Accepting Psychiatric Care May Be Dangerous for Homeless Women

An interesting take on homeless women's resistance to psychiatric diagnoses:

Most of the women Luhrmann interviewed said they believed that the uncertainty and danger of life on the streets drove some "crazy," and they believed that only those who were weak-willed succumbed to the harsh reality of life on the streets by becoming, for instance, psychotic, she told Psychiatric News.

"The women I interviewed, who themselves could be diagnosed with some kind of psychotic disorder, were motivated to say that they were not going to be driven crazy by life on the streets" and emphasized that they have a better chance of surviving by not seeking mental health services or social services that require a psychiatric diagnosis.

Some of the women at the center linked victimization with mental illness because the perception by others that they are mentally ill makes them vulnerable to attack, Luhrmann noted.

One woman Luhrmann interviewed mentioned that some of the women "talk to themselves.. .because they let the streets take over them.. .a lot of the women have been raped by the men here and.. .can't deal with it, so that just made them go haywire."

The author seems to present two reasons for their resistance. First, that it might make them a target for victimization. I see an implied second reason, that ,internalization of a psychiatric diagnosis might diminish their resilience.

Too bad the response is so patronizing:

In interactions with homeless women who have a psychotic disorder, "every effort should be made to avoid presenting the patient with an explicit psychiatric diagnosis," Luhrmann noted.