offers temporary refuge for those with serious mental problems, but only until they are no longer a danger to themselves or others.
"We keep them as long as necessary, but our issue is - are they mentally competent?" said Steve Lewis, marketing director for C-TH's behavioral health. He said about 10 homeless a month are seen for psychiatric, drug or alcohol-related problems.
Once they are in control and not at risk, they are released. If they cause problems on the streets, they can end up in jail.
The phrase used to define the problem, according to Lewis, is "criminalization of the mentally ill."
Carson City Sheriff's Office Chief Deputy Jerry Mather said the department deals with an average of two people a week, some with serious mental problems.
"We will take them into custody for evaluation, even though they haven't committed a crime," Mather said.
Under a statute called "civil protective custody," they are jailed to keep them out of harm's way. Evaluation by a psychologist can follow, and those needing treatment are moved to Nevada Mental Health Institute in Sparks.
If charged with a crime, they are sent to Lakes Crossing Center for the mentally disordered offender. Those who don't fall under either of these categories are released.
"We ask people their physical address," Mather said. "Some are transient and some are living in cars, but we don't track or maintain statistics on the homeless."
Focus House, a facility that houses the homeless in Carson City, doesn't have staff or funds to cope with the mentally ill, and funds for housing from Carson Mental Health have fallen short.
"We have a small housing program called Residential Support which locates and pays for apartments," said Larry Buel, director for Nevada's Rural Clinics Outpatient Services said.
"These are economic problems, and the resources are limited. The question is, how do you allocate these funds? It's very tough."
The lack of services is a problem for DeeDee Formaster, resource specialist for Carson City Center for Independent Living, an all-volunteer, non-profit organization run by and for the disabled. The organization is dedicated to improving the quality of life for all disabled people.
"Every year I go to the Legislature and tell them they need more housing slots for the mentally ill," Formaster said, noting there are good programs in Las Vegas and Reno but at least another 25 slots are needed in Carson City.
"Carson City is growing at such a rapid rate, yet they're still clumping us with other rural areas. We don't have the money that a larger area has to help seriously mentally ill here, let alone deal with the complications of those that are homeless and mentally ill."
Carson Mental Health is available to these people, but unless they are a danger either to themselves or others, it can take months to be seen.
"The counselors and case managers (at Carson Mental Health) are wonderful," Formaster said. "They go well beyond what they need to, and they desperately want to help these people, but the funding isn't there."
Qualifying for that limited funding is based on the individual's financial status. An entitlement, ( Social Security or a disability income) is critical, but fewer than 3 percent of homeless men and 14 percent of homeless women actually receive their entitlements.
"Sometimes, if they have Social Security, we can deal with a landlord to get them into a place," Sandy Coyle, executive director of the center, said. If they have no income, the organization will show them how to get the paperwork, and where to apply for services they need.
"(But) the mentally ill often aren't comfortable coming to a state or federal office to fill out the paperwork, and the services won't come to them," Coyle said.
Housing is key to their quality of life and their ability to cope with their problems, according to Formaster.
"It's been statistically proven. Those with severe mental illness that have a stable environment show up for appointments and take their meds," Formaster said.
"Most need emotional support, friendships, and community. They need to feel like they are a part of something."
"We have some wonderful success stories," Coyle said.
Few of these people choose to be homeless, and once they've made the transition from homeless to a working member of society they can become responsible members of the community, she said.
