Dr. Robert Keisling Two days a week Robert Keisling, M.D., provides psychiatric care for CCH/FP clients and consulting time with the staff. Originally from Tennessee, Bob Keisling has worked in this area since 1976 and is much respected for his work at St. Elizabeth’s and with the DC Mental Health Commission. He has also taught at Georgetown University Medical School and the Bethesda Naval Hospital and is currently teaching at George Washington University Medical School. Dr. Keisling is probably the only psychiatrist in the city working with clients on the street, and we asked him to write about that work. "A recent study in New York found that 88% of homeless mentally ill who were placed in housing remained in housing for five years. If services are flexible and intensive, many of these people can be moved off the street. I recently gave a homeless mentally ill gentleman my birth date so he could do my astrological chart – a technique you won’t find in the collected works of Sigmund Freud. You have to pay attention to what the homeless mentally ill think their needs are, not what you think they need. "Some of my most interesting conversations with the mentally ill have taken place on the street, park benches, sidewalk cafes, etc. Most of these individuals can eventually be convinced to take medication but it takes awhile. Don’t rush, it may take some time but is worth it in the end. "One program of engagement with homeless individuals who were recently released from jail showed that with assertive community-based treatment, the cost of such individuals to society declined from $75,000 per person per year to $15,000. Once engaged in treatment, people spend less time in jails and hospitals. This saves the taxpayers money and it’s a lot more humane. You can’t do it however, by sitting in your office waiting for people to come in. "Some of the people working in the shops and restaurants you patronize are ex-homeless mentally ill people. Think about that the next time you buy a cup of coffee. I’ve been in the business 29 years. I run into people all the time who have spent a good part of their lives in jails, hospitals and on the street, and who are now working full time and living in their own apartments. "Programs like CCH/FP work. We need to close down some of these dysfunctional mental health clinics and direct the money to programs that get results. Talk to your politicians about this. Did you know that DC spends more money per capita than any other jurisdiction in the country on mental health services? Don’t let anyone tell you that the homeless mentally ill are hopeless. Some of these treatment programs that are consuming your tax dollars are hopeless."